DSHS – HCS has received approval to continue the programs, add-ons, and incentives listed below.  These have been designed to assist with transitions from acute hospitals.  Please note that the $100/day SNF incentive applies to individuals that admit before January 31, 2021.  The payments will continue after that, but must be in place before the end of the month.

• Overtime: Will continue the use of overtime to assess acute hospital referrals timely and to focus efforts on transition of complex patients to all settings.
• $60 Specialized Dementia Care Program (SDCP) add on: Re-implemented the $60 rate add on for contracted SDCP facilities accepting individuals out of acute care hospitals as in the first surge, utilizing the same process and criteria.
• Expanding contracts:  Continue resource development efforts to increase specialty contracted Enhanced Adult Residential Care contracted facilities.
• Transitional Care Center of Seattle (TCCS): Began accepting dually eligible, Medicare and Medicaid, admissions on 12/28/2020 and will continue to work closely with this facility as it expands capacity to transition patients from acute care hospitals.
• $100 day SNF incentive: The $6000 SNF incentive for new acute care hospital admissions ended on 12/31/2020.  During the month of January dually eligible individuals newly admitting to nursing facilities from acute care hospitals will receive a $100 daily add on to the Medicaid nursing facility rate for a period not to exceed six months when:
  • A client specific approval letter is requested and approved by Home and Community Services prior to admission.
  • The Individual admits on or before 01/31/2021. 
  • The Department receives a Nursing Facility Notice of Action confirming Admission date.
  • The Department has confirmed that this is a new Nursing Facility admission.  Readmissions and Nursing Facility transfers are not eligible for this incentive.
  • The department will follow up with a Dear Provider letter specific to this incentive.
• COVID+ Units: Multiple nursing facilities across the state now have dedicated COVID-19+ units.  A current list of contracted facilities can be found via this webpage link (COVID-19+ Unit Nursing Facilities).  The department will continue to evaluate the need for additional bed capacity and add nursing facilities as needed.  The planned time frame for these nursing facilities to have dedicated units providing care to residents COVID-19+ is through March 31, 2021, but may be extended depending on need and as funding is available.
• MCO assistance: HCA is continuing to request that MCOs pay increased rates to SNFs willing to accept acute hospital patients. If the individual is Medicaid only MCOs have a responsibility to assist in the transition from acute hospital to lower level of care. If the lower level of care is a SNF the MCOs also have a responsibility to assist in the transition from the SNF to another community setting of the individual’s choice.

DSHS has approval to move forward with these and are working to develop a Dear Provider letter.  HCS will also be reaching out to contracted SDCP providers as well.  We will send out more information as it becomes available. Please reach out if you have any questions or concerns.

Questions?

Contact:

David Carter | Director, Health Care Finance & Policy

C 360.888.5702