- NEW (4/3/20) LeadingAge North Carolina Creates New Job Partnership Portal
LeadingAge NC is creating a job clearinghouse for displaced workers from a variety of industries including food service, housekeeping, transportation, and other licensed positions, who would like to work in aging services in North Carolina. Click here to check out a quick form that those interested would complete.
- NEW (4/3/20) Responding to Negative Views on Aging Services During the Pandemic LeadingAge members are taking a calm, caring, and thoughtful approach to this growing public health crisis. However, the stark reality is that, in the face of the coronavirus pandemic, we all are forced to continue to fight long-standing, negative narratives. We can assure you that we are carrying forward the truth about the incredible work our members are doing in the face of this global pandemic. Here’s how.
- NEW (4/3/20) The resource below is offered to NCADSA members for PPE supplies. Please contact Megan Bartlett with your needs. Tariff fees of 2 cents per item will be applied to the prices below.
- (4/2/20) Free COVID Training for LeadingAge Members until April 10
NextStep created an online course designed to improve the safety of Certified Nursing Assistants (CNAs) and caregivers working with COVID-19 patients. But it will be equally useful to all staff of all provider types. The COVID-Ready Caregiver program uses expert-developed online learning to help develop critical skills for safety during the pandemic. LeadingAge members can access the course at no cost through April 10. Use code COVIDCERTNOW at check-out.
North Carolina-Specific Information
- (4/1/20) North Carolina Department of Revenue Extends Deadlines
The North Carolina Department of Revenue won't impose penalties for late filing or payments of many tax types, including sales and use and withholding taxes, through July 15, Revenue Secretary Ronald Penny said. The department previously pushed back the April 15 deadline for 2019 income taxes to July 15. It is important to note that State law prevents the Department from waiving any interest except in the limited case of interest on taxes imposed prior to or during a period for which a taxpayer has declared bankruptcy under Chapter 7 or Chapter 13 of Title 11 of the United State Code. As such, if additional tax is owed, the Department is required to charge interest on any unpaid tax, accruing from the original due date, until the tax is paid. The interest rate is currently 5% per year. This is the minimum rate allowed by statute. Click here for detailed information from the department.
- (3/30/20) COVID-19 Dashboard Includes More Data
The state of North Carolina continually updates its COVID-19 Dashboard. It includes the following information for North Carolina:
• Number of Cases Statewide and by County
• Number of Deaths Statewide and by County
• Number of Tests Completed
• Number of People Currently Hospitalized
• Percent of Cases by Age Range
• Percent of Deaths by Age Range
• Percent of Cases by Gender
• Percent of Deaths by Gender
• Number of Intensive Care Unit Beds – Total and Empty
• Number of Inpatient Hospital Beds – Total and Empty
- (3/27/20) Postal Service
Some members have raised concerns that postal workers are refusing to be screened when delivering mail to communities. Yesterday we received a response that offers three alternatives: (a) redirect to a temporary mail receptacle inside or outside the building where screening would not be necessary; (b) place the mail on hold at the post office for up to 30 days and pick it up; or (c) redirect all mail to an alternative location. This article explains the response and links to the letter from the Postal Service.
- (3/26/20) Governor Cooper's Executive Order No. 120 which included additional limitations on mass gatherings, restrictions on venues and long term care facilities, and extension of school closure date.
- (3/24/20) Governor Cooper’s Executive Order No. 118 which included the shuttering of bars and restaurants now has a companion FAQ that provides specific guidance around dining rooms.
- (3/24/20) Governor Cooper’s Executive Order No. 118 which included the shuttering of bars and restaurants now has a companion FAQ that provides specific guidance around dining rooms.
- (3/23/20) Governor Roy Cooper earlier this afternoon announced a new Executive Order that lowers the ban on mass gatherings to no more than 50 people and continues the current closure of schools until at least May 15. The order also closes gyms, movie theatres, sweepstakes parlors, health clubs, hair and nail salons, barber shops, and massage therapists.
