As the Coronavirus pandemic evolves, we are actively observing our world change at an exponential pace. Despite this rapid change, the commitment level of the team at Harmony Healthcare International (HHI) has not deviated from our uppermost dedication to you, your staff and most importantly, to our role in helping you provide the highest quality care to your residents.
First, and most importantly, the safety of you, your staff and your residents remain the number one priority. Most of you have readily adapted and maintained our Harmony Healthcare International (HHI) services using remote access. We are grateful for your flexibility and appreciate your awareness of the potential risks of missing your monthly medical record reviews. Many scenarios cannot be recouped and a heightened focus on care and reimbursement is essential to successfully navigate the upcoming months.
This leads me into a very important subject matter that fits the current world situation:
Isolation of patient’s with infectious diseases.
The CDC, CMS, AHCA and all State Associations are working around the clock to assist Skilled Nursing Facilities with navigating through this unprecedented time. The resources are available, but it may difficult for operations to problem solve and prioritize due to the overwhelming risk and mortality of the senior population from COVID-19.
Coronavirus is a member of larger “family of viruses” called Coronaviruses (which includes the common cold). The name is derived from the shape of the virus at the molecular level, it looks like a “crown” with projections. Those spikes on the virus allow it to stick to human cells and proceed to take over the normal cellular structure and then replicate itself. This family of viruses has been around over 50 years. COVID-19 (SARS-CoV-2) is the 7th coronavirus known to effect humans.
Landmark legislation for long term care, OBRA ’87, mandates that certified nursing facilities are to provide services so that each resident can “attain and maintain their highest practicable physical, mental, and psychosocial well-being.” Recent requirements in Phase 3 of the Requirements of Participation (RoP) for trauma informed care have spurred a focus on behavioral health and psychological well-being. It has been questioned whether the attention to behavioral health issues has kept pace with the attention to the quality of medical care that we’ve seen increase in SNFs.
The Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) is adding a new diagnosis code, U07.1, COVID-19, to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), effective April 1, 2020. The Index and Tabular Addenda and the Coding Guidelines for the new diagnosis code U07.1, COVID-19, can be accessed on the CDC website at https://www.cdc.gov/nchs/icd/icd10cm.htm.
The Centers for Medicare & Medicaid Services (CMS) has posted an updated FY 2020 PDPM Mappings file that includes the ICD-10 CMS code “U07.1 – 2019-nCoV acute respiratory disease” as an appropriate code for MDS item I0020B, the primary reason for the skilled nursing facility (SNF) stay. For Minimum Data Set (MDS) assessments with an Assessment Reference Date (ARD) of April 1, 2020, or later, this code, U07.1, maps to the PDPM Pulmonary clinical category for the PT, OT and SLP components. It does not currently impact either the PDPM Nursing or the NTA component. Providers should check with their software vendors to confirm when the update for this change has been applied.