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*Updates are listed by date with the most recent listed first.

3/31/20: 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 ourbrief summaries of the latest data and analysis, including these recently posted articles:

3/31/20: US Chamber of Commerce Coronavirus Emergency SBA Loans & Streamlined Application Process: The Coronavirus Aid, Relief, and Economic Security (CARES) Act allocated $350 billion to help small businesses keep workers employed amid the pandemic and economic downturn. Known as the Paycheck Protection Program, the initiative provides 100% federally guaranteed loans to small businesses. READ MORE. The SBA has streamlined the process for COVID-19 economic injury disaster loan application. Streamlined Process Requirements.

3/31/20: Relief and Support for Low Income Seniors in Federally-Assisted Housing

3/31/20: Blanket Waivers & CMS Call - with 3/31/20 Update

3/29/20: CMS Accelerated and Advance Medicare Payments Additional Information

3/29/20: Families First Coronavirus Response Act: Questions and Answers MORE FROM DOL

3/29/20: Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19): A few questions have come up regarding healthcare personnel and return to work. CDC issued guidance on March 7 related to healthcare personnel with potential exposure in a healthcare setting. This chart from CDC (pulled into a word document for your use) can be used in assessing return to work considerations.

3/29/20: Updated Guidance on Evaluation and Testing for Persons for COVID-19: Today, Nebraska DHHS, Division of Public Health issued and updated Health Alert Network (HAN) related to testing in the state.  It includes information on current labs doing testing, which lab you may want to use, and information on prioritization of testing.

3/28/20: Governor Issues Executive Order Related to Bolster Healthcare Workforce: On Friday, March 27, Governor Pete Ricketts issued an executive order to expedite the entry of medical professionals into the workforce.  The purpose of the order is to prepare for the possibility of a surge in COVID-19 cases and/or the unavailability of some medical professionals due to quarantine restrictions.

3/28/20: New CMS Long Term Care Telehealth & Telemedicine Toolkit: CMS put out a  Nursing Home Telehealth Toolkit on Friday evening (3/27). 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.

3/28/20: Hospice visitor flow chart: If you have been struggling to explain visitor questions related to hospice or just like a visual version of the process, here is the hospice visitor flow chart.  It depicts very clearly: (a) inpatient hospice visitor guidance; and (b) screening and guidance for nursing homes related to hospice workers and other visitors in end of life situations.

3/27/20: CMS Announcement Expanding Accelerated and Advance Payment: CMS sent out an announcement that it is expanding its accelerated and advance payment for Medicare providers, to help fight Coronavirus and have provided this Fact Sheet.  An explainer will be coming soon.

3/27/20: Memorandum from the Assistant State Fire Marshal, Doug Hohbein, regarding CISA federal access letter: This memorandum is intended to provide guidance for building owners and operators in regard to access for vendors considered as Essential Critical Infrastructure Workers.   While I, and the Agency have no opinion on the letter and how it is interpreted or used, I feel it is necessary to recognize its presence and to respond to numerous questions received regarding this and similar issues.

Individual facilities will determine who enters based on their policies.  The presence of the Access Letter does not override their policies, but should provide owners and operators with information they can use to make an informed decision.

Let me know if you have any questions.

Doug Hohbein, Assistant State Fire Marshal
doug.hohbein@nebraska.gov
Office: 402-471-2027
Cell: 402-326-2765

3/27/20: Federal Coronavirus Response Increases Medicaid Funding for States: This article summarizes key provisions related to Medicaid in the legislation signed on March 18, the Families First bill, as well as the third coronavirus stimulus bill expected to become law by the end of March.

3/27/20: New Paid Sick Leave and FMLA Leave in the Families First Response Act (FFCRA): The FFCRA is the second bill to respond to the COVID-19 pandemic.  LeadingAge has put together this FFCRA Q&A.  Congress passed this with overwhelming support and signed into law by President Trump on March 18, 2020 (P.L 116-127). This bill created (1) a new requirement for paid sick leave for workers affected by the COVID-19 crisis and (2) a new requirement for paid leave under the FMLA (Family Medical and Leave Act). The new provisions go into effect no later than April 2, and last until December 31, 2020. This Q&A is designed to help answer questions about the new paid leave requirements and will be amended to include any regulations or guidance issued by the Department of Labor and Department of Treasury.

