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Communications From Our Members



Weekly Support Calls for Members of LeadingAge North Carolina
  • LeadingAge NC will host 30-minute support phone calls for members on Mondays at 2pm for the foreseeable future.
  • The next call will take place next week on Monday, April 6th. Thanks to the 50+ members who joined us this week.
  • Feel free to invite staff to participate.
  • During these calls members are invited to ask questions, share resources, generally problem-solve and support one another.
  • To participate, dial 201-616-0673, and enter code 841692.

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Statement from LeadingAge North Carolina


(4/3/20) LeadingAge North Carolina Creates New Job Partnership Portal
LeadingAge NC is creating a job clearinghouse for displaced workers from a variety of industries including food service, housekeeping, transportation, and other licensed positions, who would like to work in aging services in North Carolina. Click here to check out a quick form that those interested would complete.


Manager Training Seminar, April 16
We have made the decision to reschedule the seminar in compliance with the Governor's executive order around large gatherings.


(4/10/20) 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.

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North Carolina-Specific Information


  • (April 24, 2020) Governor Releases Three-Phase Plan, Extends Stay at Home Order Through May 8
    Governor Roy Cooper yesterday issued Executive Order No. 135 extending North Carolina’s Stay at Home order through May 8. Click for more information about the plan to lift restrictions, include specifics about Phase 1, Phase 2, and Phase 3.

  • (4/10/20) 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.

  • (4/10/20) 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.

  • (4/10/20) 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.

  • (4/10/20) Governor Roy Cooper issued Executive Order Number 131, placing mandatory requirements on skilled nursing facilities.

  • (4/8/20) 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.

  • (4/6/20) 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.  Providers are encouraged to review this important information.

  • (4/1/20)  North Carolina Department of Revenue Extends Deadlines
    The North Carolina Department of Revenue won't impose penalties for late filing or payments of many tax types, including sales and use and withholding taxes, through July 15, Revenue Secretary Ronald Penny said. The department previously pushed back the April 15 deadline for 2019 income taxes to July 15. It is important to note that State law prevents the Department from waiving any interest except in the limited case of interest on taxes imposed prior to or during a period for which a taxpayer has declared bankruptcy under Chapter 7 or Chapter 13 of Title 11 of the United State Code. As such, if additional tax is owed, the Department is required to charge interest on any unpaid tax, accruing from the original due date, until the tax is paid. The interest rate is currently 5% per year. This is the minimum rate allowed by statute. Click here for detailed information from the department.

  • (3/31/20) DoI Insurance Commissioner Mike Causey Extends Deadline
    North Carolina Department of Insurance Commissioner Mike Causey has issued an order extending the deadline for annual disclosure statements that would have been due on May 31, 2020 for a period of 30 days, until June 30, 2020. A special thanks to Commissioner Causey and his team, including Jeff Trendel, Nancy Wise, and Jackie Obusek, for meeting with LeadingAge North Carolina and responding so quickly to our request for assistance.

  • (3/30/20)  New Patient Fact Sheet Available
    “What to do if You Feel Sick” For people who think they might have COVID-19 and have mild symptoms, the CDC now recommends you stay home and call your doctor if you need medical advice. Most people who get COVID-19 will have mild illness and recover at home. NCDHHS has developed a Fact Sheet to help North Carolinians know what to do if they feel sick.


  • (3/30/20) COVID-19 Dashboard Includes More Data
    The state of North Carolina continually updates its COVID-19 Dashboard. It includes the following information for North Carolina:
    • Number of Cases Statewide and by County
    • Number of Deaths Statewide and by County
    • Number of Tests Completed
    • Number of People Currently Hospitalized
    • Percent of Cases by Age Range
    • Percent of Deaths by Age Range
    • Percent of Cases by Gender
    • Percent of Deaths by Gender
    • Number of Intensive Care Unit Beds – Total and Empty
    • Number of Inpatient Hospital Beds – Total and Empty
  • (3/26/20) Governor Cooper's Executive Order No. 120 which included additional limitations on mass gatherings, restrictions on venues and long term care facilities, and extension of school closure date.
  • (3/24/20) Governor Cooper’s Executive Order No. 118 which included the shuttering of bars and restaurants now has a companion FAQ that provides specific guidance around dining rooms.

