February 19, 2021

We have a conference update!!!! Thank you for your continued grace as we make plans for our annual conference during a time of so many unknowns.

NEW DATE: We have made the decision to push back the date of our Annual Conference and Expo to August 17-20, 2021. The location, Wilmington Convention Center in Wilmington, NC, will remain the same.

Conference schedule and registration: We are working with our wonderful Education Committee to develop a schedule to host conference attendees in a safe manner. While we do not know what future restrictions may be in place at the time of our conference, we are making preparations that will include limiting the number of attendees to adhere to safety protocols and inclusion of some distance learning/virtual components.

We will continue to monitor trends and restrictions related to the pandemic with the goal to provide final details and registration information by early May. Our room block will also open at that time, with reservations only allowed after conference registration is submitted.

Attendee Registrations, Exhibit Booths and Presentations that were confirmed in 2020 will carry over to our 2021 Annual Conference and Expo, in addition to new presentations selected this year. The association will begin contacting registrants, exhibitors and presenters next week to confirm their intent to move forward. The deadline to submit proposals for the conference is closed, however all are welcome to continue to submit proposals through our year-round portal.

New Submission Deadline for the Awards Program and Leadership Academy is April 23. We have already reached out to communities who submitted award nominations in 2020 to confirm consideration for 2021.

The kick off date for the incoming class of the Leadership Academy coincides with our annual conference dates, which affect the Leadership Academy dates. Please note the following new meeting dates:
August 19-20, 2021 – Wilmington
November 18-19, 2021 – Raleigh
February 17-18, 2022 – Charlotte
May 9-10, 2022 - Asheville

Click on the following for details about:
2021 Annual Conference and Expo
2021 Awards Program
Leadership Academy
Submit Proposals Year-Round

As always, contact us with any questions you may have.

Welcome to the LeadingAge North Carolina Member Update

CCRC Independent Living Residents NOT Covered in Pharmacy Partnership Program
We received word late last night that CCRC/LPC independent living residents are NOT covered in the Pharmacy Partnership Program. It was originally believed that IL residents would have an opportunity to be vaccinated with others in the 1A group, part of a classification system developed by the CDC’s Advisory Committee on Immunization. ACIP’s guidance, adapted by the state of North Carolina, includes “long-term care staff and residents (people in skilled nursing facilities and in adult, family and group homes)” in the 1A group, slated to receive the first doses of the vaccine (along with front-line hospital staff). Limited availability of the vaccine initially will restrict vaccination to those who live and work in the highest risk areas (North Carolina’s initial supply of the Pfizer will be around 85,000 doses). It appears at this point that IL residents will be included in 2 group, “Adults at High Risk of Exposure and at Increased Risk of Severe Illness.” We are in conversations with senior leadership at the NC Department of Health and Human Services around the process and timing for IL residents to be offered the opportunity to receive the vaccine and we’ll keep you updated as we receive more information.

LeadingAge NC and NCHCFA Host Vaccine Webinar
LeadingAge NC and NCHCFA hosted a vaccine webinar on Wednesday of this week with State Health Director Betsey Tilson and NC Public Health Section Chief Susan Kansagra. The hour-long webinar featured the latest information on the vaccine process in North Carolina. A copy of the powerpoint presentation used in the webinar can be accessed by clicking here.

CMS Announces Updates to Five Star Quality Rating System
Late last week, CMS announced that the health inspection domain would be unfrozen with the January 27, 2021 quarterly refresh. Domain ratings will be recalculated and will include data from infection control-focused surveys. The method for calculating this data will be consistent with methodology for calculating complaint surveys and will be available in an updated Five Star Technical Users’ Guide expected by January 15, 2021. Of note, this domain update will impact certain related programs. Facilities will see changes to the Special Focus Facility (SFF) program, including SFF candidates, as well as the abuse icon. Click here for more details.

CMS Releases Testing FAQ
CMS has released a Nursing Home COVID-19 Testing FAQ. It’s available on the CMS current emergencies page and by clicking here.

Helpful COVID-19 Information
This 4-page “Update” file reads like an FAQ and includes a table that describes each vaccine developed. Click here for the document.

'The Great Demographic Reversal’ Review: The Perils of Aging
As workers become fewer in number and global wages rise, we may see less inequality but more inflation and higher interest rates. Click here for this thought-provoking Wall Street Journal article.

 Vaccine Hesitancy Among African American Communities
The Region IV Public Health Training Center will be hosting a webinar on vaccine hesitancy among African American communities. Vaccine refusal or delay has substantial public health implications. Presenters will discuss vaccine hesitancy among African American communities, as well as discuss the history of vaccine hesitancy and how to build trust in the African American community to increase vaccine uptake. Click here for a link to the training.

New Mentors Podcast from LeadingAge
LeadingAge National has launched a new podcast called The Mentor's Voice. This podcast, available on Apple Podcasts, Spotify, Overcast, and other platforms, provides students and young professionals an opportunity to candidly learn from leaders in the field of aging. The goal is to disseminate wisdom and knowledge to emerging leaders and to inspire and inform their career journey. Click here for more information.

Your peers across the state have questions and you have answers. It's incredibly helpful. Please email us with responses to the following member questions:

• Are you mandating the COVID-19 vaccine?  If not mandating, are you offering any incentives to take it?
• A member community is considering installing charging stations for electric cars.  Does your community charge for installation of the equipment?  Does your community charge for using the charging station?
  

New Mailing Address for LeadingAge North Carolina
Please make note of LeadingAge North Carolina's new mailing address. Please direct all mailings to LeadingAge North Carolina to PO Box 27527, Raleigh NC 27611.

Investor Bill Ackman and NBA’s Chris Paul Back Housing Fund
Turner Impact Capital has raised $357 million for its second fund focused on providing affordable housing to people who earn too much to qualify for subsidized housing but not enough to afford homes in the areas where they live and work. Click here for more details.

Fridays at 12:30pm
Let's have a quick chat over lunch with your peers about what is going on, best practices and questions you may have.  This is a great time to share and connect.  Calls will begin in November.  Click here for connection details.

December 15
1:00pm - 2:00pm
Click here to register

Although we’re beginning to see a light at the end of the tunnel and hear more about impending COVID-19 vaccines, there is still much uncertainty around who, when, and how. As an employer, you also have questions specific to your employees and health plans: Can we require employees to get vaccinated? Does the vaccine change our plan to bring employees back into the workplace?

Join Marsh & McLennan Agency for an upcoming webcast designed to offer insight into what we know today about the vaccines as well employer considerations to help guide you as we move into 2021.

November 9, 2020

Join us!  LeadingAge North Carolina and our Business Members are offering the following opportunities to connect.

November 13
November 20
Member Community CEOs and Platinum Business Members are invited to a forum to share an exchange of ideas about our field and its future.  Community CEOs can register online by clicking here or on your desired meeting date above. Please register for only ONE day. Space will be limited to optimize conversations.  Platinum Business Members please contact Leslie Roseboro to register one representative per date. 

Click here to download flyer

Fridays at 12:30pm
Let's have a quick chat over lunch with your peers about what is going on, best practices and questions you may have.  This is a great time to share and connect.  Calls will begin in November.  Click here for connection details.
 

 
Click here to hear a message from Christopher

December 9 - Click here to register
We would like to take the time to celebrate and encourage those who have been on the front lines.  Communities are invited to include anyone who:

• Needs to learn how to stay inspired despite challenges, conflicts and changes
• Desires to be more courageous while influencing others positively
• Needs to reconnect with that energetic and optimistic human who used to stare back in the mirror
  

Click here to download flyer

This program can be brought to your community - at no charge through the CMP grant program. Training delivery is offered in a combination of online and remote formats, along with full year AGE-u-cate trainer support for the duration of the grant.
It's "QAPI in a box"- and improves quality of life and care for those you serve, and your caregivers.

Do something wonderful for your amazing employees!  Register by clicking on the following link:  NC Informational Webinar.

Telemedicine presents a completely different way to care for patients, so it understandably presents some unique legal situations for doctors.  We will discuss how the rapid expansion has impacted legal liability and how insurance is addressing this liability.  Click here to register. 

Join us!  You are invited to attend the following upcoming virtual events.  Be sure to forward this email to your co-workers and plan to attend together.

November 6
November 13
November 20
Member Community CEOs and Platinum Business Members are invited to a forum to share an exchange of ideas about our field and its future.  Community CEOs can register online by clicking here or on your desired meeting date above. Please register for only ONE day. Space will be limited to optimize conversations.  Platinum Business Members please contact Leslie Roseboro to register one representative per date. 

Click here to download flyer

 
Click here to hear a message from Christopher

December 9 - Click here to register
We would like to take the time to celebrate and encourage those who have been on the front lines.  Communities are invited to include anyone who:

• Needs to learn how to stay inspired despite challenges, conflicts and changes
• Desires to be more courageous while influencing others positively
• Needs to reconnect with that energetic and optimistic human who use to stare back in the mirror
  

Click here to download flyer

Fridays at 12:30pm
Let's have a quick chat over lunch with your peers about what is going on, best practices and questions you may have.  This is a great time to share and connect.  Calls will begin in November.  Click here for connection details.

On Demand through December 27, 2020
Thank you to those who joined us for our live virtual conference held on September 24th.  You can continue to access sessions, virtual sponsor booths and all resources until December 27, 2020 by clicking here and logging in using the same way you did when the event was live. 

Didn't join us during the live event?  There is still time to register to access the conference.  Click here for details.

Click here to download conference brochure

November 4
11:00 am - 12:00pm
Webinar:  COVID Issues for LTC Providers
Click here to register

Join Womble Bond Dickinson, Platinum Business Member, for this informative Webinar!

COVID-19 has changed much about the way we treat residents and conduct business. Join a discussion about the latest information you need to know to stay in compliance with new laws, prepare for state surveys and keep residents and staff healthy.
In this webinar, Alissa Fleming, Catherine Wrenn and David Broughton discuss:

• An overview of certain CMS actions taken during the pandemic
• CMS and CDC guidance
• Risk management strategies for communities
• Resident and third-party agreement considerations
• Regulatory compliance
• Workforce issues
• Corporate governance best practices
• Fiduciary duties

November 4
November 5
November 6
2:00pm each day
COVID-19 Sentiment Report Webinar Series
Hosted by LeadingAge VA and IL:  Email Leslie Roseboro for registration information

A national survey of more than 23,000 residents, prospects, and staff uncovered insights into the pandemic’s impact on sentiment toward senior living. In this four-part webinar series, presented by the research sponsors, they dive into actionable strategies to help your community adapt its operations, marketing and sales, capital planning, and strategic direction to a new normal.  You are invited to tailor your learning experience — register for just one webinar or join us for the whole series:

• COVID-19 Sentiment Report & Leadership Roundtable Discussion
  October 27, 2020, at 12:00 p.m. (ET)
• Marketing and Sales Strategies During a Pandemic
  November 4, 2020, at 2:00 p.m. (ET)
• CapEx Planning & Asset Repositioning as a Result of COVID-19
  November 5, 2020, at 2:00 p.m. (ET)
• Changing the Resident Experience with Culinary Solutions & Technology Advancements during COVID-19
  November 6, 2020, at 2:00 p.m. (ET)

Click here to download flyer

November 18 and 19
10:00am - 1:00pm
Virtual Caregiver Connections Conference
Email Jodi Kolada to register

Caregiver Support from Well∙Spring Solutions, in partnership with Senior Resources of Guilford, offers a Virtual Caregiver Connections Conference!

Well∙Spring Solutions and Senior Resources of Guilford are working in partnership to offer a Virtual Caregiver Connections Conference in celebration of National Family Caregivers Month. This ZOOM event will be held on two days: Wednesday, November 18th and Thursday, November 19th from 10:00 a.m. to 1:00 p.m. and is designed to provide family caregivers of frail and impaired adults an opportunity to laugh, relax and get connected!

This conference for caregivers includes valuable information from community organizations including Piedmont Triad Regional Council Area Agency on Agency; Dementia Alliance NC as well as the Family Justice Center and their Elder Justice Committee. Giveaways will be awarded throughout to family caregivers and activities promoting fun and relaxation can be enjoyed with a loved one too!

Registered caregivers will also be able to pick up a ‘welcome bag’ of materials from community resources at designated times to be announced.

Register to attend and get the ZOOM link.
To register online, visit www.well springsolutions.org/registration. You may also contact Jodi Kolada at jkolada@well-spring.org or (336) 545-4245.

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Advocacy & Policy  |  Strategic Thinking 
   News & Notes   |   Fall Conference

Regular Weekly Call with NC DHHS Leadership Addresses Key Issues
During this week's regular call with leadership at NC DHHS, we covered several key topics:

• Voting. Legal action concerning the prohibition against SNF staff assisting residents with voting matters has been filed by a statewide organization; a decision could come as soon as early next week. We’ll continue to monitor the case and the implications of any decision.
• Visitation. The department is beginning the process of developing guidance around indoor visitation, so that when that becomes a possibility, we’re not starting from ground zero.
• False Positives. We discussed false positive tests some of our member communities are experiencing. CMS has developed an algorithm that provides information about interpreting antigen test results.
• Self-insured plans and Omnicare testing. The department is working with a special team at Omnicare to try and resolve this issue. We anticipate a report back from the department early next week.

Governor Signs COVID-19 Relief Legislation with Significant Nonprofit Funding
Last Friday, Governor Roy Cooper signed into law the Coronavirus Relief Act 3.0 (H.B. 1105), which appropriates the final $900 million of North Carolina’s COVID-19 relief funding from the federal CARES Act. More than $145 million of this funding was allocated to a wide range of nonprofits, including food banks, arts organizations, YMCAs, free and charitable clinics, nonprofit residential facilities, domestic violence agencies, and sexual assault centers.
Key provisions include:

• $23 million for “COVID-19 related supplies and equipment necessary for life safety, health, and sanitation, such as ventilators, touch-free thermometers, gowns, disinfectant, sanitizing wipes,and personal protective equipment, such as surgical and respiratory masks and gloves.
• $29 million for COVID-19 tests, with 50% of that reserved for rapid tests, with specific amounts set aside for testing visitors.
• $45.5 million in new funding for the Job Retention Grant Program, which provides grants of up to $250,000 to nonprofits and businesses that suffered economic loss during the pandemic and did not receive loans through the Paycheck Protection Program or Main Street Lending Program.
• Increasing the amount of unemployment insurance benefits for North Carolinians by $50 per week for the remainder of 2020. This will temporarily increase the maximum benefit amount to $400 per week.
• Providing state matching funds for the new temporary federal program providing for $400 per week in supplemental UI benefits for workers who have been laid off or furloughed because of COVID-19; without these matching funds, these workers only would have received $300 per week in supplemental benefits.
• Extending state agencies’ authority to provide regulatory flexibility – such as extension of statutory filing deadlines – through the end of the Governor’s emergency declaration for the pandemic. Originally, the General Assembly had only allowed agencies this flexibility through August 1, 2020.
• Creating a new “Extra Credit Grant Program” that provides for $335 grants for North Carolina families with children aged 17 and younger. Because the grants will be determined based on state tax filings, low-income families that did not have enough income to have to file state income tax forms in 2019 will need to apply for the grants by October 15, 2020.
  

CMS Testing Webinar Summary
Here is an article on the CMS Testing Webinar that was held earlier this week. Among the most important takeaways – HHS will be allocating 750,000 Abbott Binaxnow tests (the cards) to nursing homes. They will start with nursing homes in “red” or high areas of positivity. LeadingAge national is aware that the feds are developing a detailed distribution plan for the 150 million Binaxnow tests they have to distribute; it sounds like assisted living providers may be on the list as well.

U.S. Senate Unable to Pass Scaled-Down COVID-19 Relief Legislation
Yesterday, the U.S. Senate voted down a new scaled-down COVID-19 relief bill. The Senate voted on the bill mostly along party lines, so the bill didn’t receive the 60 votes necessary to pass. Even though the Senate didn’t pass this proposal, it signals the next step in the negotiations between the two major political parties over the next iteration of COVID-19 relief. Notable provisions in the bill include:

• Universal Charitable Deduction. The bill would have increased the universal deduction in the CARES Act from $300 per tax taxpayer to $600 for individuals and $1,200 for married couples filing jointly. It would not have extended the temporary charitable giving incentive beyond its current expiration date of December 31, 2020. To help prevent tax fraud, the bill also would have doubled the penalty for non-itemizers who overstated the amount of their donations. This provision is an encouraging sign for nonprofits, since neither the previous Senate relief bill (the HEALS Act) nor the HEROES Act that passed the House in May would have improved upon the universal charitable deduction from the CARES Act. Nonprofits continue to advocate for Congress to expand this provision to allow all taxpayers to deduct their charitable contributions up to one-third of the standard deduction (more than $4,000 for individuals, and more than $8,000 for married couple filing jointly).
• Paycheck Protection Program. The bill would have created a second round of PPP loans, limited to employers with 300 or fewer employees that experienced a 35% decline in “gross receipts” in any quarter of 2020. The calculation of “gross receipts” would have been problematic for many nonprofits, since it would have excluded federal grants and many foundation grants. The bill also would have simplified the PPP loan forgiveness process for borrowers (including many nonprofits) receiving loans of $150,000 or less.
• Unemployment Compensation. The bill would have provided for $300 per week in supplemental unemployment insurance benefits for workers who have been laid off or furloughed due to COVID-19. This is only half of the $600 weekly benefits provided through July 31 in the CARES Act. Unlike the HEALS Act, the latest Senate proposal does not increase the federal reimbursement for self-insured nonprofits. Regardless of what Congress does, North Carolina is holding self-insured nonprofits harmless for the cost of their COVID-19 related UI claims.
• No State and Local Government Funding. The bill included no additional support for state and local governments. Its only support for state and local governments – the extension of the deadline to use CARES Act money through September 30, 2021 – would not have mattered in North Carolina since the General Assembly just approved the appropriations of the remainder of the state’s CARES Act funding.
• Liability Relief. Many nonprofits have expressed concern about the possibility of legal liability if someone who has been in their facilities contracts COVID-19 and sues the nonprofit. This is a particular concern since many insurance providers are excluding COVID-19 claims from coverage. Like the HEALS Act, the latest Senate bill would have limited liability for nonprofits and businesses for personal injuries arising from alleged COVID-19 exposure at their facilities. This provision would have complemented a new North Carolina law that provides limited immunity for nonprofits, businesses, and individuals (including nonprofit volunteers and board members) from claims of transmission of COVID-19.
  

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The VCs Betting on Aging Consumers
Bloomberg Businessweek, August 3, 2020
This article examines the tremendous market focused on products and services for an aging population and the venture capital firms new look in light of the pandemic.