- North Carolina 2-1-1 Service Now Live
NC 2-1-1 is now available as a resource for people to call for assistance related to the COVID-19 coronavirus. NC 2-1-1 is an information and referral service that families and individuals can call to obtain free and confidential information on health and human services resources within their community. To access this service, simply dial 2-1-1 24 hours a day, seven days a week, 365 days a year. You can also text COVIDNC to 898211 to get alerts and North Carolina COVID-19 updates.
- (3/18/20) Executive Order on unemployment information from the N.C. Governor’s office
(3/27/20) Essential Worker Letter Template
Here is a letter template from LeadingAge national that can be personalized and given to workers so they can show they are essential workers during a period when everyone is expected to remain at home.
(3/27/20) Infection Control Tool
LeadingAge has developed this Infection Control Tool for nursing homes to use to prepare for an Infection Control Survey. It is meant to be used with the CMS COVID-19 Survey for Nursing Homes tool and links to CDC documents.
- NEW (4/3/20) Paycheck Protection Program Forgivable Loans Open for Application Today
The Paycheck Protection Program, which provides forgivable loans to small businesses and nonprofit, opens its application process today. The National Council of Nonprofits has a great resource page with details, application forms, and an informative chart comparing the PPP program to other federal programs.
- (4/2/20) IRS Guidance on Stimulus Checks
The Treasury Department published guidance yesterday that would have required Social Security recipients who do not usually file tax returns to file an “easy,” yet to be developed tax form in order to get stimulus checks. LeadingAge national reached out to the Senate staffer who had a heavy hand in crafting the language. He was very clear that it was written to NOT require this. After many calls to the Hill and IRS, by LeadingAge and others, the Treasury department has reversed the decision and Social Security recipients will not have to file anything to receive their stimulus check. Click here for a Washington Post article explaining what happened.
- (4/1/20) Alternative Care Site Toolkit
The FEMA Federal Healthcare Resilience Task Force pushed out this Alternative Site Toolkit yesterday, for use by state/local/tribal/territorial governments and FEMA and HHS regional administrators to help identify and set up alternative sites for COVID-19 patients.
- (3/30/20) New Interpretation Broadens FMLA Exemptions
Hot off the press! LeadingAge national has just released a new FAQ on the Department of Labor’s revised interpretation of FMLA exemptions. It provides excellent guidance around the new paid sick leave and FMLA provisions in the Families First Response Act.
- Today the Small Business Administration posted COVID-19 disaster categories on its website, https://disasterloan.sba.gov/ela/Declarations/Index. This means that small entities, including not for profits, are now able to apply for SBA disaster loans as a result of economic injury caused by COVID-19. This could apply to members across settings but particularly adult day services who will have no revenue if they voluntarily or are forced to close.
- (3/25/20) The US Department of Housing and Urban Development has issued updates to its Frequently Asked Questions publication. LeadingAge also added Feds Take Some Action to Suspend Foreclosures, Evictions to their resources page.
- U.S. Tax Filing Deadline Moved to July 15
Americans will have an additional three months to file their taxes amid the coronavirus pandemic.
NC DHHS Information
- (3/31/20) NC DHHS continues to take action to protect the health and safety of our state’s patients and providers during the COVID-19 outbreak. NC DHHS received authority under Section 1135 of the Social Security Act to waive certain federal Medicare, Medicaid, CHIP and HIPAA requirements. These modifications take effect as of 6 p.m. EST on March 15, 2020, with a retroactive effective date of March 1, 2020, and will ensure that sufficient health care items and services are available to meet the needs of our state residents and providers. The Disaster Relief Provider Enrollment Application, which will be utilized for the expedited enrollment, is an abbreviated enrollment application that collects limited information to enroll a provider for a limited time (180 days). The application is available to in-state, out-of-state (OOS) and border providers that are not yet enrolled in NC Medicaid, including individual providers and organizations.