  • (3/23/20)  Governor Roy Cooper earlier this afternoon announced a new Executive Order that lowers the ban on mass gatherings to no more than 50 people and continues the current closure of schools until at least May 15. The order also closes gyms, movie theatres, sweepstakes parlors, health clubs, hair and nail salons, barber shops, and massage therapists as of 5 PM Wednesday.
  • NC 2-1-1 is now available as a resource for people to call for assistance related to the COVID-19 coronavirus. NC 2-1-1 is an information and referral service that families and individuals can call to obtain free and confidential information on health and human services resources within their community. To access this service, simply dial 2-1-1 24 hours a day, seven days a week, 365 days a year. You can also text COVIDNC to 898211 to get alerts and North Carolina COVID-19 updates.

  • Executive Order on unemployment information from the N.C. Governor’s office

 

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Federal Information

 

(4/27/20) 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 a General Distribution FAQ, which provides more clarity on what providers need to do if they have received funds under the general distributions to Medicare providers.

(4/17/20) Provider Relief Fund Payment Resources and New Attestation Portal Launched
Health and Human Services announced that its Provider Relief Fund Attestation Portal is 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.

(4/15/20) 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.

(4/15/20) 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.

(4/15/20) 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.

(4/10/20) FEMA Assistance for COVID-19 Expenses
A few questions have come in about the FEMA Public Assistance Program for COVID-19 expenses. This explainer may be helpful in sorting through the details.

(4/10/20) Small Business Administration Provides More Clarifications on Paycheck Protection Program
SBA officials have provided additional clarification on the Paycheck Protection Program.  Click here for their latest Frequently Asked Questions document.

(4/8/20) COVID-19 Heroes Fund Proposed
U.S. Senators Bob Casey, Jr. and Ron Wyden announced plans yesterday to support a COVID-19 Heroes Fund to reward, retain and recruit essential frontline workers – “healthcare professionals, first responders personal care and home health workers…and other unsung heroes.”

(4/8/20) New Calculators Available to Navigate the FFCRA and Cares Act
There are two new calculators to help aging services providers know what help is available to them through the two Federal COVID-19 Bills: 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 the COVID-19 Stimulus Bill Facility Impact Calculators Explainer Document to determine your organization’s eligibility under the various programs.

(4/7/20) Revised USDA FAQs
USDA updated its FAQs for multifamily affordable housing. The FAQ is behind the multi-family housing button on this page.

(4/7/20) PPP Loan Program and Faith Based Organizations
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 an article on the guidance, with links to it. LeadingAge members will be interested in the affiliation guidance related to ownership and management.

(4/7/20) 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.


(4/3/20) Paycheck Protection Program Forgivable Loans Open for Application Today
The Paycheck Protection Program, which provides forgivable loans to small businesses and nonprofit, opens its application process today. The National Council of Nonprofits has a great resource page with details, application forms, and an informative chart comparing the PPP program to other federal programs.

(4/2/20)  IRS Guidance on Stimulus Checks
The Treasury Department published guidance yesterday that would have required Social Security recipients who do not usually file tax returns to file an “easy,” yet to be developed tax form in order to get stimulus checks. LeadingAge national reached out to the Senate staffer who had a heavy hand in crafting the language. He was very clear that it was written to NOT require this. After many calls to the Hill and IRS, by LeadingAge and others, the Treasury department has reversed the decision and Social Security recipients will not have to file anything to receive their stimulus check. Click here for a Washington Post article explaining what happened.

 

(4/1/20)  Alternative Care Site Toolkit
The FEMA Federal Healthcare Resilience Task Force pushed out this Alternative Site Toolkit yesterday, for use by state/local/tribal/territorial governments and FEMA and HHS regional administrators to help identify and set up alternative sites for COVID-19 patients.


(3/27/20) Postal Service
Many members have raised concerns that postal workers are refusing to be screened when delivering mail to communities. Yesterday we received a response that offers three alternatives: (a) redirect to a temporary mail receptacle inside or outside the building where screening would not be necessary; (b) place the mail on hold at the post office for up to 30 days and pick it up; or (c) redirect all mail to an alternative location. This article explains the response and links to the letter from the Postal Service.

 

(3/27/20)   Family Medical Leave Under the Families First Bill
The FMLA provisions of the second stimulus bill have been a big source of anxiety for members. Employees are able to receive up to 10 weeks of FMLA to care for a sick relative, or a child (or older person) who is at home due to the coronavirus emergency. Last night’s Senate bill caps that at $10,000 per worker. This frequently asked questions document provides a summary of the provisions.


Foreclosure Relief
Here’s a template letter that may be shared with employees about foreclosure relief.


Small Business Administration Loans
Today the Small Business Administration posted COVID-19 disaster categories on its website,
https://disasterloan.sba.gov/ela/Declarations/Index
. This means that small entities, including not for profits, are now able to apply for SBA disaster loans as a result of economic injury caused by COVID-19. This could apply to members across settings but particularly adult day services who will have no revenue if they voluntarily or are forced to close. Be on the lookout soon for an article that explains to members how to apply.