How to Promote Racial Equity in the Workplace: A Five-Step Plan
Harvard Business Review, September-October 2020
Intractable as it seems, the problem of racism in the workplace can be effectively addressed with the right information, incentives, and investment. Leaders may not be able to change the world, but they can certainly change their world.

 The Last Geriatrician
AARP The Magazine, August/September 2020
Donnie Batie, M.D., is one of Louisiana’s few doctors who specializes in treating older patients. He somehow balances a backbreaking workload with skill, faith, and grace.

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NC NHA License Renewal
The NC State Board of Examiners for Nursing Home Administrators have mailed out Renewal notices. If your NHA license renews 9-30-2020 please visit our website www.ncbenha.org. Scrolling across the middle of the page you will find a place to click and download the renewal form.

Monday’s Online National Coronavirus Policy Update
Nationally, some LeadingAge members are beginning to share fears that they will not have the financing to stay open -- some have even begun closing. On Monday, September 14, Sean Beloud of St. Johns Retirement Village in California, will join the LeadingAge national Online Policy Update at 3:30 pm to talk through his community’s difficult decision to close its five-star nursing home in order to preserve its assisted living program. Register here to join the call.

Absentee Ballot Requests Now Available Online
Last week, the NC State Board of Elections opened its online portal for requesting absentee ballots online. The online application process only takes about three minutes to complete. Voters who request an absentee ballot will receive one by mail and can still choose to vote in person during the Early Voting period or on Election Day instead of submitting their absentee ballot. The online portal for absentee voting also allows voters to check on the status of their absentee ballots.

New Wellness Tips for Staff
Do your member leaders need some practical tips on how to support their staff's well-being during this crisis? Check out a one-pager that was just posted by LeadingAge national for ideas you can implement today.

Act Now: Be Certain Everyone You Know Completes the Census Questionnaire
With so many North Carolina households still uncounted in the Census, it is to get a complete and accurate count in the next three weeks. The call to action for staff, volunteers, and board members is simple: Make sure that everyone with whom your community engages completes the Census questionnaire. To help with last-minute get-out-the count efforts, the NC Counts Coalition has a new toolkit with sample messaging, social media posts and graphics, and outreach ideas. For households that have not yet completed the Census questionnaire, there is still time to respond online, by mail, by phone, or through an in-person visit from a Census Bureau representative.

Scenario Planning Toolbox
This new Spotlight in the LeadingAge Knowledge Center explores the future need for and delivery of aging services in the context of expectable, challenging and visionary futures. The Scenario Planning Toolbox includes a detailed video presentation describing the four scenarios that will impact aging services. It also includes a downloadable discussion guide to get your board and senior leadership team talking about how these scenarios will impact your plans for the future, as well as supplemental resources to help you hold your own scenario workshop. The Toolbox is free to members!

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Fall Conference

We are looking forward to seeing you virtually at our 2020 Fall Conference. Be sure to register today. We are partnering with LeadingAge national to host our conference on a platform that will provide an optimal experience for attendees and sponsors. Sessions will focus on leadership, workforce, spiritual and physical well-being, clinical support and adult day services.

This is no ordinary webinar or Zoom meeting...here is why you should attend:

• Need CEUS for your Nursing Home Administrator License? Up to 5.0 hours of in-person continuing education credits are available.
• CEUs available for human resources and finance.
• Learn from forward thinking and nationally recognized industry experts and thought leaders on a variety of topics related to the field of aging.
  
• Connect with senior living professionals in networking and sponsor areas via text and video chat.
  
• Learn about products, services, and resources provided by business member sponsors who are experts in their respective fields
  
• Depart with takeaways that can be implemented by you and your community.
  
• Convenience and flexibility from the comfort of your own office, home or location of your choice.
  
• Extreme value – No travel expense and lowered registration fee.
  
  

Click here to download the conference brochure.

We encourage you to join us on Thursday, September 24 at the LeadingAge North Carolina Fall Virtual Conference – Click here for more information.

LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org

Advocacy & Policy  |  Strategic Thinking  |  News & Notes
2020 Fall Conference  |

Latest Information on Required Bi-Weekly Staff Testing Earlier this week, NC DHHS Secretary Mandy Cohen issued an order requiring mandatory testing for staff in skilled nursing facilities. At this point, the first reporting deadline is set for September 8, reflecting testing activity on or after August 17. While many details remain to be finalized, the state will reimburse facilities for the cost of testing. The state is not requiring a specific lab; rather, facilities will be reimbursed for the testing costs charged by whatever lab they contract with. The state plans on paying for testing through November, with reimbursement scheduled to go to facilities in September, October, and November. DHHS is in the process of creating a web-based reporting tool (LeadingAge North Carolina is providing two of our member communities for beta testing of the tool…we are working in collaboration with the North Carolina Health Care Facilities Association which is also providing two beta testers). Reporting will be summary level with no individual information being required. DHHS will be hosting a two-part webinar series to provide additional information about the testing, reporting requirements, and related reimbursement opportunities. You are strongly encouraged to attend BOTH sessions. The first session will be held on Monday, August 17 and the second session will be held on Friday, August 21…both sessions will begin at 3:30 pm and last for one hour. To register for both webinars, please click here. Important Information on Absentee Ballots by Mail On June 12, 2020, the General Assembly passed HB1169, “The Bipartisan Elections Act of 2020, “which changes how NC voters vote their absentee ballots by mail. Detailed information is available by clicking here. A copy of the Absentee Ballot Request Form can be found by clicking here. Who can assist a voter in completing this Request Form? All voters are entitled to assistance from a near relative or verifiable legal guardian. If a voter is blind, disabled or unable to read or write and needs assistance in completing the Absentee Ballot Request Form (and a near relative is not available), they may request some other person to give assistance. That person’s name and address must be listed under Part 2 of the request form. If a voter is a patient in a facility (hospital, clinic, nursing home, rest home), a member of a Multipartisan Assistance Team (MAT) authorized by the county board of elections can assist the voter in completing the request form. No owner, manager, director, or employee can request an absentee ballot on behalf of the voter. Follow these 5 Steps to Vote by Mail Complete the Absentee Ballot Request Form Return the Request Form to your County Board of Elections. Return it in person, by email, fax or US Postal Service. The form must be received by Tuesday, October 27, 2020 by 5:00 p.m. Note: You will not receive a confirmation mailing if your application is accepted. However, you will hear back if your application needs to be corrected or is rejected. Your County Board of Elections will mail absentee ballots the first week of September to registered voters who have completed the Absentee Ballot Request Form. The package will include an Absentee Ballot, a return envelope with a certificate statement on it and an instruction sheet. Mark your ballot with your choices in the presence of one witness who is at least 18 years of age and is not a candidate for the election. The voter and the witness must each complete and sign the certificate on the return envelope and provide their addresses. Note: Employees of a facility may not serve as a witness for voters in a facility. Return the ballot in the return envelope by mail or deliver it in person to your County Board of Elections. If returning by mail, it must be postmarked by 5:00 pm on Election Day. You may not turn it in at an Early Voting site or an Election Day precinct. For a complete listing of County Boards of Elections, please click here. PBJ Staffing Data Submissions Due Nursing home providers must resume submission of payroll-based journal (PBJ) staffing data by the end of this week. While an 1135 federal blanket waiver related to the COVID-19 public health emergency had previously suspended these data submissions, this waiver was terminated by CMS effective June 25. Nursing home providers must submit PBJ data for the second quarter of calendar year 2020, April – June, by today: Friday, August 14. CMS is also encouraging providers to submit PBJ data for the first calendar quarter of 2020, though this data is not required. PBJ data filed for calendar quarter 1, when the waiver was in effect, can be accessed here. Calendar quarter 2 staffing data will be available on Nursing Home Compare, and subsequently calculated in the staffing domain of the Five-Star Quality Rating System, with the next regularly scheduled update for this domain in October 2020. More information on the termination of this waiver and the impact of the COVID-19 public health emergency on the five-star rating system are available here. Update on Provider Relief Funds Our friends at Ziegler have been providing great information to member communities and recently shared additional detail on Provider Relief Funds. On Aug. 7, HHS announced that $5 billion in funding will be distributed in two waves. The first wave will provide approximately $2.5 billion to support increased testing, staffing and PPE needs, as well as provide funding for establishing COVID-19 isolation facilities. The balance of the $5 billion will be distributed in a second wave based on the nursing home’s performance in controlling COVID-19. Unlike prior Provider Relief Fund distributions, this second wave will be based on factors such as the nursing home’s ability to minimize COVID-19 spread and COVID-19-related fatalities among its residents in light of the prevalence of the virus in the nursing home’s local geography. HHS announced that the initial $2.5 billion distribution to nursing homes and long-term care facilities will occur in mid-August 2020, and the performance-based distributions will occur throughout the fall of 2020. Click here for a link to the complete HHS press release.  Ziegler will be holding a webinar on this subject for CFOs and finance professionals in conjunction with LeadingAge Virginia on Monday, August 17 at 11 am. Click here to join the meeting. NC Legislative Oversight Committee Considers COVID-19 Issues The Joint Legislative Oversight Committee on Health and Human Services and the Joint Legislative Oversight Committee on Medicaid and NC Health Choice both met Tuesday. The agenda for the JOC on Health and Human Services focused on a COVID-19 update, DHHS COVID-19 funds, and the impact of COVID-19 on children. Handouts from the meeting can be found here. The agenda for the JOC on Medicaid and NC Health Choice centered around Medicaid transformation, enrollment in Medicaid and NC Health Choice, and a financial update on the program. The agenda and handouts from this meeting can be found here. Back to top

Why Do Boards Have So Few Black Directors? Despite the growing body of evidence of these advantages and the proliferation of company-sponsored diversity initiatives, the advancement of Black professionals up the corporate ladder has been painfully slow and may even be reversing. This thought-provoking article provides food for thought and action steps. (Harvard Business Review, August 13, 2020)  Back to top

Inspiration from LeadingAge National Board Chair, Carol Silver Elliott Carol Silver Elliott, board chair for LeadingAge national, recently penned her thoughts on endurance…words of wisdom worth reading! Like others of you, my organization was hit hard by COVID-19. The nightmare we had hoped to avoid became reality and we fought our way through it. We battled to save our elders and, to do so, also battled to save our staff, acquire PPE, acquire testing, and so much more. There was a period of about two endless months when we wondered if we would ever see light again. The good news for us, and I know for some of you as well, is that we have stabilized. Our buildings are COVID-free, or perhaps close to that. Staff has recovered and we have been able to acquire adequate PPE and, for the most part, adequate testing. The bad news is that this is not over. We have not reached the endpoint or crossed the finish line. This is not our new normal. It is not pre-COVID, it is not (for some of us) in the midst of COVID but the enemy has not been defeated. This we all know. As I’ve thought about this, I’ve thought that we will win this war through endurance, we will win it with our long-game and being as alert and vigilant now as we were at the beginning. And that’s not easy. I know that many of us are just plain tired. We are tired of being anxious about the impact of this virus. We are tired of struggling to do everything we need to do to help our elders. We are tired of keeping our elders isolated and away from friends and family. We are tired of worrying about the future of our organizations and how we will survive. It’s not one thing, it is everything. Endurance is key to our success, both as it applies to our emotional stamina as well as our physical endurance. We don’t have to be pillars of strength at every moment and we must give ourselves some breathing room when we need it. But when we come back to our organizations, come back to lead, we have to remember that we are in this for the long-haul and that we are in it together. We are, as I like to say, in it to win it for our elders and for our future. Stay strong. Carolinas Planned Giving Conference Set for Early September The North Carolina Council of Charitable Gift Planners and the South Carolina Planned Giving Council will host a virtual two-day conference on September 2nd and 3rd. The councils have put together a quality continuing education opportunity for development professionals to expand their planned giving knowledge, learn new skills they can apply in their organizations, and network with peers and industry leaders. A group rate for organizations will be offered so you can encourage team members to join and grow, as you work together in your gift planning efforts. Continuing education will be offered for CFRE, CTFA, CFP, CLE, and CPE credit where applicable. Click here for more information. Compassionate Touch Program Continues its Work in North Carolina The AGE-u-cate Training Institute is launching the second year of Compassionate Touch training through the CMP Grant Program. The Compassionate Touch® program will help 66 North Carolina certified nursing homes improve the care provided to residents with dementia by incorporating the Compassionate Touch® techniques into their day-to-day care practices. Click here for more information about the program. Back to top

We are looking forward to seeing you virtually at our 2020 Fall Conference. Be sure to register today…the first 100 provider registrants will receive a conference thank you kit compliments of our sponsors! We are partnering with LeadingAge national to host our conference on a platform that will provide an optimal experience for attendees and sponsors. Sessions will focus on leadership, workforce, spiritual and physical well-being, clinical support and adult day services. This is no ordinary webinar or Zoom meeting...here is why you should attend: Need CEUS for your Nursing Home Administrator License? Up to 5.0 hours of in-person continuing education credits are available. Learn from forward thinking and nationally recognized industry experts and thought leaders on a variety of topics related to the field of aging. Connect with senior living professionals in networking and sponsor areas via text and video chat. Learn about products, services, and resources provided by business member sponsors who are experts in their respective fields Depart with takeaways that can be implemented by you and your community. Convenience and flexibility from the comfort of your own office, home or location of your choice. Extreme value – No travel expense and lowered registration fee. Click here to download the conference brochure. We encourage you to join us on Thursday, September 24 at the LeadingAge North Carolina Fall Virtual Conference – Click here for more information.   Back to top

LeadingAge North Carolina
222 N. Person Street Suite 205 | Raleigh, NC  27601
Ph. 919.571.8333 | Fax 919.869.1811 | www.LeadingAgeNC.org

May 20, 2020

COVID-19 Update

Next Week’s LeadingAge NC COVID-19 Call-in
Moved to May 26
In recognition of Memorial Day, next week’s LeadingAge North Carolina “COVID-19 Call-in” will be held on Tuesday, May 26 at 2 pm. Call-in to share what you’re hearing, seeing, and doing and learn from your peers across the state. To access the call, dial (201) 616-0673 and, when prompted, enter the passcode 841692.

NHSN Reporting
CDC’s NHSN COVID-19 LTC Module reporting is now required by CMS. Providers have until May 24 until CMS will implement enforcement remedies. If you are still awaiting something in order to report, please email me at tom.akins@leadingagenc.org and cc: Cindy Deporter at DHSR at cindy.deporter@dhhs.nc.gov on the note.

PPP Member Survey
LeadingAge national is fielding a short (5 question) member survey on the Paycheck Protection Program loans. The survey link is here: https://www.surveygizmo.com/s3/5606132/PPP-Survey. National is looking to gauge whether members are accessing these loans and which member types are doing so more than others. National is also using this to gather stories both from those who have and have not received PPP loans to support advocacy efforts in this area.

CMS Reopening Guidelines for Nursing Homes
CMS issued recommendations to state and local officials on Monday related to reopening of nursing homes. These recommendations are to be considered along with a number of other community- and nursing home-specific factors and must be adopted and implemented by the state. CMS released a FAQ document to accompany this memo. LeadingAge provided a high-level analysis of these recommendations, available here.

States may choose from a number of options for how nursing homes within the state will progress through the phases of reopening. States must also consider a number of factors in determining when nursing homes may begin reopening. Reopening is contingent upon a testing strategy outlined by CMS, in which all nursing home residents and staff receive an initial baseline COVID-19 test. The testing strategy then outlines subsequent testing of residents and staff, which will be maintained throughout the 3 phases of reopening. The feasibility of this testing strategy and other factors such as adequate PPE and staffing, will impact reopening. We’re working with the state and other key stakeholders and will keep you updated as North Carolina finalizes its plans.

Medicare Payment for COVID-19 Diagnostic Tests
CMS has developed two codes that laboratories can use to bill for certain COVID-19 lab tests, including serology tests. CMS has updated its guidance to include payment details for additional CPT codes created by the American Medical Association. There is no cost-sharing for Medicare patients.

Springmoor, Sharon Towers Share Good News
Two of our member communities, Sharon Towers in Charlotte and Springmoor in Raleigh, recently shared good news from their communities with us. Click here for Sharon Tower’s story and click here for the one from Springmoor. Please send us your stories so we can share those with others around the state!

SBA Loan Forgiveness Application
The Small Business Administration has released the forgiveness application for the Paycheck Protection Program loans. The application form is linked in the handout. Lenders will likely program the application into their own websites, and borrowers will need to fill out the application with their lender to get their loan principal forgiven. The PDF document in handouts, though, outlines the information and data that PPP borrowers will need to submit to get their loan forgiven. Borrowers will need to provide detailed information on how their funds were used, including payroll data at the employee level. We will have more information on this in the coming days.

FTC Blog on Stimulus Checks
On Friday, a new blog post came out from the Federal Trade Commission on the $1,200 stimulus checks that went out last month as they relate to nursing homes and assisted living. The blog posts states what we already know: that the stimulus checks are considered tax credits and cannot be taken from Medicaid residents. The article’s framing suggests that state attorneys general should get involved if facilities are taking these checks, so we definitely encourage you to read this piece.

LeadingAge Leadership Summit Cancelled
After thoughtful consideration for the health and welfare of member organizations and the people they serve, LeadingAge national has decided to cancel the 2020 Leadership Summit, scheduled for August 10-12 in Washington DC. While members may not come together for a live event in August, LeadingAge national is actively planning a series of online learning and networking opportunities to enable LeadingAge members to connect and share ideas. They look forward to sharing more about these opportunities in the coming weeks.

Those who have already registered for the 2020 Leadership Summit will be contacted directly regarding their registration fees. LeadingAge national will honor requests for credits or full refunds. They hope that those who have registered will take advantage of the option to apply their registration credit to a future event. Please look for an email with details on these options soon. Any hotel reservations booked through the Omni have been cancelled. No further action is required on your part.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

Ralph Waldo Emerson asked “how much of life is lost waiting?”

Check in question: For many – our residents, our teams, our families – the pandemic has left us waiting for a sense of certainty, of connection, and of comfort. As we continue our vital work, what kinds of things can we do to instill a sense of purpose and hope in our lives and the lives of those around us?

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

May 18, 2020

COVID-19 Update

NCDHHS Updates Guidance on Who Should be Tested for COVID-19
The North Carolina Department of Health and Human Services issued updated guidance Friday on who should be tested for COVID-19. The new guidance recommends that clinicians test any patient in whom COVID-19 is suspected. The new guidance recommends clinicians ensure the following populations have access to testing, regardless of symptoms:

• Anyone with symptoms suggestive of COVID-19
• Close contacts of known positive cases, regardless of symptoms
• Persons who live in or have regular contact with high-risk settings (e.g., long-term care facility, homeless shelter, correctional facility, migrant farmworker camp)
• Persons who are at high risk of severe illness (e.g., people over 65 years of age, people of any age with underlying health conditions)
• Persons who come from historically marginalized populations
• Health care workers or first responders (e.g. EMS, law enforcement, fire department, military)
• Front-line and essential workers (grocery store clerks, gas station attendants, etc.) in settings where social distancing is difficult to maintain
  

Testing, along with contact tracing and supplies of personal protective equipment, is part of the state’s strategy to slowly ease restrictions, while protecting North Carolinians from COVID-19. The state is looking at a composite of metrics to guide its path forward, including the number of cases, the percent of tests that are positive, the number of hospitalizations and the number of emergency department visits for COVID-like illness. Friday, Governor Roy Cooper and NCDHHS Secretary Cohen shared these metrics remain stable for the first week of Phase 1.