For an FAQ from DOL:  DOL Q& A on FFCRA

For an summary and Poster from DOL:  Employee Paid Leave Rights

For an summary and Poster from DOL: Employer Paid Leave Requirements

More to follow as information becomes available.

3/26/20: CDC PPE Burn Rate Calculator: The CDC released a Personal Protective Equipment (PPE) Burn Rate Calculator [cdc.gov] yesterday.  You can use the calculator to gauge your PPE use compared against the benchmark or expected burn rate. The website tells you about the spreadsheet with specific instructions listed as well. Given the extremely limited supply of PPE, all healthcare providers should understand where you may have opportunities to conserve and optimize PPE use.  The recommendation is also being made to secure/lock PPE and limit the number of staff with access.

3/26/20: A statement from State Fire Marshal Christopher Cantrell in regard to requirements for fire drills in Assisted Living Facilities: Waiver for Residential Board and Care Facilities: Bi-monthly fire drills as specified in the Life Safety Code (LSC) shall continue; however, because of the unique nature of the current COVID-19 outbreak and the need to limit social contact and gatherings, the Nebraska State Fire Marshal is waiving the requirement in the LSC that requires "actual evacuation of all residents to an assembly point." In lieu of this requirement, the assisted living facility will provide written or verbal instruction to each resident regarding the facility's emergency action plan specific to the residents' evacuation routes, assembly points, and expectations. The delivery of this written or verbal instruction to each resident shall be documented and kept on file with the record of each fire drill conducted.

This waiver shall not apply to health care occupancies classified as hospitals or nursing homes, nor to assisted living facilities classified as limited care facilities.

This waiver shall continue in force for the duration of the Governor's Emergency Declaration related to COVID-19 and its limitations on public gathering size and social distancing. Contact Jenifer Aciero at Jenifer.acierno@leadingagene.org if you have questions.

3/25/20: Up In The Air: How Coronavirus Lives in the Air and On Surfaces By Dee Pekruhn Many people are rightly asking long how this novel coronavirus lives in the air and on surfaces, once it is shed by another person; researchers are racing to find answers. Here, below, is a quick review of three emerging studies, and the official word - so far - from the CDC and WHO.  READ MORE +

3/25/20: New Insights and Tools From LeadingAge

3/24/20: LeadingAge Nebraska and NHCA Submit Joint 1135 and State Waiver Request to to Governor Ricketts and DHHS: As the State works to submit Waivers to CMS, we wanted to make sure that the voices of those we serve are heard.  Please see the 1135 Waiver request and the State Waiver request submitted to the Governor on behalf of our LeadingAge Nebraska members.

3/24/20: CMS Updates Survey Prioritization Guidance Featuring Jodi Eyigor, LeadingAge

3/23/20: CMS Announces Findings at Kirkland Nursing Home and New Targeted Plan for Healthcare Facility Inspections in Light of COVID-19

3/23/20: CMS Survey Memo

The Medicaid and LTC FAQ on COVID-19 is available HERE. It will be updated regularly as new information is available.

3/23/20: REMINDER FROM DR. TIERNEY, NEBRASKA ICAP: Many and probably close to all of your member facilities are screening their employees each day when they come, or even better, before they come to work. Dr. Tierney has received calls about HCPs who work in LTC settings while symptomatic.  She is asking that you please screen staff for COVID-19 symptoms before they begin work for the day.  Symptoms include a fever of 100 or greater, cough, sore throat, shortness of breath, chest pain, severe fatigue.  If you are doing this, keep up the good work.  If you have any questions you can contact Dr. Tierney or her team members during call in hours between 7:30-9:30 a.m. and 2:00-4:00 p.m. CT at (402) 552-2881 or as needed.  Information is also available on the ICAP website.