U.S. Tax Filing Deadline Moved to July 15
Americans will have an additional three months to file their taxes amid the coronavirus pandemic, the US treasury secretary said on Friday. We’ll be providing additional information on this in next week’s updates.

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LeadingAge National Tools


LeadingAge national has compiled and updated the most relevant and essential tools from the CDC, WHO, and others to help members prepare your organizations for the possibility of an outbreak.

Daily Call-in Briefings with LeadingAge National
The LeadingAge national daily call-in is back and better than ever! Each day's call will provide up-to-the minute policy news and talk about implications for day-to day-operation of provider organizations across the continuum and highlight the latest Congressional actions that can provide relief and support for aging services providers.

Please note: whether you’ve participated in the calls before or not, you’ll need to register again. You’ll only have to register one time and you’ll will be registered for a 3:30 pm call every day (seven days a week) through April 26. Recordings will be posted on their website daily, so you can listen even if you can’t dial in. To join the call, register now.

Member Community COVID-19 Group
LeadingAge national has created a new group in the MyLeadingAge Member Community: COVID-19. This group is a place to connect with your peers to share and discuss everyday practices related to the coronavirus. Take a moment now to log into your my.leadingage.org account and join the group to stay connected.

Leadership Summit Postponed
In light of the President’s national emergency declaration to address the coronavirus pandemic, LeadingAge national is postponing the 2020 Leadership Summit originally scheduled April 20-22. Please note: those who registered for the conference will be sent an email regarding their hotel and registration for national’s rescheduled program – August 10-12, 2020 at the Omni Shoreham Hotel. LeadingAge national will be transferring all registrations over to the new date, and allowing members to cancel at a full refund if the new dates do not work for them.

 

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.

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

 

  • (4/13/20) Additional 1135 Waivers Released
    As promised, the charts on HHS blanket waivers for SNFs have been updated on the LeadingAge national Resources page.
  • (4/9/20) USDA relief for rural housing providers and residents
    In an updated statement issued 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 online here.
  • (4/9/20) 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).

  • (4/8/20) HUD Releases New Update
    HUD released a recorded update on COVID-19 issues…LeadingAge national has this article about 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.

  • (4/7/20) 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

  • (4/6/20) Letter to IRS on Low Income Housing Tax Credit
    LeadingAge sent this letter to the IRS urging 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.

  • (4/3/20) Responding to Negative Views on Aging Services During the Pandemic
    LeadingAge members are taking a calm, caring, and thoughtful approach to this growing public health crisis. However, the stark reality is that, in the face of the coronavirus pandemic, we all are forced to continue to fight long-standing, negative narratives. We can assure you that we are carrying forward the truth about the incredible work our members are doing in the face of this global pandemic. Here’s how.

  • (4/2/20)  Free COVID Training for LeadingAge Members until April 10
    NextStep created an online course designed to improve the safety of Certified Nursing Assistants (CNAs) and caregivers working with COVID-19 patients. But it will be equally useful to all staff of all provider types. The COVID-Ready Caregiver program uses expert-developed online learning to help develop critical skills for safety during the pandemic. LeadingAge members can access the course at no cost through April 10. Use code COVIDCERTNOW at check-out.

  • (3/30/20) New Interpretation Broadens FMLA Exemptions
    Hot off the press! LeadingAge national has just released a new FAQ on the Department of Labor’s revised interpretation of FMLA exemptions. It provides excellent guidance around the new paid sick leave and FMLA provisions in the Families First Response Act.

  • (3/27/20) Essential Worker Letter Template
    Here is a letter template from LeadingAge national that can be personalized and given to workers so they can show they are essential workers during a period when everyone is expected to remain at home.

  • (3/27/20) I nfection Control Tool
    LeadingAge has developed this Infection Control Tool for nursing homes to use to prepare for an Infection Control Survey. It is meant to be used with the CMS COVID-19 Survey for Nursing Homes tool and links to CDC documents.

  • (3/26/20) This 7-minute LeadingAge national QuickCast offers ideas to leverage a variety of available technologies to connect older adults during times of social distancing.

  • (3/25/20) LeadingAge sent a letter to the US Department of Health and Human Services requesting blanket 1135 waivers for hospice and home health. The letter offers telehealth options and relief on regulatory requirements for these two service lines. It also suggests waiving the homebound requirement for home health which could make it easier for services to be covered for people when they leave the hospital and go home.

  • (3/25/20)   Two new template letter tools were added to LeadingAge national's resource page. One is when facilities are testing for coronavirus and the other is for facilities that have a positive case of COVID-19 infection.