The new guidance updates testing criteria for the North Carolina State Laboratory of Public Health. Those include hospitalized patients, health care workers or first responders, persons who live in or have regular contact with a high-risk setting, persons who are at higher risk of severe illness and for whom a clinician has determined that results would inform clinical management, and uninsured patients.

PPE Available Through Value First
Value First, the group purchasing organization owned by LeadingAge North Carolina and 24 other state LeadingAge associations, has a number of PPE supplies available. For more information or to coordinate orders, please reach out to our Value First representative, Bobby Bernal, at (850) 509-8112:

• Reusable personal safety masks – America Knits, Standard Textile – American Knits is caught up on orders, so any orders placed today will ship in 2 days.
• Reusable gowns – America Knits, Standard Textile, Encompass – American Knits has capacity of approximately 8k – 10k gowns per week starting the 3rd week of June. Value First is just starting to promote this to members.
• Disposable gowns – Jostens – they were initially overwhelmed with member orders and stopped accepting new orders, but the latest update this week is they plan to have tripled their capacity in the next two weeks and hope to be caught up by then. Value First is currently telling members to allow 4-6 weeks for new orders, but that may be improving.
• Face shields – Cintas, Hubert as well as a number of local manufacturers – this item doesn’t seem to be much of a challenge to find anymore.
• Hand Sanitizer – Cintas, US Foods, Sysco – Cintas requires a minimum purchase of a full pallet. US Foods has an agreement with Bevolution to distribute hand sanitizer and Sysco has partnered with a manufacturer and should have product available to their customers.
• COVID-19 test kits – This is a new development, but Vizient entered into a contract with a company that can provide test kits with a seven-day lead time. One of the complicating issues is this is just the test kit, so the member would then need to send the sample to a lab for analysis.
  

Don’t Forget!
Our weekly LeadingAge North Carolina “COVID-19 Call-in” will be held this afternoon at 2 pm. Call-in to share what you’re hearing, seeing, and doing and learn from your peers across the state. To access the call, dial (201) 616-0673 and, when prompted, enter the passcode 841692.

Free Basic Care Aide Skill Competency Training Tool
Maximize your workforce and maintain quality standards with LeadingAge’s new Basic Care Aide Skill Competency Training Tool. The new, free, 9-hour training will help you redeploy current staff, and train displaced workers and others new to our field. Developed by EduCare©, this new program is designed specifically for the Basic Care Aide role and provides a foundation for the skills for a variety of settings. The training tool is FREE to members and is available now on the Learning Hub.

Protecting Mental Health and Wellbeing During the Pandemic
The impact of the coronavirus pandemic goes beyond physical health. The mental health and wellbeing of residents, clients, leadership, and staff are also at risk. LeadingAge is offering resources to help you address these aspects of the public health crisis.
The LeadingAge Knowledge Center continues to add new content, including learning tools for the wellness and mental health challenges. The third of the new Virtual Sessions will be held June 4 at 2:00 p.m. ET:

• Mental Wellbeing: Regaining Confidence and Control
  

Free QuickCasts offer on-demand, short-form learning opportunities:

• Managing Mental Health: Considerations in COVID-19
• Boosting Your Resilience During Adversity
• Creating Calm: Simple Activities for Stressful Times
• Purposeful Reflection: Leading Through Uncertainty
• Supporting Social Connectedness through Technology
• Engagement in a Time of Quarantine
  

Access these and other resources for free on the Learning Hub page.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

Albert Einstein, the German-American physicist who is probably the most well- known scientist of the 20th century, said that, “No problem can be solved from the same level of consciousness that created it.”

Check in question: How has your response to COVID-19 forced you to look at things in a different way? How can you work to constantly change the lenses through which you see the pandemic and your response to it?

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

May 15, 2020

COVID-19 Update

Clarification from NC Department of Insurance on Semi-annual Meetings
We reached out to the North Carolina Department of Insurance with a question about the statutory requirement that CCRCs “hold semiannual meetings with the residents of each facility operated by the provider for free discussions of subjects including, but not limited to, income, expenditures, and financial trends and problems as they apply to the facility and discussions of proposed changes in policies, programs, and services.” The department replied that “given that there is no specific date that the meetings have to be held by, and the fact that we are only a little less than 2 months into this, we are going to wait before we do anything. We obviously will work with providers as things move along. We also would encourage any providers that have the ability to hold meetings virtually to do so, but also understand that may not be a good alternative since residents may not have the ability to participate in such a manner.” Please let us know if you have questions or contact Nancy Wise at the department.

Chief State Fire Marshal Provides Information on Inspections
One of our member communities contacted us with a question about inspections by local fire marshals. We reached out to the Chief State Fire Marshal, Brian Taylor, who indicated that fire officials are not going on site to do any type of inspections. He also said that, “some inspection jurisdictions are doing Live Remote (Facetime) Inspections with site maintenance personnel and emailing annual fire protection reports to Fire Marshal/Fire Official.” He also said that he has not 'heard of anybody doing inspections” and that they "would like to hear if anyone is.” Chief State Fire Marshal Taylor and his team are tremendously helpful and we would encourage you to reach out to them at brian.taylor@ncdoi.gov if you have any questions.

DHHS LTC Call
Yesterday’s long term care call with NC DHHS featured a number of helpful issues and commentary from departmental staff. A recording of the one-hour meeting can be found by clicking here, and the PowerPoint used in the meeting can be found by clicking here. And remember these resources that are updated on a daily basis:

• Governor’s COVID-19 task force website specific to long term care facilities https://www.ncdhhs.gov/divisions/public-health/covid19/long-term-care-facilities
• Long term care facility toolkit https://www.ncdhhs.gov/divisions/public-health/covid19/covid-19-guidance#long- term-care-facilities
  
  

NHSN enrollment
LeadingAge national had a good call with CDC yesterday to discuss issues we have been hearing around NHSN enrollment and reporting. CDC confirmed that the issues that we reported are consistent with the issues they have identified. Work-arounds are in progress for a few specific problems, one of which was identified by CDC only shortly before the scheduled call. We brainstormed a few ways to address some of the other issues and will be assisting CDC with some of these tasks. National received information on in-progress responses or suggested responses to the following main themes: confusion around CDC requests vs. CMS requirements, issues with SAMS registration, issues with completing enrollment, and issues with accessing the module once enrollment has been completed (or activating the module for previously-enrolled facilities). We also notified them of consistent themes for which members seem to be reaching out for assistance: group reporting and access for multi-site organizations, updating facility administrator and contacts, and updating login for those who were previously enrolled but have not accessed NHSN for a while. We will continue advocacy efforts with these two agencies and welcome feedback along the way.

Death, Grief, and Funerals in the Age of COVID-19
A few key thoughts on grief from LeadingAge national’s recent update call. These thoughts came from Karen Hartfield of Hospice of Western Reserve in Ohio.

• Grief doesn't always show up the way we expect it to.
• It is important that we acknowledge losses during this time and validate the varied grief reactions of those with whom we work.
• Remember that if someone is acting in a way you are not accustomed to or that you do not understand, they may be experiencing a grief or trauma reaction.
• It's OK if you don't quite understand it. Most important to validate and allow people to have space to experience their emotions.

The Virtual Funeral Collective banded together as part of a larger initiative called the Global COVID-19 Relief Coalition. The Global COVID-19 Relief Coalition is a 501c3 project of The Giving Back Fund bringing together world leading labs and organizations to provide solutions for the current COVID-19 pandemic. This White Paper contains a collection of resources and best practices from our collective to help you during this stressful time.

New QuickCast Available…Managing Mental Health: Considerations in COVID-19
In this 13-minute LeadingAge national QuickCast, Elizabeth Hale explains how the current global pandemic is affecting our mental health and emotional wellbeing—and ways we can manage it. Click here to register.

CDC Guidance on Memory Care
CDC released new guidance yesterday on COVID-19 considerations for memory care. We note that this information and guidance can be useful for work with all residents with cognitive impairments, regardless of the level of care or placement on a designated memory care unit. While much of this information is standard practice for working with those with cognitive impairments, one interesting recommendation is that CDC recommends that staff working on a memory care unit wear eye protection and N95 respirators at all times when on the unit to minimize risk of exposure from ill, wandering residents. CDC also recommends maintaining consistency in staff, activities, and environments as much as possible, including continuing to allow safe physical activity such as walking the unit or walks outdoors.

COVID-19 Symptoms: A Primer
According to the CDC, people with COVID-19 can have a wide range of symptoms — ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. People with these symptoms may have COVID-19:

• Cough
• Shortness of breath or difficulty breathing
• Fever
• Chills
• Muscle pain
• Sore throat
• New loss of taste or smell
  

Learn more by clicking here.

Telehealth Video: Medicare Coverage and Payment of Virtual Services
CMS updated a video that answers common questions about the expanded Medicare telehealth services benefit during the COVID-19 public health emergency. New information includes how CMS adds services to the list of telehealth services, additional practitioners that can provide telehealth services, and the distant site services that Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) can provide. Further, the video includes information about audio-only telehealth services, telehealth services that hospitals, nursing homes and home health agencies can provide, along with how to correctly bill for telehealth services.

Heroes Act
Yesterday, at the request of House leadership, LeadingAge national released a media statement on the Heroes Act. LeadingAge supports the proposed measure as a good start and seeks additional provisions in a final relief bill. In particular, the media statement highlights our requests for: (a) a $100 billion emergency fund specifically for aging services providers; (b) significant investments in PPE and testing for aging services providers; (c) a $1.2 billion investment in relief for HUD-assisted affordable housing; and (d) reimbursement for home health telehealth services. LeadingAge national posted this article on provisions of the proposal that would affect nursing homes.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

A big part of our role in providing hope to those who live on our campuses is being realistic with expectations around when certain restrictions may be lifted. As you and others look forward to some limitations going away, what’s the one thing you look forward to doing?

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

May 13, 2020

COVID-19 Update

Q and A with Cindy Deporter
Cindy Deporter with DHSR sent two clarifications yesterday afternoon that we want to share:
Question: Facilities are calling the state about their residents that are in the assisted living area of the nursing home. In NC we call these combination homes. They are asking should they include both the assisted living and the SNF numbers on the reporting data? It does not seem that this is covered in the QAs.
Answer: The data should only include those residents and staff in the certified portion of the facility.
Question: Does CMS expect that providers in states that are licensed only have to report COVID information through the CDC?
Answer: The Reporting requirement is a federal requirement for participation, and does not apply to non-certified or licensed only nursing homes.

CDC/NSHN Issues Continue to Plague System
LeadingAge continues to field a number of questions about reporting requirements and even more concerns about issues with enrollment with the National Healthcare Safety Network (NHSN), which nursing homes will soon be required to use to report COVID-19 data. LeadingAge is sharing concerns with CMS. While the CDC will be the body to address actual enrollment issues, LeadingAge feels it is important for CMS to understand that the process is not running smoothly and that providers want to comply but may be unable to do so for reasons beyond their control. Please share your concerns with LeadingAge's Jodi Eyigor at jeyigor@leadingage.org.

CMS Issues Additional Blanket waivers
Late yesterday, CMS announced that they are issuing additional blanket waivers. The waivers include:

Flexibility to allow hospitals to establish “swing beds” to accommodate patients who no longer require acute care but are unable to find placement in a SNF. To qualify for the Swing Bed waiver, hospitals must not use the swing beds for acute care, must comply with the hospital and SNF conditions of participation in 42 CFR 482.58(b) to the extent not waived, and be consistent with the state’s emergency preparedness/pandemic plan. To establish swing beds pursuant to the waiver, the hospital must call the CMS MAC enrollment hotline to add swing bed services and attest that they have made a good faith effort to exhaust all other options, there are no skilled nursing facilities within the hospital’s catchment area that under normal circumstances would have accepted SNF transfers, but are currently not willing to accept or able to take patients because of the COVID-19 public health emergency. This waiver is permissible for swing bed admissions during the COVID-19 PHE with an understanding that the hospital must have a plan to discharge swing bed patients as soon as practicable, when a SNF bed becomes available, or when the PHE ends, whichever is earlier.
Paid Feeding Assistants. CMS is modifying the requirements at regarding required training for paid feeding assistants to reduce the training from a minimum of 8 hours to a minimum of 1 hours. CMS is not waiving any of the requirements related to paid feeding assistants or the required training content.

Certain Life Safety Codes were also waived, they include:
Alcohol-based Hand Rub (ABHR) Dispensers: CMS is waiving prescriptive requirements related to the placement of ABHR dispensers for use by staff and others due to the need for the increased use of ABHR in infection control. However, ABHRs do contain ethyl alcohol which is considered flammable so do need to have restricted access by certain resident populations to prevent accidental ingestion, and bulk containers of ABHR (over 5 gallons) should still be stored in a protected hazardous materials area. (See 483.90(a)(4) for more information).
Fire Drills: CMS will permit a documented orientation training program related to the current fire plan, which considers current facility conditions in lieu of drills that move and mass staff together. The training will instruct employees on their duties, life safety procedures and the fire protection devices in their assigned areas.
Temporary Construction: CMS is waiving requirements that would otherwise not permit temporary walls and barriers between patients.

Provider Relief Fund
Nick Uehlecke, Senior Advisor to HHS Secretary Azar, spent some time on the 3:30 LeadingAge national call yesterday talking about the Provider Relief Fund. One caveat: this conversation was not “official policymaking;” but Nick recognized he was talking to 950 people, too. He indicated that HHS is thinking that the funds can be used for any purpose related to dealing with COVID, including for example increased costs of laundry or food. He said more FAQs are continually being written based on the thousands of questions the department receives. He added that there’s a new question (either just posted or appearing soon) that talks about all the CARES Act funding sources and suggests how to view Provider Relief Funds in coordination with those other sources. He encouraged LeadingAge members to send more questions – if members, send questions to Nicole Fallon at nfallon@leadingage.org.

National Gallery of Art Guided Meditation for Front Line Staff
The National Gallery of Art created a guided meditation for front line workers that is free and simple to use.

Association of Professionals in Infection Control and Epidemiology Free LTC Resources
The Association of Professionals in Infection Control and Epidemiology (APIC.org) is offering LTC-focused resources free to non-members, until September, 2020. The library includes APIC's Infection Prevention Guide to Long Term Care.

HEROES Act Relief Bill
U.S. House of Representatives Democrats released their draft $3 trillion relief package yesterday afternoon. The Health and Economic Recovery Omnibus Emergency Solutions Act or the HEROES Act proposal includes many LeadingAge requests or elements that address our asks in part. Here’s an article on the housing highlights.

Here are some health highlights:

• Two of LeadingAge national's big Medicaid asks are included: FMAP is increased by a total of 14% from July 1, 2020 through June 30, 2023, giving states additional funds to help recover. MFAR, the Medicaid Fiscal Accountability Regulation that we lobbied vigorously to rescind, cannot be finalized under the end of the COVID-19 public health emergency.
• The health care provider relief fund is increased by $175 billion, with $100 billion for providers and $75 billion for testing, contact tracing, vaccines and other items.
• For aging services employers who want to provide some extra pay to their essential staff, the Heroes Fund that was developed in the Senate, is included.
• There are a number of provisions addressing nursing homes: The only new reporting requirement is to report age, race/ethnicity and preferred language of residents with COVID 19 or symptoms and all residents who have died, an effort to understand the impact on minority communities that we support. LeadingAge national asked for funds to help nursing homes develop extended care centers and the bill contains incentive payments for SNFs that want to develop a COVID-only treatment center. We have asked for assistance not punishment, and the bill contains funds for state strike force teams to provide assistance to nursing homes with COVID cases, and a provision for the QIOs to provide assistance with infection control, which is not exactly what we asked for but does indicate that some of our concerns were heard. Much more, so stay tuned.

LeadingAge National Coronavirus Daily Member Updates
LeadingAge is sharing the very latest with members twice daily. Morning updates go out via email, and they are hosting daily live online updates each weekday afternoon. Subscribe to "LeadingAge Need to Know" via communications preferences in your MyLeadingAge account to receive email updates. Register for live online updates. You can find an archive of all member updates there.

Practical Ideas From Members
LeadingAge is offering even more ways for members to learn from one another by gathering examples of the innovative solutions you’re deploying. Read new stories on topics including:

• Resident Engagement During Social Isolation: Members are finding new ways to socialize, build community, and keep busy.
• Treatment and Testing to Beat COVID-19: Members are playing a crucial part in the treatment for COVID-19-positive people, and the testing that will help defeat the virus.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

Margaret Atwood wrote in The Handmaid's Tale, "We were the people who were not in the papers. We lived in the blank white spaces at the edges of print. It gave us more freedom. We lived in the gaps between the stories."

Check in questions: How many residents have lived under your care? How many resident stories have you heard and retold? How many of their joys have you shared? How many of their tears have you dried? But, what about you as a caregiver? Don’t you have a story to tell about the value of the work you do? The focus always seems to be on someone else – the other heroes, the other caregivers, the other essential employees. No longer is it acceptable to live in the white spaces of print or in the gaps between the other stories. Our time has come. What is the story you will tell and to whom will you tell it? Help share our message of compassionate care and keeping individuals safe.

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

May 11, 2020

COVID-19 Update

By the Numbers…
As of 10:30 am this morning, North Carolina has had 15,045 laboratory-confirmed COVID-19 cases, with 550 deaths. 195,865 tests have been completed and 99 counties – all but one of the state’s 100 counties – have seen a positive case. Click here for a look at the state’s COVID-19 Dashboard.

DHHS COVID-19 LTC Call Scheduled for Thursday Morning
The North Carolina Department of Health and Human Services will be holding a COVID-19 Long Term Care Update call on Thursday, May 14 at 10 am. Topics to be covered include updates on new CDC guidance, hospital to long term care discharge flow charts, PPE updates, working staffing, and Medicaid. Please click here for a sheet with more details and call-in information.

Nursing Home Reporting on COVID-19
We continue to hear a number of questions about reporting requirements and even more concerns about issues with NHSN enrollment. We are sharing concerns with CMS. While CDC will be the body to address the actual enrollment issues, we feel it is important for CMS to understand that the process is not running smoothly and that providers want to comply but may be unable to do so for reasons beyond their control. Please let us know what challenges you may be encountering with the enrollment process.