Providers can complete and submit the application through the NCTracks Provider Portal. Please refer to the Disaster Relief Provider Enrollment Application Job Aid available by clicking here . A complete summary of the new guidance is available by clicking here.
Providers should review the Job Aid in advance of working on the application, as several preliminary steps are necessary. For expedited processing, providers must indicate the application is for this public health emergency by answering “Yes” to the Disaster Relief enrollment question on the Basic Information page of the application.
- (3/30/20) New Patient Fact Sheet Available
“What to do if You Feel Sick” For people who think they might have COVID-19 and have mild symptoms, the CDC now recommends you stay home and call your doctor if you need medical advice. Most people who get COVID-19 will have mild illness and recover at home. NCDHHS has developed a Fact Sheet to help North Carolinians know what to do if they feel sick.
- NC DHHS is staffing a COVID-19 phone line to answer urgent questions from the public. That number is 866-462-3821. The state also is maintaining an up-to-date website with information about COVID-19 disease, risk and guidance.
- Long-term care facilities
- Health care professionals
- Businesses and employers
- Individuals, families and communities
- The NC DHHS website also has information about what we all can do to combat fear and anxiety about COVID-19. All North Carolinians can better prepare for COVID-19 by getting the latest information directly from reliable sources. Be thoughtful about what you read or hear about the virus and make sure you are separating rumor from fact before you share it. The latest information from NC DHHS can be found here, and please also share the posts from the NC DHHS Facebook and Twitter accounts.
- (3/30/20) NC DHHS Provides New Updates on Testing Procedures and Policies
The latest memo provides information and guidance on 1) updated criteria for submission of specimens to the North Carolina State Laboratory of Public Health (including long-term care and healthcare workers prioritized in testing at state public health laboratory), 2) providers no longer asked to fill out “person under investigation forms” for patients tested for COVID-19, and 3) requirements for reporting of COVID-19-associated deaths. Click here for the full memorandum.
Centers for Disease Control (CDC) Coronavirus Resources
- (3/30/20) Healthcare Personnel Risk Assessment and Guidance on Possible Exposure Scenarios
CDC has revised their guidance for Healthcare providers to better assess when healthcare personnel are safe to return to work.
- (3/26/20) CDC has posted information about discharging COVID-19 patients from hospitals. It’s called “Discontinuation of Transmission-Based Precautions of Patients with COVID-19 in Healthcare Settings (Interim Guidance)” and it is aimed toward hospitals. It clarifies that patients with COVID-19 can be discharged from a hospital whenever clinically indicated. It specifically covers “if discharged to a LTC or assisted living facility.” Patients can be discharged to a LTC or AL facility, and:
- Transmission based precautions are still required…they should go to a facility with ability to…ideally, place the person in a location designated for COVID-19 patients.
- Transmission based precautions have been discontinued, but the person is still symptomatic…place the person in a single room, restrict them to the room, and wear a face mask during care.
- Transmission based precautions have been discontinued and they are symptom free…no further restrictions.
- (3/26/20) The Centers for Disease Control and World Health Organization have been researching how long Coronavirus lives in the air and on various surfaces. This link will take you to the latest findings- Up In The Air: How Coronavirus Lives in the Air and On Surfaces
- (3/23/20) The CDC has issued Interim Guidance, “Preventing the Spread of COVID-19 in Retirement Communities and Independent Living Facilities.” This guidance is for owners, administrators, operators, workers, volunteers, visitors, and residents of independent living facilities and retirement communities that are not healthcare facilities, including federally-subsidized senior housing.
The Interim Guidance notes several different kinds of independent housing “that is usually age-restricted” with support services for older adults it is applicable to various housing, including:
- Public housing for low- to-moderate income elderly (i.e., HUD-assisted housing)
- Assisted living homes that do not provide medical services
- Continuing Care Retirement Communities, which include a range of housing options including independent living.