  • (3/23/20)   LeadingAge national has a set of crisis communications materials and a sample media statement already posted (along with news releases and relevant media coverage).

  • LeadingAge national has created some tips on working with the media in wake of COVID-19. They have also provided a template for a media statement in case the virus makes it onto your campus.  

  • Coronavirus (COVID-19) Information
    • Advice For Calm Preparedness
    • How to Work with Healthcare Providers
    • Free COVID-19 Webinar and Educational Resources from AHCA
    • 3-9-2020 Excellent 13-minute LeadingAge National Quickcast

    COMMUNICATIONS PLAN

    Communications if you DO NOT have a confirmed case in your county or and adjacent county

    Communication templates if you DO Have a confirmed case of COVID 19 in your county or and adjacent county

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    NC DHHS Information

    NC DHHS is staffing a COVID-19 phone line to answer urgent questions from the public. That number is 866-462-3821. The state also is maintaining an up-to-date website with information about COVID-19 disease, risk and guidance.

    Included on this page is helpful information for:

    There is also information about what we all can do to combat fear and anxiety about COVID-19. All North Carolinians can better prepare for COVID-19 by getting the latest information directly from reliable sources. Be thoughtful about what you read or hear about the virus and make sure you are separating rumor from fact before you share it.The latest information from NC DHHS can be found here, and please also share the posts from the NC DHHS Facebook and Twitter accounts.

    • (4/15/20) NC DHHS Online Video Resources on managing your overall health and prioritizing your overall wellness during COVID-19. Check out the latest by clicking here.

    • (4/9/10) 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.
    • (4/2/20)  NC DHHS Announces Revised Guidance for Long-Term Care Settings
      The North Carolina Department of Health and Human Services released new “Interim Long-Term Care Setting Guidance” pertaining to residents with COVID-19 (or are suspected to have it). It replaces the earlier March 25, 2020 guidance. We participated in a call yesterday with senior staff at the department to provide perspective on acute to post-acute transfers and will continue to work with them, particularly as it relates to our take on that portion of the new guidance that indicates SNFs should “admit all individuals that you would normally admit to your facility.”


    • (3/31/20)   NC DHHS continues to take action to protect the health and safety of our state’s patients and providers during the COVID-19 outbreak. NC DHHS received authority under Section 1135 of the Social Security Act to waive certain federal Medicare, Medicaid, CHIP and HIPAA requirements. These modifications take effect as of 6 p.m. EST on March 15, 2020, with a retroactive effective date of March 1, 2020, and will ensure that sufficient health care items and services are available to meet the needs of our state residents and providers. The Disaster Relief Provider Enrollment Application, which will be utilized for the expedited enrollment, is an abbreviated enrollment application that collects limited information to enroll a provider for a limited time (180 days). The application is available to in-state, out-of-state (OOS) and border providers that are not yet enrolled in NC Medicaid, including individual providers and organizations.

      Providers can complete and submit the application through the NCTracks Provider Portal. Please refer to the Disaster Relief Provider Enrollment Application Job Aid available by clicking here . A complete summary of the new guidance is available by clicking here.


      Providers should review the Job Aid in advance of working on the application, as several preliminary steps are necessary. For expedited processing, providers must indicate the application is for this public health emergency by answering “Yes” to the Disaster Relief enrollment question on the Basic Information page of the application.


    • (3/30/20) NC DHHS Provides New Updates on Testing Procedures and Policies
      The latest memo provides information and guidance on 1) updated criteria for submission of specimens to the North Carolina State Laboratory of Public Health (including long-term care and healthcare workers prioritized in testing at state public health laboratory), 2) providers no longer asked to fill out “person under investigation forms” for patients tested for COVID-19, and 3) requirements for reporting of COVID-19-associated deaths. Click here for the full memorandum.

    • (3/24/20)   Cindy Deporter with NC DHSR sent out a Nursing Home Infection Control Worksheet that you may find helpful to review.

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    Centers for Disease Control (CDC) Resources

     

    • (4/17/20) CDC Implements “Universal Source Control” Guidance
      The CDC released new CDC Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Positive Diagnoses.
    • (4/10/20) 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.
    • (4/7/20) CDC Posts Instructions to Sew a Face Mask
      CDC put out guidance about cloth face coverings, including an FAQ. They updated it include instructions for sewing one.
    • ( 3/26/20) CDC has posted information about discharging COVID-19 patients from hospitals. It’s called “Discontinuation of Transmission-Based Precautions of Patients with COVID-19 in Healthcare Settings (Interim Guidance)” and it is aimed toward hospitals. It clarifies that patients with COVID-19 can be discharged from a hospital whenever clinically indicated. It specifically covers “if discharged to a LTC or assisted living facility.” Patients can be discharged to a LTC or AL facility, and:
      • Transmission based precautions are still required…they should go to a facility with ability to…ideally, place the person in a location designated for COVID-19 patients.
      • Transmission based precautions have been discontinued, but the person is still symptomatic…place the person in a single room, restrict them to the room, and wear a face mask during care.
      • Transmission based precautions have been discontinued and they are symptom free…no further restrictions.

