SPECIAL BULLETIN COVID-19 #181: NC Medicaid Accepting Requests for COVID Response Facilities

Background

As established in SPECIAL BULLETIN COVID-19 #82: Expedited Hardship Advances and Retroactive Targeted Rate Increases for Skilled Nursing Facilities and Adult Care Homes Serving COVID-positive Patients and revised in SPECIAL BULLETIN COVID-19 #144: COVID-Nursing Facility Response Site Criteria Revised, NC Medicaid established the nursing home “COVID Response Facility” option to support nursing homes that accepted COVID+ beneficiaries discharging from an acute care facility. 

Due to diminished need, on June 21, 2021, NC Medicaid communicated that it was no longer accepting Response Facility applications in SPECIAL BULLETIN COVID-19 #167: NC Medicaid No Longer Accepting COVID-19 Response Facility Designation Requests.

NC Medicaid Accepting Response Facility Status

Due to the rapid increase in COVID infection and related hospitalization occupancy, NC Medicaid is reactivating its consideration of Response Facility Designation Requests submitted by skilled nursing facilities.

NC Medicaid will apply the following amended criteria when reviewing any COVID Response Site designation request:

• A facility must request COVID Response Site status.
• A facility must not have received any harm or immediate jeopardy-level deficiencies within six months prior to seeking COVID Response Site status.
• A facility must participate in an Infection Control and Response (ICAR) assessment conducted by the UNC Statewide Program for Infection Control and Epidemiology (SPICE).
• The facility must not be in outbreak status. Interested facilities are responsible for notifying NC Medicaid when an outbreak is over in order to activate or reactivate Response Facility status. NC Medicaid will not automatically reactivate Response Facility status.
• Starting with requests received in August 2021, Medicaid will retroactively activate the approved facility’s COVID Response Facility rate on the first of the facility’s application month.

Individual Arrangements between Nursing Facilities and Acute Care Settings

NC Medicaid does not facilitate individual arrangements for the transfer and discharge of COVID-19 positive patients from an acute care setting to a nursing facility. The scope of this bulletin and Special Bulletin #82 is limited to the criteria used to authorize COVID-specific Medicaid reimbursement for serving COVID+ Medicaid beneficiaries.  

Other COVID Response Site Requirements in Special Bulletin #82 Remain in Effect

Rate structure, billing criteria and reporting requirements for COVID Response Facilities established in Special Bulletin #82 remain in effect.

Current Response Facilities that were in effect on June 21, 2021, do not need to do anything to continue Response Facility status.

For Additional Information

Please email Medicaid.ProviderReimbursement@dhhs.nc.gov.