The CDC Interim Guidance takes into account that residents in retirement communities generally care for themselves. HUD senior housing communities are generally very porous buildings, where each resident may have their own network of service providers and volunteers that helps them age in community, in addition to any non-health and wellness visitors coming and going from the building.
(3/23/20) The CDC issued new guidance around COVID-19 and risk categories.
- CDC posted this Return to Work Criteria memo in the last few days. It is very short, less than one page, and describes strategies to determine when health care personnel may return to work after confirmed or suspected COVID-19 infection. It covers test-based and non-test based strategies.
- CDC posted this page, “Older adults, 65 years and older, are at higher risk for severe illness,” yesterday. It has a good graphic showing hospitalizations, ICU admissions and deaths, and notes that eight of ten deaths reported in the US have been people age 65 or older.
- CDC hosted a webinar on infection prevention and control, steps facilities should be taking and management and treatment of COVID-19. Here is the summary and article on CDC's LTC webinar. The recording of the call and the webinar slides are available here.
- The CDC has posted “Strategies for Optimizing the Supply of PPE .” The document covers facemasks, N95 respirators, gowns, and eye protection. The purpose of the document is to help optimize supply in a shortage using conventional capacity strategies, and strategies for various levels of shortages. The number of infected individuals is increasing and shortages make this guidance extremely important and helpful.
- 3-10-2020 - Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings
- CDC has a clearinghouse for all information related to COVID-19
- Handwashing resources
- CDC-Steps for healthcare facilities to take to prepare for COVID-19
- CDC Infection Prevention and Control Recommendations
- CDC’s You Tube Channel
- ICD-10-CM Official Coding Guidelines – Supplement Coding encounters related to COVID-19 Coronavirus Outbreak Effective: February 20, 2020
CMS Information on Coronavirus
- NEW (4/3/20) Updated Medicaid Frequently Asked Questions
Yesterday, CMS published updated FAQs on COVID-19 and Medicaid/CHIP. The new material includes several new questions related to eligibility determination, among other things. This has come up as an issue for some members, since Medicaid eligibility determination offices are teleworking and/or working differently; demand on the systems is high, too.
- NEW (4/3/20) Summary of CMS Nursing Home Call
Here’s a summary from CMS calls earlier this week. Covered topics include CNA training/certification, staff with multiple jobs, hiring issues, converting buildings, FEMA, and PBJ .
- (4/2/20) CMS Creates COVID-19 Email Support
CMS has set up a COVID inbox at COVID19@CMS.HHS.GOV for providers to email questions and concerns related to COVID-19.
- (4/1/20) Recap of Recent CMS Waivers
Earlier this week, CMS released a package of significant regulatory changes, granting multiple waivers for several provider types. These changes were much needed in supporting our members through this unprecedented time. LAI and LeadingAge consider these changes a huge advocacy win for members. CMS has created Fact Sheets regarding these waivers by provider types, which are listed below.
•Long Term Care Facilities (SNF/NF)
•Home Health Agencies (PDF)
•Accelerated/Advance Fact Sheet - All Provider Types
LeadingAge has created charts for Nursing Home, Home Health, and Hospice waivers. These charts compare the waivers LeadingAge requested, whether the waiver was granted, and highlights from respective rules. Additional information will follow.
•Nursing Home Blanket Waivers Chart
•Home Health Blanket Waivers Chart
•Hospice Blanket Waivers Chart
- (3/31/20) CMS released a series of new federal blanket waivers that apply to every Medicare licensed facility and do not require action from North Carolina or individual facilities for the waivers to take effect. More clarification is needed on a lot of these items but the full release of the waivers can be viewed here . Long-term care facility waivers begin on page 9 of the document.
- (3/30/20) New CMS Toolkit on Telehealth
CMS has released a Nursing Home Telehealth Toolkit. The toolkit presents policy changes that build on the blanket waiver changes CMS is implementing. Nursing homes (and states) do not need to apply to use the new flexibilities. A Special Bulletin specific to North Carolina has also been published by NC DHHS.