      Watch for more information specific to North Carolina from us in the next 24 hours.

    • (3/26/20) The Centers for Disease Control and World Health Organization have been researching how long Coronavirus lives in the air and on various surfaces. This link will take you to the latest findings- Up In The Air: How Coronavirus Lives in the Air and On Surfaces

    • (3/23/20) The CDC has issued Interim Guidance, “Preventing the Spread of COVID-19 in Retirement Communities and Independent Living Facilities.” This guidance is for owners, administrators, operators, workers, volunteers, visitors, and residents of independent living facilities and retirement communities that are not healthcare facilities, including federally-subsidized senior housing.

      The Interim Guidance notes several different kinds of independent housing “that is usually age-restricted” with support services for older adults it is applicable to various housing, including:
      • Public housing for low- to-moderate income elderly (i.e., HUD-assisted housing)
      • Assisted living homes that do not provide medical services
      • Continuing Care Retirement Communities, which include a range of housing options including independent living.

    The CDC Interim Guidance takes into account that residents in retirement communities generally care for themselves. HUD senior housing communities are generally very porous buildings, where each resident may have their own network of service providers and volunteers that helps them age in community, in addition to any non-health and wellness visitors coming and going from the building.

    • (3/23/20) The CDC issued new guidance around COVID-19 and risk categories.

    • The CDC posted this page, “Older adults, 65 years and older, are at higher risk for severe illness,” which has a good graphic showing hospitalizations, ICU admissions and deaths, and notes that eight of ten deaths reported in the US have been people age 65 or older.

    • The CDC posted this Return to Work Criteria memo in the last few days. It is very short, less than one page, and describes strategies to determine when health care personnel may return to work after confirmed or suspected COVID-19 infection. It covers test-based and non-test based strategies.
    • The CDC hosted a webinar on infection prevention and control, steps facilities should be taking and management and treatment of COVID-19. Here is the summary and article on yesterday’s CDC LTC webinar . The recording of the call and the webinar slides are available here.
    • The CDC has posted Strategies for Optimizing the Supply of PPE .” The document covers facemasks, N95 respirators, gowns, and eye protection. The purpose of the document is to help optimize supply in a shortage using conventional capacity strategies, and strategies for various levels of shortages. The number of infected individuals is increasing and shortages make this guidance extremely important and helpful.

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    World Health Organization (WHO) Resources

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    CMS Information
    • (4/27/20) CMS Suspends Advance Payment Program
      CMS released an announcement that it will suspend the Medicare Advance Payment program and provided an accompanying fact sheet.

    • (4/22/20) 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.

    • (4/13/20) PACE Guidance
      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.

    • (4/10/20) Clarification on PPE Reuse
      The FDA has updated their FAQs on reuse of cloth gowns and other personal protective equipment.  Click here for a look at the new guidance.

    • (4/6/20) Staff with Multiple Healthcare Jobs
      CMS advised in QSO-20-14-NH REVISED that facilities should identify staff that work at multiple facilities. At this time, CMS states that providers should refer to CDC guidance for return-to-work criteria and risk assessment of healthcare personnel.

    • (4/6/20) 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 suppliesAlso for nursing home stakeholders, here is the link to the summary of questions and answers covered on the CMS stakeholder call this week.
    • (4/3/20) Updated Medicaid Frequently Asked Questions
      Yesterday, CMS published updated FAQs on COVID-19 and Medicaid/CHIP. The new material includes several new questions related to eligibility determination, among other things. This has come up as an issue for some members, since Medicaid eligibility determination offices are teleworking and/or working differently; demand on the systems is high, too.

    • (4/3/20) Summary of CMS Nursing Home Call
      Here’s a summary from CMS calls earlier this week. Covered topics include CNA training/certification, staff with multiple jobs, hiring issues, converting buildings, FEMA, and PBJ
      .

    • (4/2/20)   CMS Creates COVID-19 Email Support
      CMS has set up a COVID inbox at COVID19@CMS.HHS.GOV for providers to email questions and concerns related to COVID-19.