StoryCorps Connect Toolkit
A few weeks ago, we spoke with Dave Isay from StoryCorps on a 3:30 LeadingAge national update call to talk about our collaboration to bring StoryCorps Connect to LeadingAge member communities across the country. StoryCorps Connect is a new free digital platform developed to address the pressing need for connection during the coronavirus pandemic, to older adults, their families, and caregivers across America, with the goal of conducting and recording meaningful remote conversations between loved ones. LeadingAge worked with StoryCorp to create a toolkit specifically for older adults. The toolkit is on the LeadingAge website and the link is LeadingAge.org/storycorps-connect

USDA COVID-19 Telehealth Service Changes
The US Department of Agriculture Office of Rural Development issued a document summarizing telehealth changes during the pandemic.

HUD Tenant Brochure in Lots of Languages
LeadingAge was the first to receive versions of HUD’s COVID brochure for multifamily tenants in several non-English languages, which will help our members greatly. Under the “Updates from Federal Agencies” section of the LeadingAge housing / COVID-19 page, find the brochure in Farsi, Arabic, Chinese, Spanish, Russian, and Vietnamese.

CDC Resources From Nimalie Stone
Nimalie Stone, lead of the LTC team within CDC’s Division of Healthcare Quality Promotion, sent a list of CDC resources that are relevant to LeadingAge members. The list includes an infection preventionist training course that offers approximately 20 CE hours upon completion and live Q and A sessions on COVID and LTC facilities on May 12 and May 14 (space is limited).

This Week’s Virtual Session: Ethical Dilemmas: Decision-Making in a Pandemic
The Knowledge Center is launching new Virtual Sessions, live online presentations with extended Q&A. Space is limited, so register for free today.

• Ethical Dilemmas: Decision-Making in a Pandemic with ethics expert Michael Gillette, this Thursday, May 14 at 2:00 p.m. ET
• Leadership Resilience: Moving Through Adversity with leadership consultant, author, and speaker Joanne Smikle on June 25 at 2:00 p.m. ET
• Mental Well-being: Regaining Confidence and Control with expert Susan Wehry on June 4 at 2:00 p.m. ET
  

Daily Online Live Member Updates
Every weekday at 3:30 pm, LeadingAge national policy experts continue to share the most up-to-date coronavirus information, and talk with a range of guests. Presentation materials and summaries of recent guest are available:

• Mission, Delivered: Deborah Royster of Seabury Resources for Aging on Our Daily Online Update
• CDC’s Dr. Nimalie Stone Shares Key Resources
  

Need to miss a session? LeadingAge Coronavirus Spotlights are brief but informative podcasts featuring these guest presentations. New podcasts are available now or register to join us live each afternoon.

Practical Ideas From Members
LeadingAge is offering even more ways for members to learn from one another by gathering examples of the innovative solutions you’re deploying. Read new stories on topics including:

• Resident Engagement During Social Isolation: Members are finding new ways to socialize, build community, and keep busy.
• Treatment and Testing to Beat COVID-19: Members are playing a crucial part in the treatment for COVID-19-positive people, and the testing that will help defeat the virus.
  

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

In The Second Mountain, David Brooks writes that, “Every once in a while, you meet people who radiate joy. They are kind, tranquil, delighted by small pleasures and grateful for large ones. They are not perfect, but they live for others and not for themselves. They are interested in you and take delight in your good.”

Check in: Tell us about a resident that has had some of these qualities and inspired you in the past?

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

May 8, 2020

COVID-19 Update

DHSR Offers Clarification on Construction
Officials with the North Carolina Division of Health Service Regulation yesterday provided LeadingAge North Carolina with clarification regarding construction projects on CCRC campuses. DHSR indicated that construction may continue (with adherence to CDC guidance and screening protocols). They also said that building inspectors are not considered “visitors” and can enter your campus to do their work. Please let us know if you have any questions or need additional information.

“Want to Slash Coronavirus Deaths? Start (Really) Caring About Long Term Care”
This article from “The Hill” makes the case for prioritizing resource allocation to skilled nursing facilities…required reading for every elected official and all of your stakeholders.

Nursing Home Reporting
The interim final rule that includes nursing home reporting requirements goes into effect today. CMS released guidance, including updated survey tools and a FAQ document. The memo is here and the LeadingAge analysis is on the COVID page. The first report to CDC needs to be submitted by 11:59 pm on May 17. CMS will begin publicly reporting data on May 31. CMS has unveiled 2 new F-tags for these reporting requirements and failure to report to CDC will be met with civil money penalties. In addition to reporting, nursing homes should use the updated infection control survey tool to complete self-assessments. Recall that they will be asked for these self-assessments on survey. LeadingAge national will be submitting comments on this rule.

Provider Relief Fund Deadline Now 45 days – May 24 for First Payment
HHS has announced that it is extending the time providers have to attest to the terms and conditions for payments received from the Provider Relief Funds. Providers will now have 45 days (previously 30 days) to make a decision about whether to keep the payments received and agree to the terms and conditions. No additional FAQs were provided as part of this announcement so questions remain. LeadingAge national continues to seek additional information to ensure that providers have the answers they need to make a good decision on attestation by the May 24 deadline.

Overview of “Opening Up America Again"
The White House’s “Opening Up America Again” guidelines provide three phases for the country’s reopening. State and regional areas cannot proceed to the first, second, or third reopening phase before “gating criteria” are met for a first, second, or third time, respectively.

Paycheck Protection Program Repayment Extended to May 14
A reminder that the Department of Treasury/Small Business Administration issued a new question in its FAQs a couple of days ago, extending the deadline for borrowers’ safe harbor repayment one week, from May 7 to May 14. This gives SBA time to provide additional guidance on how it will review certification. We are sending a follow up email to SBA reminding them of our letter seeking a resolution of the problems that have arisen related to SBA loans to affordable housing providers.

FEMA PPE Distribution
Here’s the official FEMA announcement about the distribution of PPE to all Medicare and/or Medicaid certified nursing homes in the country. According to the release, shipments of the first 7-day supply are going out now and should arrive this week or next. The second shipment will go out in June. We’ve been asked by the press about members who have received the FEMA shipments. If you or a member wants to let us know, please email Lisa Sanders (LSanders@leadingage.org)

LeadingAge National CEO Meeting with HHS Deputy Secretary Today
Katie Sloan, LeadingAge national CEO, will be meeting with HHS Deputy Secretary Eric Hargan today. Among other things, she will discuss aging services providers’ (across the continuum) desperate need for testing and PPE, as well as staffing shortages; and ask him for relief on these challenges. She’ll give him a picture of what we’re hearing from members about how things look for providers, their staff, and the people they serve. She’ll also push for answers to the questions we submitted about the Provider Relief Fund. In addition, she will raise our concerns about the double (or triple) reporting now required of nursing homes.

COVID-19 Illness and Minority Groups
We’re monitoring the impacts of the virus on racial and ethnic minorities. A recent CDC report showed substantially higher death rates among minority groups; HUD Secretary Carson has been tasked with leading a White House effort to support underserved communities through the crisis. Our analysis here.

Recovery Tools for Affordable Housing Operations
As some housing providers pivot from crisis-management to recovery, HUD has encouraged the use of capacity building tools to safely shift operations. The toolkit offers several key worksheets for use by housing providers moving into the recovery phase.

Ethical Decision-Making Virtual Session
There are still seats remaining in the May 14, 2:00 Eastern, free-to-members Ethical Decision Making Virtual Session. In this session, Michael Gillette will explore the simple and complex ethical decision-making leaders face during the COVID-19 pandemic. Click here for details and to register.

Value First and Information Regarding “Reusable” Gowns
Bobby Bernal, our Value First representative, has new information about reusable gowns now available for order. For details, please reach out to Bobby at (850) 509-8112 or email him at rbernal @valuefirstonline.com.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

In Of Mice and Men, John Steinbeck wrote, "Maybe ever’body in the whole damn world is scared of each other."

Check in questions: Is this what we have become -- a society where we all are scared of each other -- scared of who is infected with COVID-19, who might infect us, and who we might infect? Is this how we want future generations to see us? If not, how are we going to rise above this? How do we stop feeling frustrated, overwhelmed, and defeated? What will you do to stop being scared and start to live again?

By the way, Of Mice and Men was published in 1937.

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

May 6, 2020

COVID-19 Update

Governor Announces Transition to Phase 1 of Easing Restrictions
Governor Roy Cooper yesterday signed Executive Order No. 138 to modify North Carolina’s Stay At Home order and transition to slowly easing certain COVID-19 restrictions effective Friday, May 8 at 5 pm. Click here for a Frequently Asked Questions document on the Order. The Executive Order does not change the following:

• A Stay at Home Order remains in place;
• Mass gatherings are generally limited to no more than ten people
• Teleworking is encouraged;
  
• Social distancing, hand hygiene, and other methods to slow the spread of COVID-19 should be practiced, including staying at least six feet apart;
• Restaurants and bars remain closed for dine-in service and on-premises beverage consumption;
• Personal care and grooming businesses, including barber shops, beauty, hair, nail, and tanning salons, and tattoo parlors, remain closed;
• Entertainment facilities, including movie theaters, bowling alleys, and performance venues, remain closed;
• Fitness facilities such as health clubs and gyms remain closed;
• People may leave their homes to obtain medical services, obtain goods and services, engage in outdoor exercise, take care of others or volunteer;
• Playgrounds remain closed;
  
• Open retail businesses must meet certain requirements to ensure the safety of their employees and customers; and
  
• Visitation continues to be banned at long-term care facilities, except for certain compassionate care situations.
  

Definition of Congregate Care Settings
In Governor Cooper’s initial announcement of the three phases, his press release used the term “congregate care setting.” We will continue to seek clarification on the term and its applicability to our member communities.

Work with NC Department of Insurance
Two updates from our ongoing work with the North Carolina Department of Insurance. First, our announcement that Commissioner Mike Causey had for a second time extended the deadline for disclosure statement filings was in error. He had previously extended the deadline to June 30. His new order simply reaffirmed that the extended deadline remains June 30. Second, we have visited with the department about a potential temporary moratorium on the requirement to hold semi-annual resident meetings because of the Governor’s restrictions on gatherings of more than 10 people. We are awaiting a response from the department.

Dementia and COVID-19: Insights from the Field
In this 13-minute QuickCast, Kirsten Jacobs from LeadingAge national shares ideas and insights garnered from providers and collaborators who are supporting people with dementia amidst COVID-19. This QuickCast is available to for FREE to both members and non-members.

Best Practices for Virtual Board Meetings During COVID-19
With COVID-19, many organizations are holding their first ever “virtual” board meetings. How is your board adapting to the shift to virtual environments in this time of crisis? Join BoardEffect’s Dottie Schindlinger and Human Rights Campaign's Mitch Johnson as they discuss how to navigate the waters of successfully conducting online meetings for your organization’s board – while maintaining good governance. In the webinar, they will discuss best practices for online meetings such as:
• Ensuring transparency and staying legally compliant
• Etiquette for ensuring board member engagement on web- and tele-conferences
• Setting up your equipment and preparing attendees for success
• Easily sharing documents and files to intended users
• Taking accurate minutes during online meetings
• Practical tips for ensuring continuity of your governance functions

Training Slides Posted for CDC NHSN Module and Enrollment Instructions
CDC has posted the training slides for the NHSN COVID-19 reporting module and NHSN enrollment. Slides can be accessed by clicking here.

Letter to Congress
LeadingAge national sent their requests for the next stimulus bill to Congress yesterday. This one is going to take more discussion and time, we think. There are a number of new measures under discussion and in various stages of development. The LeadingAge headlines are:

• A $100 billion allocation specifically for aging and disability service providers to cover additional costs for PPE, cleaning supplies, staffing, and other needs associated with coronavirus.
• A $1.2 billion housing package to provide for rent and staffing supports, Service Coordinators, Wi-Fi capability, and other assistance for the more than 1.1 million older adults served by federally-assisted housing.
• A funding source that specifically provides “hazard pay” for frontline workers;
• Priority access to PPE and testing, without which our residents, clients, and staff continue to be at significant and avoidable risk;
• Uniform reporting of COVID cases and deaths in a way that enables information to be reported once and used for many purposes including public transparency and tracking needs;
• Funding that enables our members to expand their capabilities by becoming extended or step-down entities and clarification that a COVID-19 diagnosis is a skilled need under Medicare;
• Additional funding and some loosening of restrictions on the loan programs that have been set up to support providers as they fight coronavirus and struggle to survive beyond the crisis;
• Compensation for home health telehealth visits and increased access to telehealth and technology across aging settings;
• Grants to support Medicaid HCBS providers and PACE programs, to strengthen care and services in the home for vulnerable older persons and persons with disabilities;
• That Congress charter and fund a post-COVID Bipartisan Congressional Commission to develop a legislative strategy that establishes a planful infrastructure of aging services that is adequately financed, promotes quality of care and quality of life, and enables all Americans to grow old with dignity.
  

Paycheck Protection Program Updates
The Department of Treasury/Small Business Administration issued today a new question in its FAQs, extending the deadline for borrowers’ safe harbor repayment one week, from May 7 to May 14. This gives SBA time to provide additional guidance on how it will review certification. In addition, it gives us a little more time to work out a solution to the problems that have arisen related to SBA loans to affordable housing providers. Treasury/SBA also issued data on PPP Round 2 loans.

Request to HHS for Provider Relief Fund Distributions
Over the weekend, a second letter was sent to HHS Secretary Alex Azar requesting funds for aging services providers from the $175 billion Provider Relief Fund. This letter requests $53.4 billion for providers across the continuum, both those that have already received funds and those to whom HHS committed to distributing funds (for example, Medicaid providers). This letter follows a first request for $34.6 billion on April 4 and LeadingAge national’s April 20 letter seeking clarification of a number of issues and questions regarding the fund and aging services providers. As a reminder, HHS information about the fund is here and LeadingAge’s FAQs document is here.

HUD/CDC Webinar on Cleaning and Disinfecting
Yesterday, HUD and CDC jointly hosted a webinar for limiting the spread of the virus in multifamily housing. A recording will be issued tomorrow and may be helpful for housing site/maintenance staff continuing disinfection protocols. A summary is available here.

Existing Service Coordinator Funds
After several months of delays, HUD Section 2020 housing providers have reported that funds for their existing (CY20) service coordinator grants for HUD Section 202 housing have started to hit accounts. These are separate from the new service coordinator funds from the CARES Act. If you are still seeing delays, please let us know.

CDC Return to Work Guidance Updated
CDC has amended their criteria for healthcare personnel returning to work. The term "non-test-based strategy" was changed to "symptom-based-strategy" for those with symptoms and the "time-based-strategy" for those without symptoms AND the duration of exclusion from work was extended to at least 10 days since symptoms first appeared, as opposed to 7 days.

LeadingAge National Call Features CDC Staff
Join LeadingAge national’s live online coronavirus update this Thursday, May 7, for a discussion of CDC guidance on infection control in long-term care. Dr. Nimalie Stone works in CDC’s Division of healthcare Quality Promotion, leading long-term care infection control guidance and working to align CMS and CDC guidance. Dr. Stone will answer member questions on how to interpret CDC guidance. Register now to join on Thursday, and every weekday.

Coronavirus Spotlight Podcasts
A new podcast series, LeadingAge Coronavirus Spotlights, features presentations by LeadingAge members and subject-matter experts who have been guests on our live daily online updates. Listen to these brief but informative podcasts to learn more about how your colleagues are coping with the pandemic. For the full-length audio of all the daily calls and a list of upcoming guests, visit the Coronavirus Member Updates Archive.

NEW Virtual Sessions are Open for Registration
LeadingAge national is launching new Virtual Sessions, live online presentations with extended Q&A. Space is limited, so register for free today.
• Ethical Dilemmas: Decision-Making in a Pandemic with ethics expert Michael Gillette, May 14 at 2:00 p.m. ET
• Leadership Resilience: Moving Through Adversity, with leadership consultant, author, and speaker Joanne Smikle on June 25 at 2:00 p.m. ET.

Post Your Open Jobs on the Aging Services Career Center
Have you posted your open jobs on the LeadingAge Aging Services Career Center? We are partnering with major national employers to connect displaced workers from fields such as dining, retail, and hospitality with available jobs in aging services. Over 500 new jobs have been posted in recent weeks. Add your openings today! Learn more about how to post your jobs for FREE now.

Questions? Ask LeadingAge National, Your State Association, or Each Other
There are many ways to get help during this crisis. Contact LeadingAge’s national team directly or email us at covid@leadingage.org. If you have questions about local and state issues, contact LeadingAge NC.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

“You have brains in your head. You have feet in your shoes. You can steer yourself any direction you choose. You're on your own. And you know what you know. And YOU are the one who'll decide where to go,” wrote Dr. Seuss in Oh, The Places You’ll Go.

Check in questions: You are in charge of your life, your dreams, your goals, your destiny. You build your skills; you define your talents. This organization and the residents for whom you care rely on you. What is the next step in your professional growth? When are you going to take that step? What additional skills, training, or resources do you need?

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

April 29, 2020

COVID-19 Update

General Assembly Work Begins; LeadingAge NC Advocates for CCRCs in Immunity Bill
The North Carolina General Assembly’s short session began yesterday and LeadingAge North Carolina successfully worked to include CCRCs in the first piece of legislation passed by the House Health Committee. In the portion of the bill that states that it “is the purpose of this section to promote the public health, safety and welfare of all citizens by broadly protecting the health care facilities and health care providers in this State from liability that may result from treatment of individuals during the COVID-19 public health emergency under conditions resulting from circumstances associated with the COVID-19 public health emergency," your association fought to include a reference to the Department of Insurance statute (Chapter 58, Article 64) in the definition of “healthcare facility” contained in the bill. We’ve made sure similar language is present in the Senate version of the bill. We also made sure that the bill included language that broadened the definition to ensure CNAs, in particular, and other individuals who are authorized by law to provide “health care services,” are included. While the immunity bill has a long way to go, we’ll be there every step of the way for our members.

State Posts Listing of Facilities with COVID-19 Outbreaks
The North Carolina Division of Health and Human Services is now posting a weekly listing of skilled nursing facilities with an outbreak of COVID-19 cases. The state considers an outbreak to be two or more positive cases. The listing can accessed by clicking here.

DHSR Issues Guidance on Temporary Nurse Aide Waivers
Mark Payne, Director of the NC Division of Health Regulation, sent a memorandum to all nursing home administrators on Monday temporarily waiving certain regulatory requirements so they do not present barriers for facilities to hire staff to provide temporary nurse aide services during of the Declaration of the State of Emergency.

