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09.15.20

COVID-19 Update | September 15, 2020

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Coronavirus Disease 2019

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September 15, 2020

This report from the Missouri Hospital Association is designed to help you stay abreast of recent developments related to COVID-19.

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Advocacy
Government Action
Data & Analytics
Education
PPE & Supply
Sample Policies & Forms
Workforce

COVID-19 REPRODUCTIVE RATE (Re) BY REGION AS OF SEPTEMBER 8, 2020

KC

STL

NE

NW

Central

SE

SW

Green Up Arrow0.99

Red Down Arrow1.02

N/A

Red Down Arrow1.14

Red Down Arrow1.17

Red Down Arrow 1.13

Red Down Arrow 1.10

The effective reproductive rate, represents the effective transmission rate for COVID-19. Ideally, the Re should be less than 1. Click the Re rate above or visit our website to view the weekly regional dashboards and learn more.

Source: Washington University Institute for Public Health

Advocacy


Gov. Parson Engages With MHA Members On COVID-19

Staff Contact: Daniel Landon

Gov. Mike ParsonGov. Mike Parson and key members of his administration participated in a conference call with the MHA membership on the state’s response to the COVID-19 emergency. As with the series of weekly calls with the governor held mid-March through mid-June, the call provided an opportunity for an update on state activities and hospital issues, and for hospital executives to ask questions and make comments. The governor and his officials offered updates on plans for influenza and COVID-19 vaccination campaigns, Missouri’s experience with students returning to schools and universities, new options for COVID-19 testing, and the prospects for a legislative special session on COVID-19 liability protections. MHA-membership questions concerned Centers for Medicare & Medicaid Services regulatory standards for routine temperature checks for health care workers, COVID-19 vaccinations for those with natural immunity and the distribution of remdesivir. A recording of the conference call is available.

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CMS Withdraws Troublesome Medicaid Fiscal Accountability Rule

Staff Contact: Daniel Landon

The Centers for Medicare & Medicaid Services withdrew its proposed Medicaid Fiscal Accountability Rule, citing the potential for unintended consequences raised by providers and state governments. The most troubling component of the proposed rule for Missouri hospitals concerned state provider taxes. MHA voiced concerns to CMS, as did the National Governor’s Association, the U.S. Chamber of Commerce and the National Association of Medicaid Directors. In addition, MHA coordinated with several other provider associations a joint letter to Gov. Parson about the potential adverse implications of the proposed federal rule.

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MHA Seeks Clarification On COVID-19 Monitoring Of Health Care Workers

Staff Contact: Jane Drummond or Sarah Willson

MHA wrote a letter to Centers for Medicare & Medicaid Services Administrator Seema Verma asking for clarification of the CMS policy on COVID-19 monitoring of health care workers. MHA learned of CMS surveyors in other states citing hospitals who have a self-attestation process for monitoring temperatures of health care workers. MHA will continue to monitor the situation and advocate on behalf of hospitals.

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Government Action


Hospitals May Exempt Certain Staff From COVID-19 Leave Law

Staff Contact: Jane Drummond or Jill Williams

The U.S. Department of Labor revised its definition of health care employees subject to exemption from the leave provisions of the Families First Coronavirus Response Act in response to an Aug. 3 judicial decision invalidating its previous rule. The department’s initial rule exempted all hospital employees from the definition of health care providers entitled to emergency paid sick leave and expanded Family Medical Leave Act coverage. The court rejected the definition as overbroad. The department responded by filing a new rule, which defines health care workers to include physicians and other employees capable of providing diagnostic, preventive and treatment services, or other services “integrated with and necessary to the provision of patient care…”

While less encompassing than the department’s original definition, the new definition will allow hospitals to exclude employees involved in direct patient care from coverage under the FFCRA’s leave provisions. MHA updated its Fact Sheet to reflect the new definition.

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CMS Provides Additional Guidance On Medicare Inpatient COVID-19 Payment Differential

Staff Contact: Andrew Wheeler

The Centers for Medicare & Medicaid Services previously released additional reporting guidance that is required to receive the Medicare Inpatient Prospective Payment Systems 20% payment differential for treating patients with COVID-19. CMS now has updated the guidance to include a new billing note that will notify the Medicare administrative contractor when there is no evidence of a positive laboratory test documented in the patient’s medical record. CMS prescribes “NTE02” to be placed as a billing note to depict such circumstances.

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Data & Analytics


Missouri Receives Data Compliance Validation From Federal Partners

Staff Contact: Leslie Porth or Jackie Gatz

Last week, MHA received a letter from the Region 7 Office of the U.S. Department of Health and Human Services recognizing that, as of Sept. 10, Missouri hospitals are reporting COVID-19 information at the required frequency and amount of detail. This validation comes at an important time, as the Centers for Medicare & Medicaid Services recently published an interim final rule requiring hospitals to submit COVID-19 data as a Condition of Participation in the Medicare program. In addition to this requirement, a Wall Street Journal article alluded to intentions of the administration publicly releasing the names of hospitals not complying with data submission requirements. While the letter demonstrates shared progress and success after an abrupt change in data reporting platforms, we encourage hospitals to continue to prioritize daily data submission efforts to maintain this level of reporting. MHA maintains current resources on its COVID-19 web page to assist hospital staff with these requirements.

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Education


Clinical Lessons From The Northeast Surge

Staff Contact: Terrie Bauer

As part of the Northeast Hospital Association’s ongoing series on lessons learned from the COVID-19 pandemic, the Foundation for Healthy Communities will present the next session, “Behavioral Health and Substance Use Disorder,” at 3 p.m. CDT Tuesday, Sept. 22. This webinar will focus on a trauma-informed approach to care for patients seeking treatment for behavioral health issues and SUD, as well as current research on the impact of COVID-19 on substance use patterns and treatment delivery. Previous session recordings are available online.

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PPE & Supply


Battelle Closes Missouri Site

Staff Contact: Stacie Hollis

The Battelle CCDS site located in Jefferson City ceased operations on Sept. 14. Battelle notified current users on Sept. 5 that masks would be rerouted. The following locations are CCDS sites where N95 masks from Missouri can be sent, and new users can enroll for the service through the Battlle website.

  • Chicago, Ill.
  • Muskogee, Okla.
  • Topeka, Kan.
  • Indianapolis, Ind.
  • Little Rock, Ark.

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Sample Policies & Forms


MHA Updates Hospital To Facility Transfer Form

Staff Contact: Sarah Willson

MHA, in collaboration with the Missouri Health Care Association and Leading Age Missouri, updated the Hospital to Facility Transfer Form. The revised form reflects the latest guidance for consideration when transferring a patient from the inpatient setting to that of a long-term or skilled environment outside the hospital.

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Workforce


Relias Publishes Whitepaper On Mental Health Stigma

Staff Contact: Jill Williams

Relias recently released a whitepaper, “Reducing Mental Health’s Stigma in Healthcare,” identifying strategies to reduce stigma through education, transparency and advocacy. The report describes factors that contribute to an increase in health care workers’ stress levels, factors contributing to suicide and substance use disorders, the pandemic’s effect on nurses and health care workers, the difference between moral injury versus burnout during a pandemic, and how to reduce the stigma.

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Mask Up Missouri

 

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