- (3/30/20) CMS “Accelerated and Advance Payments” Fact Sheet
In order to increase cash flow to providers of services and suppliers impacted by COVID-19, CMS has expanded its current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. The expansion of this program is only for the duration of the public health emergency. An informative Fact Sheet will also help guide you through the process.
- (3/26/20) A CMS PACE call was held yesterday. Here is a of summary the call. Bottom line: CMS advises providers use their best judgment and offered hints there will be future guidance.
- (3/24/20) Here’s an article explaining the new CMS guidance on HCBS what it means for those providers. It includes a section highlighting implications for adult day services. While all providers are in a difficult position during the coronavirus crisis, adult day providers are at especially high risk because many have been forced to close.
- On 3/17/20, CMS released guidance for the telehealth waiver, in the form of a Fact Sheet and a Q&A document. Under this new waiver, Medicare can pay for office, hospital, and other visits furnished via telehealth across the country and including a patient’s places of residence starting March 6, 2020. Here is our initial analysis; it’s important for you to know that we started hearing questions about the impact of the guidance and how to use it, from the minute it went out. We’re working on getting clarification and would encourage you to reach out to us with specific questions.
- 1-31-2020 Secretary Azar Declares Public Health Emergency for United States for 2019 Novel Coronavirus
- Guidance for use of Certain Industrial Respirators by Health Care Personnel, 3-10-2020
- Immediate changes to Survey Priorities in light of COVID-19 announced by CMS on March 4, 2020
CMS will “focus their facility inspections exclusively on issues related to infection control and other serious health and safety threats, like allegations of abuse – beginning with nursing homes and hospitals. Note: The last three pages have a detailed checklist of what surveyors will be looking for.
- Sample Telehealth Privacy Acknowledgment (March 20, 2020)
- Center for Connected Health Policy Table of Telehealth Changes (March 17, 2020)
- President Announcement of Telehealth Benefit Expansion (March 17, 2020)
- CMS Medicare Telemedicine Health Care Provider Fact Sheet (March 17, 2020)
- Medicare Telehealth FAQs (March 17, 2020)
- Medicaid COVID-19 Telehealth Guidance for States (March 17, 2020)
- OCR Statement on HIPAA Telehealth Discretion (March 17, 2020)
- OIG Statement on Telehealth Copay Reductions and Waivers (March 17, 2020)
- General Medicaid Telehealth Guidance
World Health Organization (WHO) Coronavirus Resources
- WHO’s Coronavirus/COVID-19 webpage
- World Health Organization: Infection Prevention and Control Guidelines
- 3-11-2020 - WHO Declares COVID-19 a Pandemic
COVID-19 Global Map
Engagement and Social Well-Being
- (4/2/20) Alzheimer’s Association Guidance
The Alzheimer’s Association has created a document to support individuals: “Caring for Persons Living with Dementia in a Long-Term or Community-Based Care Setting.”
- (4/1/20) This new, free 12-minute QuickCast from LeadingAge national outlines several calming exercises staff can use to help reduce worry and anxiety among older adults and themselves.
- (3/26/20) This 7-minute LeadingAge national QuickCast offers ideas to leverage a variety of available technologies to connect older adults during times of social distancing.
- (3/25/20) The National Disaster Distress Helpline at 1-800-985-5990 is offering crisis counseling and emotional support 24/7 during the COVID-19 outbreak.
- The National Certification Council for Activity Professionals provides guidance for best practices related to providing in-room and virtual programming for clients. This is excellent information for your staff and includes tips on Zoom and Skype.
- The state of Massachusetts has an excellent adult day COVID-19 information sheet that you can access by clicking here.
- Emergency Preparedness Rule [Center for Medicare and Medicaid Services (CMS)]
- North Carolina General Assembly
- North Carolina Division of Aging and Adult Services