National Healthcare Safety Network LTC Component Activated
Last night, CDC released theNational Healthcare Safety Network (NHSN) LTC Facility Component, noting that the module is activated.The announcement also includes links to webinars on the module and on how to enroll in NHSN. LeadingAge national will be providing more analysis later today (and we’ll pass that along), but we do know that CMS has not yet issued the regulation that we expect will require providers to report positive cases through the NHSN.National has heard through the grapevine that the 12-hour notification requirement may not be in the rule after all, but we won’t know this until we see the rule. The 72-hour requirement for reporting an outbreak is still likely to be in the rule, according to the source. Of course, our advocacy continues with HHS/CMS and Congress to either rescind this requirement or develop a reporting system that involves only ONE report from providers (not one to the health department and another to CDC).

CDC Issues New/Updated COVID-19 Resources
CDC sent a communication yesterday to LeadingAge national about new federal resources for frontline staff.The CDC resources include webinars published on the “Key Strategies to Prepare for COVID-19 in Long-term Care Facilities (LTCFs)”web pageat the bottom under a “Webinar Series” section. CDC reports that “these new webinars are intended to be a training tool/resource for frontline long-term care staff members.”

Here are the direct links to each webinar:

• Sparkling Surfaces-https://youtu.be/t7OH8ORr5Ig
• Clean Hands -https://youtu.be/xmYMUly7qiE
• Closely Monitor Residents -https://youtu.be/1ZbT1Njv6xA
• Keep COVID-19 Out!https://youtu.be/7srwrF9MGdw
• PPE Lessons -https://youtu.be/YYTATw9yav4

Also, CDC updated three additional resources:

• Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings:https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
• Additional Guidance for Nursing Homes and Long-Term Care Settings:https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html
• Preparedness Checklist for Nursing Homes and Other Long-Term Care Settings:https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care-checklist.html
  
  

CMS Requires Medicare Advantage to Cover More Items
CMS issued an amendedmemorandumto MA plans last week expanding the list of services they must cover, which include coverage for COVID-19 testing, and Medicare Part A & B services provided by non-contracted providers. CMS also outlined a number of additional flexibilities that were giving plans including allowing more than a 14-day supply of Part D drugs to be dispensed to long term care facilities. This article from LeadingAge national provides more information.

More Information About CMS’s Most Recent Regulatory Memo
As we indicated in Monday’s LeadingAge North Carolina COVID-19 Update, CMS released amemo and new FAQ documenton April 24, addressing a number of questions collected over the past several weeks. Some new information is available, though this FAQ document we promised may help providers in decision-making. CMS states that the information in this document should be used to make decisions based on:

1. The needs of the resident,
2. Actions needed to prevent transmission of COVID-19, and
3. The circumstances of each situation.

LeadingAge national recommends that nursing homes utilize this framework in decision-making and be able to provide information for each of these considerations in justifying decisions. Many questions remain, but information available at this time is below. The LeadingAgefull update can be viewed here,and contains more information on the following items:

• Five Star Quality Rating System on Nursing Home Compare
• Release of PBJ Data
• Admissions from Hospitals
• Staying Connected
• Visiting Healthcare Workers and Essential Personnel
• Off-Site Appointments
• Cohorting
• Communal Dining
  

Heroism is Taking Place at Nursing Homes, Too
A special thanks to Acts Retirement-Life Communities’ Jefferson Kaighn for sending along this Newsday article that reminds us of the heroes we work with every day.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

“Nowadays people know the price of everything and the value of nothing,” Oscar Wilde wrote inIn the Picture of Dorian Gray.

Check in question: The work we do is measured and detailed in incremental pieces for the sake of putting a price on it for our rate of reimbursement. The work we do, however, is so much greater than the sum total of a multitude of incremental pieces. In your opinion, what is the value of the work we do?

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 hereto view the entire page.Click hereto 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. In addition, LeadingAge national keeps theirCOVID-19 resource page updated. Be sure to bookmark these pages today.

April 27, 2020

COVID-19 Update

State Begins Posting Names of Facilities with Positive Cases
This morning, we received this message from Mark Payne, Director for the North Carolina Division of Health Service Regulation:
In order to standardize reporting regarding COVID-19 outbreaks in congregate living settings, beginning on Monday, April 27th, the NC Department of Health and Human Services will post a weekly report on COVID-19 cases associated with outbreaks in congregate living settings that will include the names of facilities where there are positive casesas well as the number of positive COVID-19 cases at the facility (this will include staff also).As this pandemic continues to evolve, we continually reassess the appropriateness of data reporting to balance transparency, public health and individual privacy.

The state defines an outbreak in a congregate living setting as two or more positive cases. We will provide more information from the Division as it becomes available.

LeadingAge National Continues with Daily Calls, Moving to Weekdays Only
LeadingAge national is continuing with their terrifically helpful daily COVID-19 calls. They will continue to hold them Monday through Friday at 3:30 pm through the month of May. To register for the daily calls, click here.Members only have to register one time and they will be registered for the 3:30 call every weekday through May.

Value First Finds Disposable Gowns Supplier
Value First has been looking for viable suppliers that can meet member PPE needs and believes they have found a good option for disposable gowns. Over the last 3 weeks, Jostens has converted their manufacturing facilities in South Carolina and Mexico from producing graduation gowns to healthcare gowns. The spec sheet can be found by clicking here and some details are provided below:

• Level I disposable gown made of SMS, which is a material similar to Tyvek and is water repellent but has not been subjected to FDA testing to qualify as Level 2/3
  
• Minimum order is 1 case; 75 gowns are in each case
  XL is the only size available, this was done to maximize production capacity
  
• Cost is $4.45 per gown and can be lower based on order quantity.
  Supply is available and ready to ship depending on volume; a LeadingAge member placed an order on 4/23 and the product shipped on 4/24.
  
• Payment terms are net 30 days or via credit card
  
• This is an offering direct from Jostens; Value First is not receiving compensation of any kind from Jostens. Members are working directly with the manufacturer.

The price is higher than we all are accustomed to paying, however, raw material costs are extremely high and there is value in working with a well-known domestic company that can deliver product almost immediately with standard payment terms. If you are interested in placing an order, the contact at Jostens is Duke Walker and his contact information is included spec sheet referred to above. Jostens will require the following information when you place an order:

• Tax exempt certificate (if applicable)
• Ship to and Bill to addresses, purchasing point of contact (Name, phone number, email address)
• They will also accept a credit card or you can submit a purchase order

New COVID-19 Cost Impact Tool (free to LeadingAge NC members) Now Available from Platinum Member Marsh & McLennan
Marsh & McLennan has just released their COVID 19 Cost Impact Tool.Essentially this model allows communities to project what the virus will do to the cost of their health plan taking into account specific benefit coverage, location, organization demographics, along with any layoff/furlough plans. The model is customized to each organization.As a LeadingAge NC Platinum business partner, they are making the analysis available at no cost to any Leading Age NC community that would like to have it. This would include a brief consultation to review the results and talk through any variables. For more information, reach out to wes.bartlett@marshmma.com or, for Marsh & McLennan resources related to COVID-19, click here.

Link to CMS FAQs
While the new FAQs from CMS don’t offer much in the way of new information, we will post an article soon.Here’s the CMS posting.

CMS Suspends Advance Payment Program
CMS released anannouncementthat it will suspend the Medicare Advance Payment program and provided an accompanying fact sheet. The rationale appears to be that there are significant funds available through the provider relief fund.Unlike Advance payments, Provider Relief Funds do not need to be paid back. Here’s the relevant summary, cut and pasted:

Beginning on April 26, 2020 CMS will not be accepting any new applications for the Advance Payment Program, and CMS will be reevaluating all pending and new applications for Accelerated Payments in light of historical direct payments made available through HHS’s Provider Relief Fund. Significant additional funding will continue to be available to hospitals and other healthcare providers through other programs.

New Information Posted on the HHS CARES Act Provider Relief Fund Website
The Department of Health and Human Services added a new post that now includes aGeneral Distribution FAQ, which provides more clarity on what providers need to do if they have received funds under the general distributions to Medicare providers. LeadingAge is still reviewing and will post an article with the new information and update the Provider Relief Background, Considerations and FAQ document.

The new FAQ document discusses attestations, and the specific financial information providers who have received funds must provide in order to retain dollars. Interestingly, by submitting this information, these providers could be eligible to receive additional funds beyond those payments already received. While there is no new information on the status of distributing funds to Medicaid-only providers, it does state that just because a provider has not yet received a payment does not mean they are ineligible or won’t receive a payment. “HHS is performing an ongoing assessment of how to distribute relief to these providers.”

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

In the book,Shatter Me, Tahereh Mafi writes, “Sometimes weak and wan, sometimes strong and full of light. The moon understands what it means to be human.”

Check in question: In this incredibly difficult time, as a team, we are strong and full of light – for each other, for the residents we serve, and for our community. How can we better spread our good news, our successes, our triumphs, and our joys throughout the community?

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 hereto view the entire page.Click hereto 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. In addition, LeadingAge national keeps theirCOVID-19 resource page updated. Be sure to bookmark these pages today.

April 24, 2020

COVID-19 Update

Next LeadingAge NC COVID-19 Call-In to Feature Womble Bond’s David Broughton
Our next LeadingAge NC “COVID-19 Call-In,” scheduled for Monday, April 27 at 2 pm, will feature Womble Bond Dickinson’s David Broughton. Please mark your calendars for this opportunity to hear from David and ask questions of him and your colleagues around the state. To participate, dial (201) 616-0673 and enter the passcode of 841692.

Governor Releases Three-Phase Plan, Extends Stay at Home Order Through May 8
Governor Roy Cooper yesterday issued Executive Order No. 135extendingNorth Carolina’s Stay at Home order through May 8. The orders extending closure of restaurants for dine-in service and bars and closure of other close-contact businesses are also extended through May 8. Governor Cooper shared details about North Carolina’s plan to lift restrictions in three phases once the data show that key metrics are headed in the right direction.Click for more information about the plan to lift restrictions, include specifics about Phase 1, Phase 2, and Phase 3.

Cooper also said that the state will continue building capacity to be able to adequately respond to an increase in virus spread.These include an increase in laboratory testing(currently, North Carolina is testing approximately 2,500 to 3,000 people per day and is working to increase to at least 5,000 to 7,000 per day, an increase intracing capability (currently, North Carolina has approximately 250 people doing contact tracing across its local health departments and is working to double this workforce to 500, and availability of personal protective equipment(the state is working to ensure there are adequate supplies to fulfill requests for critical PPE for at least 30 days.This includes face shields, gloves, gowns, N95 masks, and surgical and procedural masks. Currently the state has less than 30 days’ supply of gowns and N95 masks.

President Expected to Sign New Relief Package Today
The House of Representatives overwhelmingly (and laboriously) passed the next relief package, a $484 billion package to deliver emergency aid to small businesses and hospitals. Approved by a vote of 388-5, it includes $384 billion more for the Paycheck Protection Program (small business loans), $75 billion in emergency relief for hospitals (we have to believe that like the earlier funds it will go beyond hospitals), and $20 billion to ramp up testing. We’ll be providing more details as they become available.

LeadingAge North Carolina Members Encouraged to Reach Out to Local Media to Share Your Efforts in Fighting COVID-19
We are seeing more nursing homes and assisted living facilities across the state come under public scrutiny as the coronavirus spreads throughout your communities and threatens exposure to your staff and residents.Many stories are focusing on the hospitals’ role in preventing spread of the disease, but very little is known about the measures long-term care providers are taking to protect their staff and residents and keep them safe and healthy.

Below are some talking points prepared by LeadingAge national that may guide you through questions you may receive from your local media. We would encourage you as well, to be proactive in your media contacts through a letter to the editor or a feature story to share within your communities about your efforts and contributions in the fight against COVID-19.

Talking Points: Responding to Negative Views on Aging Services in Pandemic
LeadingAge members are likely receiving a surge of media interest as a result of the COVID-19 pandemic. While many reporter queries stem from a negative event (COVID-19 diagnosis, outbreak, or death), the upside of this unquestionably challenging time is a sustained opportunity to engage with reporters and develop relationships that may be useful even after coronavirus passes.

For most media outlets, aging services is not a primary beat, and it is rare to find reporters with a solid understanding of our field. So when a media call comes in, your role is to be not only a source, but also an educator. Take a few minutes to ask some questions before you work on your response: engage in a broader conversation so you can better understand the reporter's perspective. Then strategize a response that offers the right context.

You can’t avoid the tough questions. But you can—and should—provide grounding and context that frames the realities of your organization and our field. Here’s how LeadingAge is Driving the Coronavirus Conversation and how we’re Responding to Negative Views on Aging Services During the Pandemic.The talking points below can help you in your efforts. We encourage you to pull elements from them as you develop your responses.

Message Points

• We’re on the front line of the coronavirus pandemic.The COVID-19 is a previously unidentified virus, which means care providers of all types—including those working at organizations like ours where older adults receive care—are learning about it in real time. And, because public health officials have identified older people as high risk of getting very sick from COVID-19, we are on the front line. Every day we do our part to aggressively prevent and mitigate the spread as we deliver compassionate care under challenging circumstances.
  
• The pandemic highlights that organizations like ours are a vital component of our public health system.Nursing homes, home health, visiting nurses, and other providers of aging services have long played a valuable role in how Americans receive the care they need. For example, organizations like mine collaborate with many other care providers like<insert touchpoints with the larger health care system i.e.: transitions from hospital, in-home care, interaction with doctors, end-of-life care, etc.>. As the virus spreads, our role in the public health system is magnified—and should be prioritized.
• Aging services providers like my organization have distinct and urgent needs in this pandemic.Without PPE and testing, we cannot safely orchestrate patient transitions, take care of new or current residents, or protect staff. While we understand these needs are vital in an inpatient setting, there is a major push now to move patients out of hospitals to nursing homes or to home and community-based settings. The lack of resources for aging services is an additional challenge in a health crisis unlike any we’ve seen before.
• The coronavirus pandemic exacerbates the well-documented, longstanding workforce shortage in aging services.This healthcare crisis increases our workforce needs. For instance, we need more staff to care for sicker residents, to adhere to regulatory requirements that ban communal meals and mandate enhanced infection control procedures, and to cover open shifts for sick staff or those who can’t report to work. These strains compound an already challenging workforce environment.
• Our business is complex.We don’t have a simple operating structure like, for example, a corner store or neighborhood restaurant. We have multiple sources of revenue, from reimbursements and government funding to private pay, and are working under a range of guidelines and regulations. Rising costs of caring for a full load of patients with a changing case-mix, buying extra PPE and other supplies, losing staff and paying overtime—coupled with decreased revenues—are already causing shortfalls for organizations in aging services.
• We are a mission-driven organization with deep roots in our community.The services we provide are fundamental to the lives of the people we serve, their families, and our community. We are driven by a higher moral purpose to serve this population in accordance with our mission. We care deeply about the role we play to provide much-needed care, services and supports in people’s lives. <Insert info on your community roots, board of directors, or foundation, as relevant.>
  

Action Challenge:
So let's challenge ourselves.How many of our member organizations can convince the media to cover a positive development or publish a letter to the editor in support of the those who live and work in a long-term care or senior housing setting?YOU can make that happen. As you succeed in doing so, please share your stories, letters and clips with us so we in turn can share them on our social media pages and our near-nightly communications with you. Come on...we've have so much to say and share!

FEMA Releases Best Practices for PPE Preservation
FEMA has released an informative fact sheet related to best practices for preserving personal protective equipment.

Crisis Counseling and Emotional Support Hotline
The National Disaster Distress Helpline at 1-800-985-5990 is offering crisis counseling and emotional support 24/7 during the COVID-19 outbreak.

CAST Updates Social Connectedness and Engagement Technology Tool
LeadingAge CAST updated its Social Connectedness and Engagement Technology Tool. The new tool includes a Product Matrix and Online Selection Tool for 45 products, including three new products, as well as six new case studies.

New NextStep Temp Nurse Aide Training
NextStep just pushed the 16-hour National Temp Nurse Aide Course live! It is totally FREE for enrollment now through May 8 with code HERO2020. It is for employers who want to re-skill incumbent workers (e.g. housekeeping, dietary) for direct care and for job seekers. The course is aimed at employers who want to re-skill the incumbent workforce (e.g., housekeeping, dietary) for direct care and job seekers.

CDC Clarifies Elements of Forthcoming Nursing Home Reporting Requirements
As previously reported, CMS previewed new COVID-19 reporting requirements for nursing homes on April 19. These new requirements are pending rulemaking that is forthcoming. While little information is available from CMS ahead of the rulemaking, a recent call with CDC shed some light on the reporting mechanism.

COVID-19 and Affordable Housing Providers: Recap of Key HUD Guidance
As the health emergency continues, affordable senior housing providers have questions about how best to serve residents and continue operations. Keeping in mind that COVID-19 guidance is updated frequented by HUD, LeadingAge put together a summary of existing federal guidance available in response to common questions from mid-April.

Meeting with Vice President Pence and Secretary Carson
On yesterday’s Housing and Urban Development call with Vice President Mike Pence, HUD Secretary Ben Carson, and FHA Commissioner Montgomery, Carson said he hopes one takeaway from this crisis will be we must do better by seniors; and, Commissioner Montgomery thanked LeadingAge for its advocacy.

Managing Your Team Through a Crisis
This informative webinar, offered by WittKieffer, will be held on Wednesday, April 29, from 1-2 pm. Click here for more information and to register.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s short tool:

FromThe Adventures of Winnie the Poohby A. A. Milne:
“‘What day is it?’ asked Winnie the Pooh.
‘It’s today,’ squeaked Piglet.
‘My favorite day,’ said Pooh.”
Check in question: Why is today going to be your favorite day?

COVID-19 Information Pages
In addition to these email updates, LeadingAge North Carolina is updating our COVID-19 resource page regularly with information from trusted sources, including from our business members.Click hereto view the entire page.Click hereto 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. In addition, LeadingAge national keeps theirCOVID-19 resource page updated. Be sure to bookmark these pages today.

April 22, 2020

COVID-19 Update

CMS Announces New COVID-19 Reporting Requirements for Nursing Homes
CMS announced in an April 19 Quality, Safety & Oversight memo (QSO-2026-NH) that nursing homes will soon be subject to two new reporting requirements – submitting communicable disease data to the Centers for Disease Control and Prevention (CDC) and providing COVID-related notifications to residents and resident representatives.
This announcement applies specifically to nursing homes and does not extend to assisted living. Please note that these requirements are not yet in place. CMS has not released all the details, and it has not identified the effective date when this reporting must begin, but this is what we know today:

Data Reporting to CDC

• All nursing homes will report data directly to CDC about residents or staff with suspected or confirmed COVID-19, residents with severe respiratory infection resulting in hospitalization or death, or ≥ 3 residents or staff with new-onset respiratory symptoms within 72 hours of each other.
• These CDC reports will be in addition to, and will not replace, infectious disease reports nursing homes already submit to local health departments. Unfortunately, this will result in duplication of effort.
• CMS and CDC will provide nursing homes with specific direction on standard formatting and frequency for reporting this information through the CDC’s National Health Safety Network (NHSN) system, which is a healthcare-associated infection tracking system widely used by hospitals and by some long-term care facilities.
• We do not know what specific data elements CDC will define or what data submission mechanism CDC will establish. Enrolling with NHSN has been a cumbersome process, historically, and we are hopeful CDC will develop a streamlined process.
• CDC may perform on-site infectious disease surveillance, testing of healthcare personnel and residents, or other related activities, and CMS will expect facilities to cooperate with these efforts.
  

