Skilled Nursing Facilities and Covid-19

Skilled Nursing Facility (SNF) belongs to a hospital segment that offers necessary medical professionals services that include nurses, audiologists, speech pathologists, occupational and physical therapists. While patients live for a short duration here, the workers here work 24/7.

A typical Skilled Nursing Facility (SNF) consists of private & semi-private rooms. Most of the rooms are semi-private, where two to four people live in a room. Usually, there are no physical barriers for dividing the room into different sections. A Nursing Facility also offers many other group activities such as dining areas, activity and therapy areas, etc.

SNF and Covid-19

Typically, the Skilled Nursing Facilities are not physically designed for practicing social distancing norms. On the other hand, they have to house many residents who may need quarantine measures but also isolation. The limitations of physical infrastructure mean taking preventive measures. Further, it inclines to reduce the spread of the virus that has to be achieved by the already overburdened staff.

They can use different ways to practice social distancing. Residents can dine in their rooms. Those who have received a Covid negative report and are not isolated can take part in group activities. Facilities can offer different activities while strictly sticking to preventive norms such as book clubs, crafts, movies, and exercise. 

Facility Demographics and Covid-19

Skilled Nursing Facilities located in highly populated areas are more prone to virus’ exposure. The staff and visitors are easily susceptible to the unhealthy environment. Consequently, these face more difficulties in controlling the spread of the virus. Moreover, there are more chances of them facing a staff shortage due to competitive job markets.

Staffing Consideration and Covid-19

Many residents need help from the facility staff even for their simple daily routine tasks. The facility needs additional time and resources for Covid-19 patients. Moreover, the staff fears to feel symptomatic and contract Covid. Further, this will lead to a shortage of staff. Not to mention, it will make the smooth working of the facility very difficult. Facilities can start refusing admission of new residents due to a lack of sufficient staff. Commonly, a person may have to work in more than one facility at a time. Eventually, it can increase their risk of exposure and also push for the spread of viruses.

Visitors and Covid-19

Every visitor goes through stringent checking before granting permission to enter the facility. Yet every visitor entering the facility increases the risk of infection. There may be visitors who are asymptomatic at the time of checkup, but they are Covid positive. Such visitors will unknowingly spread the virus. Visitors may also avoid following the given precautionary guidelines, risking their and others’ life.

Billing for Skilled Nursing Facilities and Covid-19

Under Section 1812(f) of the Social Security Act, Centers for Medicare and Medicaid Services will not consider the 3-day prior SNF hospitalization cover. For people who are affected by Covid or experience dislocation and do not qualify for a hospital stay will have their billing amount waived. Moreover, there would not be any new benefit period required to renew the SNF coverage if it has been exhausted. 

For private payers in Aetna, the patients do not have to pay for any charges if they shift to Skilled Nursing Facilities from acute care hospitals. However, the SNFs must notify the hospital within 48 hours of admitting the patient. Also, Inpatient Acute Rehabilitation and LTACH (Long-Term Care Hospital Admissions) need prior admission authorization. 

With respect to Cigna, there will be no process for transfer to SNF. Until March 31, 2021, the patient can move without providing any prior authorizations. On the other hand, post January 31, 2021, there will be prior authorization required for SNF and in-network United Health hospitals. 

Blue Cross Blue Shield of Massachusetts does not need any prior authorization requirements to follow. It can admit the Skilled Nursing Facility patients with only notifications.

Through December 31, 2020, AmeriHealth New Jersey has waived the cost of acute in-patient treatment. It will apply cost sharing with skilled nursing facilities where the patient shall receive post-acute care. 

The SNFs are also receiving increased financial support from IEHP (Inland Empire Health Plan). Moreover, they have increased the rates for this facility. So, they can transfer the patients to clinically appropriate rooms and lower the number of patients.

For any further information on Nursing Facilities and Covid-19, visit New England Medical Billing. With comprehensive medical services, the team offers timely and transparent reimbursement.

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