HHS announced that their calculations for September show that 65-70% of nursing homes will qualify for a Nursing Home Infection control Incentive Payment to be issued by the end of October. LeadingAge met with HHS Secretary’s office staff to discuss developments on the Nursing Home Infection Control incentive payments. The main focus of the changes focus on the mortality measure calculation and its use to determine final incentive payments.  Originally, it appeared that HHS would set aside 20% of the $400 million monthly to provide incentive payments based upon nursing homes’ performance on a mortality measure. The disadvantage of this approach is providers with no infections and therefore no deaths from infection (a good thing) would not have been eligible for these funds. Today, HHS explained that instead of setting aside those payments, it will first determine which nursing homes meet the gateway criteria on infection rate and mortality. Then it will calculate a total infection control score which will be made up of the infection rate measure performance score modified based upon mortality performance, as applicable. The adjustment to the overall score will be no more/less than 20% for mortality. 

HHS noted that nursing homes have already shown a 5% improvement on infection control between August and September. In addition, only 127 homes did not pass the mortality gateway, while 122 others who had deaths in their facilities will still qualify for an incentive payment once they complete their outreach to determine which COVID deaths were from infections obtained from within the nursing home versus those who were admitted with COVID. 

HHS could not yet provide information on the range of incentive payments but should have this information in the next few days with payments possibly beginning on the week of October 27. In addition, we did advocate for more information to be made available so members can calculate or at least better understand what data is being used to calculate these incentive payments. HHS appeared willing to provide some more information and agreed to check on the legal limits they may have in publishing information on which nursing homes received incentive payments and the amounts.

Questions?

Contact:

David Carter | Director, Health Care Finance & Policy

C 360.888.5702