Resident and Resident Representative Reporting
CMS will also require nursing homes to provide COVID-related information to residents and resident representatives. CMS will finalize specific requirements through an expedited rulemaking process, but they have not yet published that information, so there is a lot we don’t know. However, the CMS memo signals that nursing homes will be expected to do the following:

• Notify residents and representatives within 12 hours of the occurrence of a single confirmed infection of COVID-19, or the new-onset of respiratory symptoms among three or more residents or staff within 72 hours of each other.
• Provide updates weekly, or each subsequent time a confirmed infection of COVID-19 is identified and/or whenever new onset of respiratory symptoms occurs for three or more residents or staff within 72 hours.
• Include information on mitigating actions implemented to prevent or reduce the risk of transmission, including if normal operations in the nursing home will be altered.
  

Next Steps
LeadingAge North Carolina and the LeadingAge national team are working to obtain additional information from CMS, and we will report those details as soon as we have them.
As thisLeadingAge media releaseemphasizes, we are hopeful the reporting burden will be minimized, and that additional data will further inspire federal officials to prioritize allocation of PPE and testing supplies aging services provider settings, where it is desperately needed. We andLeadingAge national areadvocating strongly on your behalf and will share more news on our request to CMS this week.Please reach out by email if you have any questions about these new reporting expectations, and we will add them to a frequently-asked-questions resource for members.

Senate Passes the Paycheck Protection Program and Health Care Enhancement Act
Around 6 pm last night, the Senate passed the bill authorizing new funding for key programs that are important for LeadingAge North Carolina members engaged in fighting COVID. The Senate measure includes $300 billion more for the SBA Paycheck Protection Program which ran out of money last week; more than $50 billion for other SBA emergency loans; $75 billion more for the fund we call the Provider Relief Fund; and $25 billion for testing, with federal, state and local obligations to identify how they will implement testing. The House is expected to return on Thursday to pass the bill.

Advocacy on CDC Reporting Requirement
We are advocating on several fronts to eliminate or significantly change the nursing home CDC reporting requirements that were released on Sunday evening and referenced earlier in this update. LeadingAge national is meeting today with CDC officials and with CMS. LeadingAge national sent thisletterto HHS Secretary Alex Azar and CMS Administrator Seema Verma last night, urging that they rescind the requirement because it is duplicative and will increase consumer confusion and nursing home staff burden. They suggested one standardized reporting form for universal reporting to states, localities, federal agencies and the public. National is finalizing a legislative request that will be added to our “4th” stimulus bill requests.

COVID 19 Stimulus Bill Facility Eligibility Calculator
This tool (in concert with LeadingAge Wisconsin) was developed to help providers know what funding is available to them through the two Federal COVID 19 Bills that have been signed into law through April 16th, 2020, the Families First COVID Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES). The tool allows members to enter facility specific information that will alert organizations to their potential eligibility for certain programs based on their inputs, as well as provide estimates on funds received if calculations are known. Here’s how to use the tool and interpret your results by section.

Inputs
Providers should enter information in the boxes based on 2019 data. All data entered should be numeric except for “Entity Type” and “Do you have an existing SBA loan?” which use drop down menus.

Potentially Eligible Programs
This section has columns for “Funding Program”, “Eligible?”, “Possible Amount”, “Type”, and “For more information.”

“Funding Program” states what the individual funding program is.

“Eligible?” returns a result of “potentially” or “not likely” based on user inputs.

“Possible Amount” returns of value of the possible amount that could be received based on user inputs. For programs that do not have readily calculable amounts, footnotes are provided for more information.

“Type” identifies if the program is a Grant, Advance Payment, Loan, Payment Deferral, Debt Forgiveness, Expense Repayment, or Increased Income.

“For more information” provides links to websites where users can find more information on the individual programs to investigate further based on the results of the calculator.

Provider Relief Fund letter to HHS
Aletter to HHS Secretary Alex Azar outlining our questions about the Provider Relief Fund was sent yesterday. Our questions are mostly seeking assurances about the first tranche of funds that was paid out on April 10 to providers who billed Medicare fee for service. We want to verify whether providers who accept funds but do not have a confirmed COVID-19 patient can keep the funds. We also seek guidance on qualifying expenses and losses and on the type of reporting and documentation HHS will require. Providers who do wish to return the funds need instructions on how to do that. The letter also urges the release of the next tranche from the remaining $70 billion. Next up, probably tomorrow, we’ll finish the list of considerations for providers before signing the terms and conditions.

Clarification on Hospice Telehealth
CMS confirmed yesterday on the hospice stakeholder call that the initial and comprehensive assessment for hospice can be done through telehealth, noting that it’s still critical to be able to assess the patient to get all the data needed. LeadingAge national documented this in an article last week.

Potential Partners for Affordable Housing Providers
This article is about new funds available under the Older Americans Act and the Community Development Block Grant program. Both programs could potentially support services for affordable housing providers.

LeadingAge National Day of Action
Today, April 22nd, would have been our LeadingAge Lobby Day on Capitol Hill. While we will not be meeting face to face with congressional offices, we will use this opportunity to encourage members nationwide to take part in a National Day Of Action and help support our key legislative asks with Congress. We will be asking Congress for the requests that were in this week’s alert, which can be found here:https://mobilize4change.org/Nk3Mm5K.

New QuickCast on Resiliencyon the LeadingAge National Hub
In this 12-minute QuickCast, Wayne Scott, shares strategies for coping with toxic stresses by taking stock in the things that make individuals strong and resilient. QuickCasts are free for LeadingAge members. Questions? EmailMeetings@LeadingAge.org.

New Source for Masks
Tiffany Roberson with Presbyterian Homes, Inc. shared with us that Wells Hosiery offers a face mask that is two ply tightly woven cotton, anti-microbial and water/ moisture repellent.They have ear loops that are comfortable and adjustable and do not have rubber/ elastic. Masks are washable. Contact Rodney Debusk, or at (336) 465-0546.

Food Bank Information Now Available
If you are able, donate food to support those who may be struggling due to the COVID-19 crisis. Find a food bank near you: feedingthecarolinas.org

Free-and-Reduced Lunch Program Unveiled
This new program will help families with children who receive free-and-reduced lunch purchase food while school is out. Learn more atbit.ly/34UT7av

NCDHHS Website Information
If you're getting info on COVID-19 from social media, make sure it's straight from reliable sources. Follow NCDHHS for the latest: bit.ly/2VNDWM4

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today's tool:

“I don’t understand it any more than you do, but one thing I’ve learned is that you don’t have to understand things for them to be,”wrote Madeleine L’Engle inA Wrinkle in Time.

Check in question: We don’t understand this pandemic. Nobody does. Yet, it is. While we don’t understand it, together, we will get through it. What are you doing to take care of yourself so that you can get through the struggles and challenges of the day? How can we take better care of each other?

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

April 20, 2020

COVID-19 Update

By the Numbers
As of 10:35 am this morning, North Carolina has had 6,764 positive COVID-19 cases in 93 counties, with 179 deaths. 79,484 North Carolinians have been tested since the pandemic started. 905 of state’s positive cases have been in skilled nursing facilities with 53 deaths. 37 nursing homes have had “outbreaks” (defined as two or more positive cases) in 25 counties. Congress and Administration Look at Additional Funds for Paycheck Protection Program

Engagement with StoryCorps Connect
LeadingAge is partnering with StoryCorps to share a new way for you to engage your residents and clients—even during the pandemic. StoryCorps Connect encourages older people to share their life stories through intergenerational discussions. Families and friends can record an interview with a loved one remotely with video conference technology. “We hope StoryCorps Connect will provide a source of connection, comfort, and meaning for elders across America,” said Dave Isay, founder and CEO of StoryCorps. Help the older people you care for strengthen bonds with their loved ones. Their stories will be preserved for future generations at the Library of Congress.Learn more about StoryCorps Connect.

COVID-19 Learning Tool Is $5 for Two Weeks
NextStep’s informal COVID-Ready Caregiver online course is designed to improve the safety of caregivers of all kinds working with COVID-19 patients in all settings. Through May 2, staff at LeadingAge members can use codeLEADINGAGE5at check-out to access the program for just $5.

Recognize Our Field with Careers In Aging Week
It’s Careers in Aging Week, and we need it this year more than ever. We are marking the week by encouraging workers to join our ranks and apply for your open positions on LeadingAge Aging Services Career Center(promotional materials and instructions for posting your jobs for free are available now). Join the much-needed recognition of our field usingthis easy toolkitof ideas and sample social media posts.

New Insights and Tools From LeadingAge
LeadingAge staff experts are developing essential guidance and tools, and curating the most relevant resources for aging services providers.

• New Guidance for Healthcare Facility Mortgage Relief(REVISED)
  
• HUD Provides Guidance on Stimulus Checks; IRS Changes Plan for SSI Recipients
  
• Summary of HUD’s April 17 Recording
  
• FCC's Telehealth COVID-19 Funds
  
• Provider Relief Fund Resources and Attestation Portal Launched
  
• IRS Provides Short-Term, Limited Housing Credit Relief
  

A completetimeline of insights, tools, and useful links is available here, so you’ll never miss an update.

Practical Tools for Staff Conversations
In The Secret, Rhonda Byrne wrote, “There is a truth deep down inside of you that has been waiting for you to discover it, and that truth is this: You deserve all good things life has to offer.”

Check in question: What is a truth about you that you have discovered during this pandemic? What have you learned about the value and worth of the work you do?

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

April 17, 2020

COVID-19 Update

LeadingAge North Carolina COVID-19 Call-In Set for
Monday at 2 pm
Don’t forget to mark your calendars for Monday, April 20 at 2 pm for our weekly COVID-19 call-in. It’s your chance to share what you’re learning, seeing, and hearing with your peers around the state…and ask questions you may have. To access the call, please dial (201) 616-0675 and, when prompted, enter the passcode of 841692.

CNA Training Update from North Carolina Department of Health Service Regulation
We have received clarification from DHSR regarding the waiver below. While the waiver is in effect, skilled nursing communities can employ people not currently certified as a nursing assistant, as long as there is documentation that an RN has verified their competency prior to working.There is an 8-hour course from ACHA that is an option for the communities to help bridge the knowledge gap but does not replace the competency verification by an RN.

From CMS:
Training and Certification of Nurse Aids: CMS is waiving the requirements at 42 CFR §483.35(d), (except for 42 CFR §483.35(d)(1)(i)), which require that a SNF and NF may not employ anyone for longer than four months unless they met the training and certification requirements under §483.35(d). CMS is waiving these requirements to assist in potential staffing shortages seen with the COVID-19 pandemic. To ensure the health and safety of nursing home residents, CMS is not waiving §483.35(d)(1)(i), which requires facilities to not use any individual working as a nurse aide for more than four months, on a full-time basis, unless that individual is competent to provide nursing and nursing related services. We further note that we are not waiving §483.35(c), which requires facilities to ensure that nurse aides are able to demonstrate competency in skills and techniques necessary to care for residents’ needs, as identified through resident assessments, and described in the plan of care. Achieving adequate staffing levels may be a concern for SNFs and NFs during the public health emergency. CMS is temporarily waiving these requirements so they do not present barriers for SNFs and NFs to hire staff; the temporary waiver will help these facilities provide adequate levels of staffing for the duration of the COVID-19 pandemic.

Once the CMS waiver is no longer in effect then the temporary nurse aides will have to complete an official DHSR-approved training course and take the DHSR-approved competency exam and be listed on the NC nurse aide registry before they can continue to work as a nurse aide.

CDC Implements “Universal Source Control” Guidance
This week, the CDC released newCDC Interim Infection Prevention and Control Recommendationsfor Patients with Suspected or Confirmed Positive Diagnoses. The update includes the implementation of “universal source control” for everyone entering a health care facility. CDC guidance is asking that everyone wear a cloth face covering or a face mask including visitors and patients when in the facility. They also stated that cloth masks are not considered PPE and reiterated that surgical masks, if available, should be reserved for health care personnel.The memo also reads that everyone must be actively screened for fever and other symptoms prior to entering the healthcare facility.Finally, the guidance indicates that health care settings can forego contact tracing for exposures if they use universal source control and screening for fever and symptoms.

Seema Verma of CMS Provides Updates on Reporting
On an on-the-record call with the media yesterday, CMS Administrator, Seema Verma said that nursing homes would be required to report “real time information about outbreaks” to CDC.“We think it’s important for patients and employees to have as much information as possible about what’s going on in the nursing homes. We recognize there should be more reporting than to local health departments. You’ll be seeing some more information from us at the end of this week on that,” said Verma. (NOTE:CMS has not yet released anything about reporting.)

Video on National Healthcare Decision Day
Here is alink to a video featuring Dr. Eric Bush, Chief Medical Officer for LeadingAge member Hospice of the Chesapeake. In the video, Dr. Bush talks about National Healthcare Decision Day and why, in these uncertain times, it’s more important than ever to have a plan regarding healthcare decisions.

Today Is the Last Day to Reserve “Seats” for Free Coronavirus Training and Certification
Today is the deadline to secure free coronavirus training for current or potential future employees through NextStep. You may “purchase” (for free with the discount code) the “seats” now and access the training later (with no stated deadline for accessing/completing the training). To learn more and register, clickhereand then click on Employers - Get Seats. Remember to enter the discount code -COVIDCERTNOW- at checkout to secure your free seats.

Explainer on Hospice and Telehealth
This article on Hospice, Hospice Partners, and Telehealth in the Time of COVID-19 reviews the frequently asked questions about telehealth and offers strategies for working with other providers who serve residents needing hospice services.

Provider Relief Fund Payment Resources and New Attestation Portal Launched
Yesterday, Health and Human Services announced that itsProvider Relief Fund Attestation Portalis open. Providers who received payments from the $100 billion fund, created by the CARES law, must agree to the terms and conditions set by HHS, using the portal. If providers do not want to keep the funds because they think they may be ineligible, they must also enter the portal to inform HHS they will return the money. Providers can still contact HHS about the fund using the emailHOSPITALCOVID19@hhs.gov.

SBA loan funds depleted
LeadingAge national posted this article on the SBA announcementyesterday that the $350 billion authorized for forgivable loan funds under the Paycheck Protection Program are depleted. There is currently debate in Congress about how to appropriate new funding and how to expand the program to cover providers with more than 500 employees. We are preparing an action alert which we will share with you soon.

LeadingAge COVID-19 3:30 call Today
On today’s call, LeadingAge national will talk about advance care planning and testing. We’ll welcome Dr. Danielle Doberman of Johns Hopkins University to talk about advance care planning across all settings, from healthcare to housing to individuals’ own homes.To register for the call, go tohttps://attendee.gotowebinar.com/register/1365743381042881035. Please note: you only have to register one time and will be automatically registered for the 3:30 call every day (7 days a week) through April 26.

Additional North Carolina Resources

• Looking for ways to help during the COVID-19 crisis? If you're eligible to give blood, schedule an appointment to donatetoday:rcblood.org/3bdBchh
• Parents who need food assistance for their children can text FOODNC (or COMIDA) to 877-877 to locate nearby free meal sites.
• If you've recently lost your health insurance, or even if you're trying to buy it for the first time, you have options. Learn more:bit.ly/2XGld7N
  
  

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.

InThe Alchemist, Paulo Coelho says, “It’s the possibility of having a dream come true that makes life interesting.”

Check in question: What is your goal for your life – your dream – and what are you doing today to continue pursuing your dream?

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 hereto view the entire page.Click hereto 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. In addition, LeadingAge national keeps theirCOVID-19 resource page updated. Be sure to bookmark these pages today.

April 15, 2020

COVID-19 Update

Handy Guide to Grants and Loans
Recent federal legislation has provided some additional or accelerated funding that can be accessed by nonprofit service providers impacted by COVID-19. Click here for a handy guide to these grants, loans, and advance funding opportunities

Action Alert- Congress is Developing the Next COVID-19 Relief Package Now-Contact Your Representatives Today for Aging Services Relief!
Congress has the opportunity to provide critical funding and resources for aging services providers throughout the country. Ask your Representatives to support aging services by including these key priorities in the next coronavirus bill:

• $2.2 billion for rent and staffing supports, service coordinators, telehealth capability, and other assistance for the more than 2 million older adults served by federally assisted housing communities financed by HUD, the Rural Housing Service, and the Low-Income Housing Tax Credit program.
• Priority access to PPE and testing, without which our residents, clients, and staff continue to be at significant and avoidable risk.
• A $100 billion separate fund for aging and disability service providers to cover additional costs for PPE, cleaning supplies, staffing, and other needs associated with coronavirus.
• Funding that enables our members to expand their capabilities by becoming extended or step-down entities.
• A 5 percent increase in Medicare reimbursement rates to cover added compensation for staff.
• Compensation for home health telehealth visits.
• Grants to support Medicaid HCBS providers, including PACE programs, to strengthen care and services in the home for vulnerable older persons and persons with disabilities.
• An 8 percent FMAP increase.
  

We need you to act now by emailing and calling your elected officials. Help us ensure Congress includes these needed resources in the next coronavirus legislation. Clickhereto send a message today!

Potential Source for Hand Sanitizer and Face Shields
Bobby Bernal, LeadingAge North Carolina’s Value Representative, notified us that CINTAS has some availability of hand sanitizer and face shields. The minimum order for the hand sanitizer (liquid not foam) is 1 pallet = 11 gallons per pallet = $5,760. They do not need to be delivered all at once. The face shields are 336 per box/case, $4.50 per mask (which includes shipment). One case =$1,512.If you are interested, please contact Bobby at (850) 509-8112 or rbernal@leadingageflorida.org.

Potential Source for Face Masks
Steve Rumbley from Cross Road Retirement Community, notified us of a potential supplier of face masks that are 99% antimicrobial and machine washable. They are provided by Bossong Medical, LLC located in Asheboro. Contact: Chris Yow, Vice President of Sales, cyow@bossonghosiery.com, (336)625-2175 Ext. 230

CMS Issues COVID-19 Transfer Scenarios for LTC Facilities
Yesterday, CMS released regulatory flexibility to long-term care facilities which includes guidance on necessary requirements when considering separating or relocating residents based on COVID-19 status.Blanket waivers were issued for certain CMS requirements, including physical environment and certain transfer and discharge requirements. Along with CMS’ guidance, specific relocation scenarios were attached to help provide clarification on the following: how to transfer residents between certified long-term care facilities as well as non-certified yet state-approved facilities, how resident care responsibilities would be handled, and who obtains Medicare reimbursement during this process. To see the full memo, click here.

