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COVID-19 Update March 31, 2020

Posted By Jennifer Gill, Tuesday, March 31, 2020

March 31, 2020


COVID-19 Update
March 31, 2020

DoI Insurance Commissioner Mike Causey Extends Deadline
North Carolina Department of Insurance Commissioner Mike Causey has issued an order extending the deadline for annual disclosure statements that would have been due on May 31, 2020 for a period of 30 days, until June 30, 2020. A special thanks to Commissioner Causey and his team, including Jeff Trendel, Nancy Wise, and Jackie Obusek, for meeting with LeadingAge North Carolina and responding so quickly to our request for assistance.

CMS Releases Groundbreaking Emergency Blanket Waivers
Last night, CMS released a series of new federal blanket waivers. These waivers 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 below is a summary of the waivers.

  • CNA training changes. Overall, individuals providing direct care do not need to be licensed through a CNA training program as CMS has waived 42 CFR 483.35(d). CMS did not waive 483.35(d)(1)(i) which states “That individual is competent to provide nursing and nursing related services”. More clarification will be sought on this from CMS.
  • Payroll Based Journaling submission requirements have been waived.

  • Physician services requirements have been waived. This includes but is not limited to the requirements that “a physician must personally approve in writing a recommendation that an individual be admitted to a facility, each resident must remain under the care of a physician” as well as “the resident must be seen by a physician at least once every 30 days for the first 90 days after admission, and at least once every 60 days thereafter.”

  • Physical environment regulation relaxing. Waivers allow states to certify non-SNF buildings as temporary SNF locations in order to treat COVID-19 residents. Other physical environment regulation waivers include allowing facilities to convert areas not normally used as patient rooms into patient rooms, such as activity rooms, meeting/conference rooms, dining rooms, or other rooms; as long as residents can be kept safe, comfortable, and other applicable requirements for participation are met.

  • CMS is waiving the requirements at 42 CFR 483.10(f)(5), which ensure residents can participate in-person in resident groups. This waiver would only permit the facility to restrict in-person meetings during the national emergency given the recommendations of social distancing and limiting gatherings of more than ten people. Refraining from in-person gatherings will help prevent the spread of COVID-19.

  • The following resident roommate and transfer requirements have been waived; “the right to share a room with his or her roommate of choice when practicable, when both residents live in the same facility and both residents consent to the arrangement”; “the right to receive written notice, including the reason for the change, before the resident's room or roommate in the facility is changed”; as well as “the right to refuse to transfer to another room in the facility”.
  • Resident Transfer and Discharge. CMS is waiving requirements to allow a long-term care facility to transfer or discharge residents to another LTC facility solely for the following cohorting purposes:
  • Transferring residents with symptoms of a respiratory infection or confirmed diagnosis of COVID-19 to another facility that agrees to accept each specific resident, and is dedicated to the care of such residents;
  • Transferring residents without symptoms of a respiratory infection or confirmed to not have COVID-19 to another facility that agrees to accept each specific resident, and is dedicated to the care of such residents to prevent them from acquiring COVID-19; or
  • Transferring residents without symptoms of a respiratory infection to another facility that agrees to accept each specific resident to observe for any signs or symptoms of a respiratory infection over 14 days.

The full release of the waivers can be viewed here. Long-term care facility waivers begin on page 9 of the document. As well, you can see a chart detailing the waivers we’ve been working on and their status.

NC DHHS Waives Numerous Background Check Requirements
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.

NC DHHS has implemented a temporary, expedited enrollment process to allow non-Medicaid enrolled health care professionals rendering services to Medicaid beneficiaries due to the COVID-19 outbreak to quickly enroll as a NC Medicaid provider. The screening and enrollment requirements temporarily waived are described below:

Temporarily waiving payment of application fee to temporarily enroll a provider;

  • Temporarily waiving fingerprinting background checks to temporarily enroll a provider;
  • Temporarily waiving site visits to temporarily enroll a provider;
  • Temporarily ceasing revalidation of providers who are enrolled with NC Medicaid or otherwise directly impacted by the emergency;
  • Temporarily waiving requirement that physicians and other health care professionals be licensed in the state in which they are providing services, so long as they have equivalent licensing in another state or enrolled with Medicare;
  • Providing payments to facilities for providing services in alternative settings, including an unlicensed or temporary facility, if the provider’s licensed facility has been evacuated, compromised, is inadequate to meet the demand as determined by the state or the facility or is necessary to protect the health and safety of other patients.