    • (4/1/20)  Recap of Recent CMS Waivers
      Earlier this week, CMS released a package of significant regulatory changes, granting multiple waivers for several provider types. These changes were much needed in supporting our members through this unprecedented time. LAI and LeadingAge consider these changes a huge advocacy win for members. CMS has created Fact Sheets regarding these waivers by provider types, which are listed below.
      Long Term Care Facilities (SNF/NF)
      Home Health Agencies (PDF)
      Hospices (PDF)
      Accelerated/Advance Fact Sheet - All Provider Types


      LeadingAge has created charts for Nursing Home, Home Health, and Hospice waivers. These charts compare the waivers LeadingAge requested, whether the waiver was granted, and highlights from respective rules. Additional information will follow.
      Nursing Home Blanket Waivers Chart
      Home Health Blanket Waivers Chart

      Hospice Blanket Waivers Chart

    • ( 3/31/20)   CMS released a series of new federal blanket waivers that apply to every Medicare licensed facility and do not require action from North Carolina or individual facilities for the waivers to take effect. More clarification is needed on a lot of these items but the full release of the waivers can be viewed here . Long-term care facility waivers begin on page 9 of the document.

    • (3/30/20) New CMS Toolkit on Telehealth
      CMS has released a Nursing Home Telehealth Toolkit. The toolkit presents policy changes that build on the blanket waiver changes CMS is implementing. Nursing homes (and states) do not need to apply to use the new flexibilities. A
      Special Bulletin specific to North Carolina has also been published by NC DHHS.

    • (3/30/20)  CMS “Accelerated and Advance Payments” Fact Sheet
      In order to increase cash flow to providers of services and suppliers impacted by COVID-19, CMS has expanded its current Accelerated and Advance Payment Program to a broader group of Medicare Part A providers and Part B suppliers. The expansion of this program is only for the duration of the public health emergency. An informative Fact Sheet will also help guide you through the process.
    • (3/26/20)   A CMS PACE call was held yesterday. Here is a of summary the call. Bottom line: CMS advises providers use their best judgment and offered hints there will be future guidance.
    • (3/24/20)   Click here for a short article explaining the Quality Reporting guidance from CMS. Click here for a revised SNF reporting deadline chart, taking the new guidance into account. The important point is that while the guidance appears to offer some relief for providers, in reality you will need to continue submitting assessments as they are used for other purposes, such as determining payment.
    • (3/24/20) On March 23, CMS announced further suspension and re-prioritization of survey activity in response to the COVID-19 pandemic. Memo QSO-20-20-ALL highlights this re-prioritization, as well as new guidance for non-nursing home settings on visitors and screening, and access to all settings for health care providers. The analysis on survey re-prioritization follows below.

    Effective immediately for a period of 3 weeks only beginning March 20, the following types of surveys will be prioritized:

    • IJ complaint and facility-reported incident surveys: State survey agencies (SSAs) will conduct surveys related to complaints and facility-reported incidents (FRIs) that are triaged at the Immediate Jeopardy (IJ) level, including revisits necessary to confirm removal of IJ.
    • Targeted Infection Control Surveys: Federal and state surveyors will conduct targeted Infection Control surveys of providers identified through collaboration with the Centers for Disease Control and Prevention (CDC) and the HHS Assistant Secretary for Preparedness and Response (ASPR).
    • Initial certification: Initial certification surveys will be authorized within current guidance and prioritization in order to help increase capacity.

    The following surveys will not be conducted during this 3-week period of prioritization:

    • Standard surveys, including the Life Safety Code and Emergency Preparedness components of these surveys. Complaint surveys triaged at a level below IJ.
    • Revisit surveys that are not related to situations of IJ.

    Surveys that are in process and do not meet the above criteria will be ended and surveyors will exit. When a survey is conducted due to a complaint or facility-reported incident triaged at IJ level, but the facility is ultimately not cited at IJ level, a revisit will not occur during the prioritization period. The case will be held and the facility has the option to hold submission of the plan of correction during the prioritization period. CMS will issue forthcoming guidance to address these scenarios.

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    Affordable Housing/HUD

    • (4/3/20) Updated HUD FAQs
      HUD updated their Q&A yesterday with additional information about recertifications. It also includes information on construction, rehab, and RAD conversions going on during this time.

    • (3/27/20)  Senate CARES Bill
      This summary of the importan t housing-related provisions of the Coronavirus Aid, Relief, and Economic Security (CARES) Act provides information about the $50 million for Section 202 Housing for the Elderly to make up for reduced rent, maintain housing stability and help communities pay for costs associated with coronavirus, and a sweeping moratorium on eviction from federally assisted housing.