Provider Relief Complaints and Feedback for Health and Human Services
We’ve heard mostly positive feedback about the payments from the HHS Provider Relief Fund (aka the $100 billion CARES payments to health care providers, recognizing their added expenditures and lost income). The US Department of Health and Human Services has set up an inbox for questions/complaints/feedback on the program. The email address is: HOSPITALCOVID@hhs.gov.

North Carolina Department of Health and Human Services Releases Online Video Resource
NCDHHS has released resources on managing your overall health and prioritizing your overall wellness during COVID-19. Check out the latest by clicking here.

Medicare Proposed Rule Provides Inflation Adjustment of 2.3%
CMS last week issued a Proposed Rule that provides updates about the SNF PPS rates that will take effect October 1, 2020. CMS will follow up with a final rule on the October 1 rates around August 1.

CARES Act Temporarily Suspends Federal Student Loan Payments and Interest
The federal COVID-19 relief bill known as the CARES Act includes benefits that go beyond payments to individuals and financial assistance to health care providers. One of the lesser known benefits is a temporary suspension of interest accrual and monthly payments on some student loans. Under the CARES Act, no payments will be due and no interest will be charged on federal student loans from March 23 to September 30. Click here for more information.

CMS Nursing Home Stakeholder Call Today
The weekly CMS Nursing Home Stakeholder meeting is today at 4:30pm PM Eastern. Here’s the call-in information:
Wednesday, April 15th from 4:30pm – 5:00pm
Attendee Dial-In:833-614-0820
Conference ID:3770227
Web Link:https://protect2.fireeye.com/url?k=7d3ffbf8-216af2eb-7d3fcac7-0cc47adb5650-85d81913711edd45&u=https://engage.vevent.com/rt/cms2/index.jsp?seid=1888

LeadingAge COVID-19 3:30 Call Today
LeadingAge National will hold their daily 3:30p call. To register for the call, go tohttps://attendee.gotowebinar.com/register/1365743381042881035. Please note: you only have to register one time and will be automatically registered for the 3:30 call every day (7 days a week) through April 26.

HUD Vacancies and Evictions
HUD has added eight pages of guidance to their multifamily housing FAQs, including how to handle vacancies and evictions. A summary is available here.

HUD Forbearance Options
HUD issued three mortgagee letters with forbearance options for all FHA-approved MFH mortgages, and underwriting adjustments for Sections 223(f) and 232 Healthcare facilities. A summary of the flexibilities is available here.

Updated Rural FAQ
Rural Development issued an updated FAQ covering tenant income changes, waitlist management, and more. Check out our summary here:https://leadingage.org/regulation/rural-housing-guidance-tenant-income-changes-wait-list-management

Practical Tools for Staff Conversations
In an effort to help leaders inspire and motivate their teams…

Angela Duckworth, Author of Grit, defines grit as passion and sustained persistence applied toward long-term achievement. She contends the secret to outstanding achievement is not talent, but a passionate persistence.
Check- in question- What are some characteristics of our team that you believe help us sustain grit in our work?

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. 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.

April 13, 2020

COVID-19 Update

LeadingAge NC Annual Conference and Expo Cancelled
At LeadingAge North Carolina, we understand that COVID-19 preparedness means it’s all-hands-on-deck for our Member Communities and our Business Members…including travel bans and social distancing practices. To that end, and in light of the President’s national emergency declaration, LeadingAge North Carolina has made the difficult decision to CANCEL our 2020 Annual Conference and Expo originally scheduled for May 18-21. The Golf Outing has also been cancelled. At the heart of this decision: we cannot in any way risk the health of the aging services staff we support or the elders we serve. While we believe this decision is prudent, we will miss gathering with everyone at the conference. We look forward to the 2021 Annual Conference and Expo to be held May 11-14, 2021 in Wilmington, NC, with particular anticipation.

COVID-19 Confirmed Positives in North Carolina Reach Nearly 5,000
As of yesterday at 10:45 am, the number of laboratory-confirmed COVID-19 cases in North Carolina numbered 4,520…91 of the state’s 100 counties have been impacted. 81 North Carolinians have died as a result of the pandemic. 28 skilled nursing facilities in 21 counties have a confirmed outbreak (2 or more laboratory-confirmed cases) and seven residential care facilities in six counties have an outbreak.

HHS Disburses First $30 Billion in Provider Relief Funds
This past Friday,HHS announcedthat it had deposited the first $30 billion of the $100 billion Provider Relief Fund authorized in the CARES Act. All providers who billed Medicare FFS in 2019 got funding, in line with a formula. HHS said the funds aim to provide relief to providers in heavily affected areas AND providers struggling to keep their doors open due to healthy patients delaying care and cancelled elective services.In the announcement HHS said it would disperse the other $70 billion in a more targeted fashion, including areas more heavily affected by the COVID-19 outbreak, rural providers, Medicaid providers, and those requesting treatment for the uninsured.We anticipate the next tranche in a week to ten days.

New QuickCast in the HUB
Please check out the new LeadingAge National HUB QuickCast,Purposeful Reflection: Leading Through Uncertainty.In this 30-minute QuickCast, Judy Brown and Wendy Green explore six simple but powerful daily questions to help leaders at all levels stay centered and grounded during quarantine.

While you’re in the HUB, here’s a link to the other COVID resources you may have missed.

Fair Housing and Evictions Over COVID-19 Concerns
HUD and fair housing advocates see COVID-19 status as covered by the Fair Housing Act’s prohibition of discrimination based on disability, and HUD cautions strongly against evictions over concerns a COVID-19 positive tenant is a threat to others’ health. Here’sa LeadingAge article on the topic. The article references and links a HUD statement and a release from the National Fair Housing Alliance.

COVID and Large Medicare Advantage Plans
Here’s an analysis of policies of the large Medicare Advantage plans related to COVID-19.

Additional 1135 Waivers Released
As promised, thecharts on HHS blanket waivers for SNFshave been updated on the LeadingAge national Resources page. For SNFs, physician assessments may be delegated to NPs, PAs or clinical nurse specialists.

New PACE Guidance
CMS issued anew document applicable to PACE organizations, allowing them to submit updates on participant diagnoses for risk adjustment payment purposes via telehealth, rather than in person, visits. Notably, it limits this extension to Telehealth to audio and video, not telephone only. LeadingAge national is submitting a follow up to CMS to see why that is, since they otherwise are allowing telephone-only contact.

Letter to NACCRA
LeadingAge national CEO, Katie Sloan, sent aletter to NaCCRAto share our resources, extend support, and let them know they are in good hands with LeadingAge and our member communities.

Practical Tools for Staff Conversations
In an effort to help leaders inspire and motivate their teams…

Elizabeth Gilbert in Eat, Pray, Love wrote: “People think a soul mate is your perfect fit, and that’s what everyone wants. But a true soul mate is a mirror, the person who shows you everything that is holding you back, the person who brings you to your own attention so you can change your life.”

Check-in Question: Each of us has been influenced by many individuals. In these past few weeks who has influenced you most? Who has seen something in you and brought it to your attention so that you have the courage to continue the work you do here?

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 hereto view the entire page.Click hereto 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 emailinginfo@leadingagenc.org. Thank you to everyone who has already submitted information.

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

April 10, 2020

COVID-19 Daily Update

LeadingAge NC Annual Conference and Expo Cancelled
At LeadingAge North Carolina, we understand that COVID-19 preparedness means it’s all-hands-on-deck for our Member Communities and our Business Members…including travel bans and social distancing practices. To that end, and in light of the President’s national emergency declaration, LeadingAge North Carolina has made the difficult decision to CANCEL our 2020 Annual Conference and Expo originally scheduled for May 18-21. The Golf Outing has also been cancelled. At the heart of this decision: we cannot in any way risk the health of the aging services staff we support or the elders we serve. While we believe this decision is prudent, we will miss gathering with everyone at the conference. We look forward to the 2021 Annual Conference and Expo to be held May 11-14, 2021 in Wilmington, NC, with particular anticipation.

Governor Issues New Executive Order with SNF Implications
Yesterday, North Carolina Governor Roy Cooper issued Executive Order Number 131, placing mandatory requirements on skilled nursing facilities. The order is effective at 5 pm today, April 10. The order also “strongly encourages the same measures, to the extent possible given constraints on the availability of personal protective equipment, for other kinds of long term care facilities, including adult care homes, family care homes, mental health group homes, and intermediate care facilities for individuals with intellectual disabilities.” The order specifically mandates that skilled nursing facilities shall:

1. Remind staff to stay home when they are ill and prevent any staff who are ill from coming to work and/or staying at work.
2. Screen all staff at the beginning of their shift for fever and respiratory symptoms. This shall include:
   • Actively taking that staff member's temperature; and
   • Documenting an absence of any shortness of breath, any new cough or changes in cough, and any sore throat.
     If the staff member is ill, the facility must have the staff member put on a facemask and leave the workplace.
3. Cancel communal dining and all group activities, including internal and external activities.
4. Implement universal use of facemasks for all staff while in the facility, assuming supplies are available.
5. Actively monitor all residents upon admission, and at least daily, for fever and respiratory symptoms (shortness of breath, new cough or change in cough, and sore throat), and shall continue to monitor residents.
6. Notify the local health department immediately about either of the following:
   • Any resident with new, confirmed, or suspected COVID-19.
   • A cluster of residents or staff with symptoms of respiratory illness. A ··cluster" of residents or staff means three (3) or more people (residents or staff) with new-onset respiratory symptoms in a period of 72 hours.

CMS Issues Clarification on PPE Reuse
The FDA has updated their FAQs on reuse of cloth gowns and other personal protective equipment. Specifically, this allows that “cloth gowns that will not be used in a sterile field, such as surgery, can be reused if they are laundered in enzymatic detergent or per the hospital’s SOP.” Click here for a look at the new guidance.

CDC Issues New Interim Guidance for Workers Who May Have Had COVID-19 Exposure
Click here for a look at the CDC’s latest guidance for your staff that may have had COVID-19 exposure.

Small Business Administration Provides More Clarifications on Paycheck Protection Program
SBA officials have provided additional clarification on the Paycheck Protection Program, the federal government’s initiative to provide support to small businesses during the COVID-19 pandemic. Click here for their latest Frequently Asked Questions document.

Duke, RTI, and UNC-Chapel Hill Provide Analysis on State-specific Modeling
Click here for an informative piece from North Carolina Health News about COVID-19 modeling specific to our state. Scientists affiliated with Duke University, RTI International and the University of North Carolina at Chapel Hill shared their findings with reporters on Monday as the number of COVID-19-related hospitalizations continues to climb. They looked at two questions: What would be the need for hospital beds if the state lifted the physical distancing restrictions included in the governor’s executive order set to expire on April 29? What would happen if those policies remained in place longer?

Nursing Homes Added to Amazon Preferred List for PPE
This note from Alyssa Odegaard, of LeadingAge Washington, came in at 8 pm last night: “I just got word that Amazon has added nursing homes, assisted living, and senior living to the priority list to buy PPE. They would just need to fill out and submit the following form.” Thanks to LeadingAge Washington for that hometown advocacy for all LeadingAge!

Federal Stockpile of PPE Nearly Depleted
The federal stockpile of N95 respirators, gloves, gowns, surgical masks, and other equipment needed to care for patients with COVID-19 is now nearly depleted, according to reports from theAssociated Press and other news outlets. A statement from the Department of Health and Human Services has confirmed that about 90% of federally held personal protective equipment has been distributed to state and local governments.The remaining 10% of PPE in the stockpile is reserved for federal workers and will not be distributed to the states.

PPE Guidance and Allocation for North Carolina
North Carolina’s process pertaining to PPE Allocation, and a letter from NC DHHS explaining it, is now available.

New Online Search Tool from NC 2-1-1
NC 2-1-1 has launched a new online search tool to help you find resources in your local community during the COVID-19 crisis.

FEMA Assistance for COVID-19 expenses
A few questions have come in about the FEMA Public Assistance Program for COVID-19 expenses.Thisexplainermay be helpful in sorting through the details.Bottom line? There are a lot of conditions that must be met and the process includes a lot of separate steps – this is not an easy application.It may be useful to some members, but we don’t anticipate that its use by LeadingAge NC members will be widespread.

HUD Official to Join LeadingAge National 3:30 call on Thursday, April 16
On Thursday, April 16, Toby Halliday, Director of HUD Multifamily Housing’s Office of Asset Management and Portfolio Oversight (OAMPO), will speak on LeadingAge’s daily COVID-19 3:30pm ET call. Please send questions in advance to Linda Couch at LeadingAge national.

Potential Mask Supply Identified
Paratus Service Group in Cary has availability for surgical and KN95 masks. Click here for more information. Thank you to our friends at K4Connect (LeadingAge NC bronze business member) for sharing this resource.

Practical Tools for Staff Conversations
In Toy Story 4, Woody said to Forky, “You have to understand how lucky you are right now. You’re Bonnie’s toy. You are going to create memories that will last for the rest of her life! Like it or not, you are a toy. Maybe you don’t like being one, but you are one, nonetheless. That is your job.”

Food for Thought for All Leaders: Read that line from the movie again but take out the word “toy” and replace it with the word “leader.” You are a leader. You might not like being one, but you are one. It’s your job to lead people. As a leader, you influence what your team thinks and how they feel about their work. But you have to understand how very lucky you are. You are creating memories that will last for the rest of your employees’ lives. You keep showing up for them. You continue to check on them -- each and every employee who works for you. You care about what happens in their lives. You keep telling them that they matter, that we will get through this, that the work they do is valuable, and that they are appreciated. These small actions are meaningful.

Check-in: How will you approach your leadership and ensure your team feels supported in their work?

Questions? Ask LeadingAge National, Your State Association, or Each Other
There are many ways to get help during this crisis. Staff at LeadingAge’s national office are always here for you. Contact our team directly or email us at covid@leadingage.org. If you have questions about local and state issues, contact us and we’ll get right on it.

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 hereto view the entire page.Click hereto 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 the LeadingAge NC office. Thank you to everyone who has already submitted information.

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

April 9, 2020

COVID-19 Daily Update

COVID-19 Hits Skilled Nursing Facilities with a Vengeance
Yesterday brought news of several large COVID-19 outbreaks in skilled nursing facilities across the state. Orange County’s health department first reported an outbreak on April 2 involving two positive cases at a skilled nursing facility in Durham. Yesterday, the number at the facility had increased to at least 60 positive cases. Seven of those people have been hospitalized and two have died. In Moore County, more than 30 people at a nursing facility in Pinehurst have tested positive. DHHS Secretary Mandy Cohen said yesterday there are 18 ongoing outbreaks in skilled nursing facilities across North Carolina (the state defines an outbreak as two or more cases). Statewide, as of yesterday afternoon, there were 3,426 laboratory-confirmed cases and 53 deaths.

Cooper Issues New Executive Order Granting DHHS Secretary Broad Authorities
Recognizing the ongoing severity of the COVID-19 pandemic, Governor Roy Cooper yesterday issued a new Executive Order granting DHHS Secretary Mandy Cohen broad authority to waive or modify a number of departmental enforcements. Click here for an FAQ detailing the specifics, including a special section on page two regarding fingerprinting.

List of Template Letters for Positive Cases
Our friends at LeadingAge California have a comprehensive set of positive case communication templates. You can find them on the LeadingAge California website (page down to the “Crisis Communication Tools” section) and include a COVID-19 Member Toolkit, Media 101 Primer, Symptoms and Ongoing Testing (Suspected Case), Positive COVID-19 Diagnosis in your Community(Staff or Resident), Community Notification Letter of Positive Case, Positive Case Letter to Friends and Family, Media Response to Loss of First Resident, Loss of First Resident to COVID-19, and Loss of First Resident Letter to Friends and Family.

Resources Available to Help Manage Stress and Anxiety
Is COVID-19 causing you stress or anxiety? You're not alone. Click here for a number of resources.

FEMA Disaster Relief Fund Information
Another potential source of assistance with COVID-19 expenses is a $45 billion infusion into the FEMA Disaster Relief Fund.Our friends at Ziegler provided us with information on the fund. These moneys will be distributed to states, localities, tribes and private nonprofits for expenses associated with COVID-19 response.FEMA will cover 75% of eligible costs, while you cover the other 25%. Funding is available for private nonprofitsregardless of size or number of employees;senior living, healthcare and housing organizations are eligible to apply.SeePNP Eligibility Listto clarify your eligibility. Click here for more information provided by Ziegler on details of the program.

LeadingAge North Carolina Weekly Call-in Change
Beginning next Monday, April 13, LeadingAge North Carolina’s weekly COVID-19 Call-In will switch to 2 pm. We heard from a number of participants that they would like an earlier start time so they could make the daily LeadingAge national calls.

3:30 pm LeadingAge National Daily Update Call Pauses
A reminder that LeadingAge national will NOT hold 3:30 calls today and Sunday. They WILL hold calls Friday, Saturday and every day until April 26.

CMS Update
Not much of consequence to report from LeadingAge’s CMS nursing home stakeholder call yesterday afternoon. The number one questions the national keeps hearing from members relate to the 3-day stay, extension of care past 100 days, MDS submissions, and PBJ submissions. Apparently, it is national’s understanding that FAQs on these issues are coming soon from CMS.

The Latest Rumor: CMS Plans to Approve CMP Grants for Communication Devices
We’ve heard through the grapevine that CMS officials plan to authorize the use of Civil Money Penalty funds to help nursing home residents stay in touch with loved ones. CMS has indicated the plan is to provide every nursing home with a $3,000 grant to purchase electronic devices so residents can remotely communicate with family and friends.It is estimated the grant would fund one device (e.g., IPad) for every seven residents. Assuming CMS actually goes forward with this plan, details should be released within a few days.

CMS Open Door Forum on Telehealth
CMS’s open door forum on telehealth yesterday covered the current flexibilities and noted that there will be more waivers coming based on the new flexibility provided by the CARES act. One area in which they emphasized they were reviewing the ability to be more flexible included physical, occupational, and speech therapy.

USDA relief for rural housing providers and residents
In anupdated statementissued on April 8, USDA-Rural Development implemented several new relief measures for rural housing providers and residents. Highlights include CARES Act eviction protection, increased voucher amounts, and forbearance options. LeadingAge national’s ongoing requests for rural housing support are available to view onlinehere.

Practical Tools for Staff Conversations
In an effort to help leaders inspire and motivate their teams...