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.

LeadingAge Working on Jobs Partnership; Career Center Now Free
We want to share a new plan LeadingAge national is developing to help members reach displaced workers for job opportunities in aging services. They are working on establishing partnerships with major national employers to reach displaced workers from fields such as dining, retail and hospitality. Through these partnerships (with organizations including Marriot, Hilton and the Peace Corps), they will drive awareness about available jobs in aging services.

For this effort to succeed, we need members to post jobs of all kinds (including temporary positions and those that do not require certification) on the LeadingAge national Career Center. To help that happen, LeadingAge national is making all job postings FREE to members starting this week. We hope this makes it easier for members to fill staff roles during this unprecedented time of need.

SBA Loans Streamlined
The CARES Act (the third stimulus bill approved by Congress and signed by the President) includes $350 billion for loans to small businesses, with opportunities for loan recipients to receive forgiveness and not have to repay the amount borrowed. There are two key programs: thePaycheck Protection Program and Economic Injury Disaster loans.Click here for more information about both programs.

LeadingAge North Carolina Member Call
Over 50 members called in yesterday for our weekly COVID-19 support call. Highlights from the call included members sharing best practices and innovative ways they are recognizing and rewarding their team members through this time (shift flexibility, employee assistance funds, gift card drawings, pop-up produce markets, home shopping programs and more). Join us next Monday, April 6 at 3:00pm for our weekly call. Please contact Tom Akins if you have any questions or would like more information about the call.

CMS Emergencies Website
CMS’s Current Emergencies website has everything they’ve released for the coronavirus emergency and it’s all dated so you can tell what’s new.

HUD Regulatory Relief Requests
LeadingAge has requested that HUD provide immediate relief for senior housing properties. The asks range from more availability of HUD staff to answer the myriad questions housing providers have to HUD agreeing to allow properties to accept the SBA loans included in the CARES Act. We are also requesting that HUD work across government and with others to increase access to cleaning supplies, PPE and other critical supplies needed to continue supporting older adults.

Telehealth Provisions for Medicaid Providers
The North Carolina Division of Health Benefits has updated Telehealth Provisions related to Clinical Policy Modification. Two changes include “Telephone Assessment and Management Codes/FQHCs” and “RHCs and Psychiatric Diagnostic Evaluation and Psychotherapy Codes.” Additional details can be found by clicking here.

NEW CMS Announcement for PACE
Last night a memo on PACE was released suspending routine audit activity for PACE organizations. Audits related to instances of “noncompliance where the health and/or safety of beneficiaries are at serious risk (for example, lack of access to critically needed health services or prescription drugs)” and those related to infection control related complaints will be prioritized and investigated.

LeadingAge Daily 3:30p Call In
Today’s call will feature up to the minute policy updates.Click here for the link to register for the call. Please Note: you only have to register one time and will be registered for a 3:30 call every day (7 days a week) through April 26.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, we will be providing a short excerpt or tool that you can use each day.

Gratitude provides a perspective from which we can view life in its entirety and not be overwhelmed by temporary circumstances. A crisis can make us more grateful—but research says gratitude also helps us cope with crisis. Consciously cultivating an attitude of gratitude builds up a sort of psychological immune system that can help cushion us if we fall. Research suggests that grateful people are more resilient to stress, whether minor everyday hassles or major personal upheavals.

Gratitude Works
by Robert Emmons
Check-in: What are you grateful for today?

COVID-19 Information Pages
In addition to these daily email updates, LeadingAge North Carolina is updating our COVID-19 resource page every day with information from trusted sources, including from our business members.Click here to view the entire page.Click here to view the section of the page that highlights business member expertise in areas such as investments, financing, human resources, and rehabilitation as those topics relate to COVID-19. All business members are invited to share their COVID-19 resources by emailing Jennifer Gill. Thank you to everyone who has already submitted information.

In addition, LeadingAge national keeps their COVID-19 resource page updated. Be sure to bookmark these pages today.


LeadingAge North Carolina | 222 N. Person Street, Raleigh, NC 27601
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