    • (3/25/20)   The US Department of Housing and Urban Development has issued updates to its Frequently Asked Questions publication. LeadingAge also added Feds Take Some Action to Suspend Foreclosures, Evictions  to their resources page. HUD’s Multifamily Office of Asset Management and Portfolio Oversight will hold a call on COVID-19 issues on Thursday, March 26 at 2:30 ET. Here’s the call-in information: Phone number: 844-867-6169 Passcode: 882 3979.

    • (3/23/20)  The CDC has issued Interim Guidance, “Preventing the Spread of COVID-19 in Retirement Communities and Independent Living Facilities.” This guidance is for owners, administrators, operators, workers, volunteers, visitors, and residents of independent living facilities and retirement communities that are not healthcare facilities, including federally-subsidized senior housing.

      The Interim Guidance notes several different kinds of independent housing “that is usually age-restricted” with support services for older adults it is applicable to various housing, including:
      • Public housing for low- to-moderate income elderly (i.e., HUD-assisted housing)
      • Assisted living homes that do not provide medical services
      • Continuing Care Retirement Communities, which include a range of housing options including independent living.

    The CDC Interim Guidance takes into account that residents in retirement communities generally care for themselves. HUD senior housing communities are generally very porous buildings, where each resident may have their own network of service providers and volunteers that helps them age in community, in addition to any non-health and wellness visitors coming and going from the building.

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    Telehealth

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    From our Business Members

    • (5/8/20) HJ Sims is providing three educational pieces for members:  1) Podcast that was held with The Bond Builder that offered some perspective around the impact of COVID-19 on the senior living industry and and associated investments; 2) Summary of the Main Street lending Program and recent updates on CARES Act and EIDL Program; and 3) An overview and summary of the SEC disclosure statement with recommendations of best preactices and guidance.
    • (5/1/20) SFCS (LeadingAge NC Platinum business member) is offering assistance for providers that are trying to manage care in long term care settings. This white paper article provides suggestions in best design practices and some adjustments from facility guidelines that can help to mitigate the spread of Covid-19 and future contagions in skilled nursing. Staying ahead of this virus is challenging, however we hope these precautionary measures will make our senior living facilities safer while we continue to look at additional long-term solutions. 
    • 5/1/20) Our friend, Dr. Sandi Lane, Associate Professor at Appalachian State University, thought members might find this article from NEJM on leadership during these unprecedented times helpful. The article outlines five actions that leaders should take: put people first, manage operations creatively, attend to teamwork and communication, create outside partnerships, and embrace clear and humble leadership.
    • (4/27/20) 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.
    • (4/27/20)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.
    •  (4/15/20)  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.
    • (4/15/20) Potential Source for Face Masks We have been 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.
    • (4/15/20) Sodexo (LeadingAge NC Silver business member) is offering a Preventitive Disinfection Program to prevent the spread of infections by implementing a cleaning program that reduces 81% of pathogen load on surfaces. This program adheres to infection prevention and control guidance from the CDC, utilizes EPA-registered, hospital-grade disinfectants appropriate for use against SARS-CoV-2, the cause of COVID-19, and brings pulsed UV technology to eliminated pathogens in seconds.
    • (4/9/20)   Ziegler (LeadingAge NC Platinum busines member) provided us with information on the FEMA Disaster Relief 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 nonprofits regardless of size or number of employees; senior living, healthcare and housing organizations are eligible to apply. See PNP Eligibility List to clarify your eligibility. Click here for more information provided by Ziegler on details of the program.
    • (4/3/20) Local Hand Sanitizer Resource - 5% LeadingAge NC Member Discount
      A company based out of Durham, Next Level Spirits, has developed a sizeable inventory of hospital-grade sanitizer at the ready. If of interest, please contact them directly at the link provided and enter the code LEADINGAGENC for a 5% discount. Thank you to our friends at K4Connect (LeadingAge NC Bronze business member) for sharing this resource.


    • Ziegler (LeadingAge NC Platinum business member) hosted a webinar to provide senior living investors, both public market fixed rate investors and banks, the opportunity to hear directly from providers on their preparedness and experience thus far with COVID-19. Click here for the recording of this call, including the questions and answers.
    • Marsh & McLennan Agency (LeadingAge NC Platinum business member) is reaching out to LeadingAge NC members with the white papers below. They also have a COVID-19 resource page that your human resources office might find useful.

    • CliftonLarsonAllen (LeadingAge NC Platinum business member) is providing LeadingAge NC members a link to their resources page and upcoming webinars regarding accounting issues and COVID-19.