In the book,Between the World and Me,Ta-Nehisi Coates writes, “I would not have you descend into your own dream. I would have you be a conscious citizen of this terrible and beautiful world.”

Check in question: In your opinion, what is the most terrible thing in our world right now? What is the most beautiful thing in our world right now? Why is it important, especially now, to be aware of these things, to live in the moment, and to not lose ourselves in dreams or fears?

Questions? Ask LeadingAge National, Your State Association, or Each Other
There are many ways to get help during this crisis. Staff at LeadingAge’s national office are always here for you. Contact our team directly or email us at covid@leadingage.org. If you have questions about local and state issues, contact us and we’ll get right on it.

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 hereto view the entire page.Click hereto 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 the LeadingAge NC office. 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.

April 8, 2020

COVID-19 Daily Update

By the Numbers
As of 10:15 am Tuesday morning, the state of North Carolina had 3,221 laboratory-confirmed cases of COVID-19 in 90 counties. 46 people have died in North Carolina due to COVID-19 and 354 are currently hospitalized. There are ongoing outbreaks (classified by the state as “two or more confirmed cases”) in nine skilled nursing facilities in North Carolina and three adult care facilities. Our sense is that the number of skilled nursing facilities with at least one positive case is much higher than the nine outbreaks listed.

Value First Releases PPE Survey Results
Value First just completed a national survey of member community personal protective equipment needs. Click here for a look at the results.

LeadingAge North Carolina Weekly Call-in Change
Beginning next Monday, April 13, our weekly COVID-19 Call-In will switch to 2 pm. We heard from a number of participants that they would like an earlier start time so they could make the daily LeadingAge national calls.

CMS Schedules Nursing Home Call - April 8th at 3:30 pm
The Centers for Medicare and Medicaid Services (CMS) has scheduled a call on COVID-19 with Nursing Homes for tomorrow, Wednesday, April 8th at 3:30 PM CST. CMS leadership will provide updates on the agency’s latest guidance and we will be joined by leaders in the field interested in sharing best practices with their peers. The call will be recorded if you are unable to join. Conference lines are limited, so we highly encourage you to join via audio webcast, either on your computer or smartphone web browser. Attendee Dial-In: 833-614-0820 Conference ID: 6798274 The weblink can be found here.

New Calculators Available to Navigate the FFCRA and Cares Act
There are twonew calculators to help aging services providers know what help is available to them through the two Federal COVID-19 Bills that have been signed into law through April 1,2020, the Families First COVID Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES). One tool is specific to providers that bill Medicare Part A (SBA and Part A Calculator) as there are certain advance payments and sequestration suspensions that apply to these providers. The other calculator looks at the Small Business Administration loan and forgiveness program (SBA Calculator). These tools are simply an estimate of the potential impact based on your inputs. The analysis itself does not evaluate eligibility. Please refer to the information and the links in theCOVID-19 Stimulus Bill Facility Impact Calculators Explainer Documentto determine your organization’s eligibility under the various programs.
A special thank you to our friends at LeadingAge Wisconsin for sharing these tools.

NCIOM and SCIMPH Issue COVID-19 Brief
The North Carolina Institute of Medicine and the South Carolina Institute of Medicine and Public Health have issued a COVID-19 Issue Brief. Click here to access a copy.

LeadingAge National Call-in Schedule Changes
We let you know yesterday that LeadingAge national will not be holding Daily Update Calls at 3:30 on this Thursday, April 9 and this Sunday, April 12, to recognize Passover and Easter, so members may spend time with those in their communities and with their families.There will be calls on Friday and Saturday. Today’s call will feature Liz Weingast, VP for Clinical Excellence at the New Jewish Home in New York City, talking about setting up a special care unit. In addition, there was a great deal of interest on yesterday’s call about the LeadingAge infection control tool and checklist. Here’s the link.

HHS Announces $34 billion in Accelerated/Advance Payments under Medicare
Yesterday, CMS AdministratorSeema Verma announced the firstweek’s spendingon Accelerated/Advance Payments under Medicare. In addition, Verma announced that very soon HHS will begin to award the first tranche of funds from the CARES $100 billion provider rescue fund. Politico reports that the first $30 billion will be awarded in the form of grants to providers and will primarily go to hospitals, based on how much they bill Medicare. Verma said CMS will follow up with another pot of money that will focus on nursing homes, pediatricians and children’s hospitals.HHS Secretary Alex Azar has also indicated some of the $100 billion will cover coronavirus expenses of uninsured individuals. Last week Verma assured Katie Sloan of LeadingAge national and Mark Parkinson with AHCA that Vice President Mike Pence is very concerned about nursing homes. More on this as we get more information.

HUD Releases New Update
Last night, HUD released a recorded update on COVID-19 issues…LeadingAge national hasthis articleabout it. One of the most significant statements was that HUD is looking to waive its usual procedures for getting funding out as it figures out how to move the new service coordinator funding out to housing providers. Here’s the direct quote: “The funding to replace tenant incomes will be triggered by tenant recertifications and should be a fairly quick and invisible process. For the portion of funding going to Service Coordinators, this is slightly more complicated because these dollars usually would come with a NOFA and a longer process. We’re working through the procedures to see what we can waive and what we can do to get that funding out to properties as quickly as we can.”

COVID-19 Heroes Fund Proposed
U.S. Senators Bob Casey, Jr. and Ron Wyden announced plans yesterday to support aCOVID-19 Heroes Fundto reward, retain and recruit essential frontline workers – “healthcare professionals, first responderspersonal care and home health workers…and other unsung heroes.” It would provide $25,000 premium pay to essential workers from the start of the public health emergency to December 31, 2020 and $15,000 as a recruitment incentive for new workers.The idea has not yet been introduced as legislation. The likely path to enactment would be to include it in the upcoming 4thstimulus bill.

Congressional Letter to CMS/CDC Seeks List of Nursing Homes with COVID-19 Cases
On April 2, Senators Casey and Wyden sent aletter to CDC/CMSseeking a list of nursing homes with people who have positive diagnoses of COVID-19 and an extended list of additional requests. Given the press of the coronavirus crisis and the fact that the COVID status of any community or nursing home changes hourly, it is possible that HHS may miss the April 16 deadline the Senators set for a response.

NextStep COVID-19 training offer extended to April 17
TheNextStep COVID-19 trainingfor anyone who is a paid or unpaid caregiver of older people in any setting will be available for free for LeadingAge member until April 17. The code at checkout is code for members remains the same: COVIDCERTNOW. This is not a formal certification program.

Practical Tools for Staff Conversations
In an effort to help leaders inspire and motivate their teams...
In the book,Being Mortal, Atul Gawande writes, “Human beings need loyalty. It does not necessarily produce happiness, and can even be painful, but we all require devotion to something more than ourselves for our lives to be endurable. Without it, we have only our desires to guide us, and they are fleeting, capricious, and insatiable.”
Check in question: Your loyalty to this organization is instrumental as we continue to work together to keep our residents safe, happy, and comfortable. We could not do this without you. But, during these trying times, what does your loyalty to this organization, to your co-workers, and to your residents mean to you?


Questions? Ask LeadingAge National, Your State Association, or Each Other
There are many ways to get help during this crisis. Staff at LeadingAge’s national office are always here for you. Contact our team directly or email us at covid@leadingage.org. If you have questions about local and state issues, contact us and we’ll get right on it.

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 hereto view the entire page.Click hereto 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 the LeadingAge NC office. 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.

April 7, 2020

COVID-19 Daily Update

Yesterday’s Weekly COVID-19 Call-In Recap
Yesterday’s weekly LeadingAge NC COVID-19 Call-In featured great discussion, with 43 communities participating. During the call, we promised to share information about several items:

1. Of the 13 communities responding to our question about the use of premium pay, 71% indicated they are providing premium pay to employees or considering it.
2. Click here for a memo from Mark Payne at DHSR regarding temporary waivers on 10% increases (special thanks to Tiffany Roberson, Director of Health Systems and Informatics at The Presbyterian Homes, Inc. for sending this along).
3. Jonathan Erickson from United Methodist Retirement Homes, Inc. talked about a link relating to masks. Here’s the contact information: Chase Johnson, Contempora Fabrics, 351 Contempora Drive, Lumberton, NC 28358, 910-738-7131, 910-733-5519.
   
   

Influential Modeling Tool Available Online
The Institute for Health Metrics and Evaluation (IHME)is an independent population health research center at UW Medicine, part of the University of Washington, that provides rigorous and comparable measurement of the world's most important health problems and evaluates the strategies used to address them. Their interactive modeling tool is in use worldwide in tracking the potential impacts of COVID-19.

NEW LeadingAge Resource to Help You Fill Jobs During this Crisis
LeadingAge is establishing partnerships with major national employers and associations to reach displaced workers from fields such as dining, retail, and hospitality.LeadingAge is directing out-of-work staff from other settings to their job board to find positions in your communities. Please post jobs of allkinds – for FREE - (including temporary positions and those that do not require certification) on the Leading Age Job Board atcareers.leadingage.org.

“What are the Benefits of Wearing a Face Mask?”
Click here for an informative look at the benefits of wearing a face mask.

From LeadingAge Centers
The LeadingAge LTSS Center @UMass Boston is sharing research studies and research-based articles focusing on how the coronavirus pandemic is affecting older adults and the people who care for them. Check out brief summaries of the latest data and analysis, including these recently posted articles:

• Why is COVID-19 So Lethal for Elders?
• How Congress Can Address Social Isolation in a Pandemic
• Protecting the Mental Health of Workers
  

EXTENDED OFFER: COVID-19 Learning Tool
NextStep is offering an informal online course designed to improve the safety of caregivers of all kinds working with COVID-19 patients in all settings. The COVID-Ready Caregiver program uses expert-developed online learning to help develop safety skills during the pandemic.
The program is NOT a formal certification—but it can be used to complement additional training. It can also be used by caregivers, housekeeping, and dietary teams, or any staff at independent living, adult day, PACE, and affordable housing, or other settings, as well as by family caregivers at home. Staff at LeadingAge members can access the course at no cost, and we just extended the offer so it's valid through April 17. Use code COVIDCERTNOW at check-out.

PPP Loan Program and Faith Based Organizations
Late Friday, the Small Business Administration issued guidance for the Paycheck Protection Program on affiliation of organizations as it relates to eligibility for the program and FAQs for faith based organizations. Here’s anarticle on the guidance, with links to it. LeadingAge members will be interested in the affiliation guidance related to ownership and management. The FAQs for faith based organizations indicates that faith based organizations are eligible to receive PPP and EIDL loans.

Revised USDA FAQs
Yesterday, the USDA updated its FAQs for multifamily affordable housing. The FAQ reminds owners to complete income recertifications as quickly and flexibly as possible, to not count the $1200 checks toward resident income, and that they can access their operating accounts to pay for COVID-19 expenses, among other items. The FAQ is behind the multi-family housing button onthis page.

CDC Posts Instructions to Sew a Face Mask
CDC put out guidance over the weekend about cloth face coverings, including an FAQ. They updated it last night to includeinstructions for sewing one. Questions about face masks are by far the most commonly asked questions on LeadingAge national's afternoon calls.

LeadingAge COVID-19 3:30 pm Call Today
LeadingAge National will hold their daily 3:30pm call. To register for the call, go tohttps://attendee.gotowebinar.com/register/1365743381042881035. Please note: you only have to register one time and will be automatically registered for the 3:30 call every day (7 days a week) through April 26.

LeadingAge COVID-19 Call Schedule Modified This Week
The team at LeadingAge has been inspired by the dedication of everyone. In the midst of a sacred week for many of us, LeadingAge national will pauseits live online updateson both Thursday, April 9,and Sunday, April 12,in recognition of Passover and Easter. Know that we will be working for you through the religious holidays this week, but will take these two days to allow members a chance to observe in their communities and with their loved ones.

Practical Tools for Staff Conversations
In an effort to help our leaders inspire and motivate their teams, here is today’s practical tool:

Brené Brown writes about three learnings that have been life-shifting for her.

1. Anxiety is one of the most contagious emotions - that’s why it always takes down groups of people, not just individuals.
2. Calm is also contagious, but it’s a daily intention and practice.
3. We all have patterned ways of dealing with anxiety that are often set up in our first families. Understanding how and why can set us free.
   

Check in question: What calming practices have you found to be particularly helpful as you move through your day?

Questions? Ask LeadingAge National, Your State Association, or Each Other
There are many ways to get help during this crisis. Staff at LeadingAge’s national office are always here for you. Contact our team directly or email us at covid@leadingage.org. If you have questions about local and state issues, contact us and we’ll get right on it.

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 hereto view the entire page.Click hereto 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 the LeadingAge NC office. Thank you to everyone who has already submitted information.

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

April 6, 2020

COVID-19 Daily Update

Staff with Multiple Healthcare Jobs
Many nursing home providers throughout the country employ staff who hold multiple healthcare jobs. Some employees work at more than one nursing home. Others work in both nursing homes and hospitals or home health agencies. CMS advised in QSO-20-14-NH REVISED that facilities should identify staff that work at multiple facilities. Recognizing the risk of transmission that this poses, LeadingAge requested CMS provide additional guidance on how to manage these risks, including guidelines around appropriate quarantine procedures for asymptomatic staff who have worked in a facility where COVID-19 has been confirmed. At this time, CMS states that providers should refer to CDC guidance for return-to-work criteria and risk assessment of healthcare personnel.

CMS guidance and recommendations
CMS continues to release new guidance/recommendations for nursing homes.The new guidance recommends that nursing homes adhere to all CMS and CDC guidance and that state and local leaders consider the needs of LTC facilities in allocating PPE supplies.Nursing homes must now control entrance and egress more tightly and screen everyone coming in for symptoms except EMS workers. CMS now recommends that full COVID-19 appropriate PPE be worn for the care of all residents and that residents cover their nose and mouth when staff are in their rooms. Staff should be assigned to treat either COVID negative or COVID positive individuals and nursing homes are instructed to work with local health departments and others to promote enrollment and use of alternate care sites.Also for nursing home stakeholders, here is the link to the summary of questions and answers covered on the CMS stakeholder call this week.

Responding to Negative Views on Aging Services During the Pandemic
Despite the incredibly challenging conditions, LeadingAge North Carolina members are taking a calm, caring, and thoughtful approach to this growing public health crisis. Wherever you support older adults—in nursing homes, assisted living, life plan communities, or in homes across the country—you are, as always, demonstrating the incredible value of your work. The stark reality is, however, that this truth of your value and the complexity of your operations is not always understood by the media and the wider public. In the face of the coronavirus pandemic, we all are forced to continue to fight long-standing, negative narratives.

We can assure you that LeadingAge North Carolina and LeadingAge national are carrying forward the truth about the incredible work you are doing in the face of this global pandemic. Here’s how.

Three New COVID-19 Medicaid Bulletin Articles Available
The NC Division of Health Benefits has published three more Medicaid Bulletin articles related to COVID-19:

• SPECIAL BULLETIN COVID-19 #31: NC Medicaid COVID-19 Updated Guidelines for Non-emergency Medical Transportation (NEMT)
• SPECIAL BULLETIN COVID-19 #32: Rate Increase and Claims Reprocessing
• SPECIAL BULLETIN COVID-19 #33: Webinars for COVID-19 Appendix K Flexibilities for the NC Innovations and TBI Waivers
  

Providers are encouraged to review this important information.

SBA Paycheck Protection Program
The Treasury Department has increased the interest rate on the SBA Paycheck Protection Program to 1%, up from .5%. Friday, April 3 was the first day the loans were made available. It is far too early to have a breakdown of any sort of who is borrowing. Community banks are reportedly getting funds out faster than larger banks, although some larger banks are taking applications but not sending out funds yet. Here’s an updated article about the SBA loans.

WHO Develops Stress Reduction Tips
The World Health Organization has developed a set of practical tips for dealing with the stress of this outbreak.

CDC Advises Americans to Wear Nonmedical Masks
The White House says the Centers for Disease Control and Prevention is recommending that Americans cover their faces when leaving the home, especially around other people.

More Requests to Congress
LeadingAge joined forces with VNAA/ElevatingHOME, National Adult Day Services Association, and leading hospice organizations to develop and deliver three sets of aligned recommendations, which include:

• Priority Access to PPE Distribution and Testing: We understand the vital need for PPE in the inpatient setting, but now there is a major push to move patients out of hospitals to nursing homes or to home and community-based settings. Without PPE, our members cannot safely orchestrate these transitions, take care of new or current patients, or protect staff. We also cannot effectively safeguard patients, residents, or staff without knowing who has COVID-19. Our members must be prioritized to receive PPE and access to testing.
• Increased Funding and Access to Payments, Grants, and Loans: Rising costs of caring for a full load of patients with a changing case-mix, buying extra PPE and other supplies, losing staff and paying overtime—coupled with decreased revenues—are already causing shortfalls for our members working in all settings. Any future stimulus package should include money to pay for what programs are spending on patient and staff safety, and to mitigate losses so that these essential providers can continue to operate into the future. It also should provide for housing infrastructure, additional staffing, and access to grants and loan programs across all our members.
• Regulatory Relief and Operational Flexibility: This crisis has created unprecedented conditions for our members as they provide care, and has underscored the already-existing workforce shortages. We require additional flexibility to ensure that patients, residents, and clients remain safe and receive the best care possible. We recommend expanding provisions that provide relief in critical areas, including CNA and palliative care training, fees and penalties, payment adjustments, telehealth—including full reimbursement for telehealth interactions—and more.

Letter to IRS on Low Income Housing Tax Credit
LeadingAge sent thisletter to the IRSurging them to move quickly on several COVID-19 fixes to the LIHTC program.The letter seeks specific guidance from Treasury/IRS to allow the Housing Credit community to adapt as best as possible during the coronavirus crisis.

LeadingAge North Carolina Weekly COVID-19 Call Today
Our weekly LeadingAge North Carolina“COVID-19 Call-in”will be held this afternoon(Monday, April 6) at3 pm. Call-in to share what you’re hearing, seeing, and doing and learn from your peers across the state.
To access the call,dial (201) 616-0673 and, when prompted, enter the passcode 841692.

LeadingAge COVID-19 3:30 call Today
LeadingAge National will hold their daily 3:30p call. To register for the call, go tohttps://attendee.gotowebinar.com/register/1365743381042881035. Please note: you only have to register one time and will be automatically registered for the 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, here is today’s practical tool:

In the book,When Breath Becomes Air, Paul Kalanithi writes: “It cannot be doubted that each of us can only see part of the picture. Human knowledge is never contained in one person. It grows from the relationships we create between each other and the world, and still, it is never complete.”

Check in question: This quote emphasizes the importance of relationships and how impactful they can be on our lives. As we live with the realities of COVID-19, why are strong relationships with our co-workers particularly important now, and what can we do today to improve these relationships?