    • Functional Pathways (LeadingAge NC Bronze business member) wants you to know: If you have not done so already, please contact your county and state emergency preparedness office to see if they provide any materials for you. Additionally, we have identified another outlet who may be able to help. The PPE Coalition and the US Digital Response Team are collaborating on Project N95. Their mission is to connect PPE manufacturers with health care providers and state and local governments that submit a request. The goal is to have millions of units available for distribution in the coming weeks.

      On their website they are taking requests for surgical masks, N95 respirators, isolation gowns, and ventilators. See the link below.

      https://www.projectn95.com/
    • Fox Rothschild law firm (LeadingAge NC Bronze business member) has developed a COVID-19 and CARES Act resource page that they are updating daily: https://www.foxrothschild.com/coronavirus-resources/. You may choose whether to be alerted to additional postings. The postings separated by category, such as employment. The page was recently updated to include information and a link to the newly released application for the small business owner Paycheck Protection Program (PPP) contained in The CARES Act.

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    COVID-19 Global Map

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    Engagement and Social Well-Being

    • (4/22/20) New QuickCast on Resiliency on 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.
    • (4/2/20)  Alzheimer’s Association Guidance
      The Alzheimer’s Association has created a document to support individuals: Caring for Persons Living with Dementia in a Long-Term or Community-Based Care Setting.”

    • (4/1/20)  This new, free 12-minute QuickCast from LeadingAge national outlines several calming exercises staff can use to help reduce worry and anxiety among older adults and themselves.

    • (3/25/20)   The National Disaster Distress Helpline at 1-800-985-5990 is offering crisis counseling and emotional support 24/7 during the COVID-19 outbreak.

    • The National Certification Council for Activity Professionals provides guidance for best practices related to providing in-room and virtual programming for residents. This is excellent information for your staff and includes tips on Zoom and Skype.

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    Communications from Members

    At the bottom of this page you will find LeadingAge NC member policies and procedures, and other member communications regarding the Coronavirus.

    • Any member who is signed in can contribute by clicking on the "Add a File" link at the top right side of the COVID-19 Resources.
    • To download or view a file, click on the document name.
    • Before you upload your file, please name it as follows: Community Name - COVID-19 Policy

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    Communications from Members re: COVID-19

    Item Name Posted By Date Posted
    CAROLINA VILLAGE - COVID-19 PANDEMIC PDF (264.06 KB) J. Gill 3/19/2020
    CAROLINA VILLAGE - COVID-19 CONTINGENCY STAFFING PDF (153.06 KB) J. Gill 3/19/2020
    CAROLINA VILLAGE - COVID-19 031020 PDF (51.31 KB) J. Gill 3/19/2020
    CAROLINA VILLAGE - COVID-19 031120 PDF (221.42 KB) J. Gill 3/19/2020
    CAROLINA VILLAGE - COVID-19 QUARANTINE CHECKLIST PDF (178.69 KB) J. Gill 3/19/2020
    CAROLINA VILLAGE - COVID-19 031320 PDF (227.87 KB) J. Gill 3/19/2020
    CAROLINA VILLAGE - COVID 19 031720 PDF (207.59 KB) J. Gill 3/19/2020
    PENICK - COVID-19 Resident Fam Staff Ltr PDF (259.24 KB) J. Gill 3/16/2020
    PENICK - COVID-19 Timeclock Posting DOCX (84.56 KB) J. Gill 3/16/2020
    PENICK - COVID-19 Door posting DOCX (91.78 KB) J. Gill 3/16/2020
    ALDERSGATE COVID-19 visitor instructions PDF (272.15 KB) J. Gill 3/12/2020
    ALDERSGATE COVID-19 visitor screening questionnair DOCX (66.73 KB) J. Gill 3/12/2020
    ALDERSGATE COVID-19 LCT email DOCX (15.6 KB) J. Gill 3/12/2020
    ALDERSGATE COVID-19 CDC What you need to know PDF (111.69 KB) J. Gill 3/12/2020
    ALDERSGATE COVID-19 Memo from CEO DOCX (29.89 KB) J. Gill 3/12/2020
    ALDERSGATE COVID-19 Employee Commitment DOCX (40.51 KB) J. Gill 3/12/2020
    DEERFIELD - COVID-19 Do not panic. Prepare. DOCX (167.54 KB) L. Portfleet 3/11/2020
    PENICK - COVID-19 Memo DOC (52 KB) J. Gill 3/10/2020
    DEERFIELD - COVID-19 Response Plan DOCX (44.66 KB) J. Gill 3/6/2020
    Deerfield- COVID-19 InfoSheet DOCX (33.66 KB) J. Gill 3/5/2020
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