3/23/20: 1135 WAIVER, NATIONAL BLANKET WAIVER - 3-Day Stay Explainer BY JANINE FINCK-BOYLE: CMS is waiving the requirement at Section 1812(f) of the Social Security Act for a 3-day prior hospitalization for coverage of a SNF stay. LeadingAge National has provided this guidance on how to bill using UB-04 form and Medicare Advantage Plan concerns.

3/23/20: CMS released Frequently Asked Questions on Medicare Provider Enrollment Relief related to COVID-19 including the toll-free hotlines available to provide expedited enrollment and answer questions related to COVID-19 enrollment requirements.

3/19/20: President Signs Families First Coronavirus Response Act; What Does This Mean for Aging Services?

3/19/20: From the CDC, Strategies for Optimizing the Supply of PPE

CDC LTC webinar: On March 17 CDC held their clinicial outreach and communication activity (COCA) call. Please see the summary  provided by one of our LeadingAge state partners.  The recording of the call and the webinar slides are available here. The webinar covered infection prevention and control, steps facilities should be taking, management and treatment of COVID-19 and resources.

3/18/20: Summary of H.R. 6201, Families First Coronavirus Response Act

3/18/20: H.R. 6201, FAMILIES FIRST CORONAVIRUS RESPONSE ACT, Title-By-Title Summary

MEDICARE TELEMEDICINE HEALTH CARE PROVIDER FACT SHEET

3/17/20: Medicare Telehealth Frequently Asked Questions (FAQs)

3/17/20: CMS Released COVID-19 Telehealth Waiver Information

3/17/20: CMS PACE Memo (COVID-19)

3/17/20: LeadingAge Review of CMS PACE COVID-19 Guidance

Letter from Katie Smith Sloan and LeadingAge to Leader McConnell and Speaker Pelosi re: COVID-19 Funding Request

3/16/20: Message from Livanta - provider helplines

3/13/20: CMS Announces New Visitor Restrictions

3/9/20: COVID-19 RESOURCES AND Q&A FROM CONNIE VOGT, DHHS LTC Program Manager

COVID-19-guidance in PALTC Settings - from The Society for Post-Acute and Long-Term Care Medicine

3/5/20: CMS Triages Nursing Home Survey Activity in Response to COVID-19

Summary of CMS Guidance on COVID-19: How Should Nursing Homes Monitor or Limit Visitors?

Long-term Care and Other Residential Facilities Pandemic Influenza Planning Checklist - CDC

EPA’s Registered Antimicrobial Products for Use Against Novel Coronavirus SARS-CoV-2, the Cause of COVID-19

Leadership Preparation Strategies for Coronavirus (COVID-19)

2/20/20: Stanton McComb Customer Letter - Coronavirus

Information and Guidance Related to COVID-19 Shared by Nebraska DHHS Pub

Nebraska Infection Control Assessment and Promotion Program (ICAP)  The ICAP team has set aside time for consultation with providers every day from 7:30-9:30 a.m. and 2:00-4:00 p.m.  The call in number is (402) 552-2881.

Message from Dr. Tom Safranek, NE State Epidemiologist DHHS: In a time of shortage of N-95 masks: this is really important: Need to apply surgical facemask  to patient with cough/URI/suspected corona --surgical facemask on both patient and staff lowers risk. Link to more information.

LeadingAge has designated a page for COVID-19 Information. As concern about the COVID-19 virus grows, LeadingAge is helping our members prepare. Following is information and resources to use as you plan for and respond to COVID-19. https://leadingage.org/covid19

Posted 3/6/20

On behalf of the NE DHHS HAI-AR team and ICAP: Thank you for attending the webinar on Thursday 3/5/2020! Slides from the webinar, including the questions and answers are now on our ICAP website using this link: https://icap.nebraskamed.com/wp-content/uploads/sites/2/2020/03/COVID-19-Webinar-for-LTCF-3.5.20.pdf

See all the COVID-19 Resources on our “Additional Resources” page https://icap.nebraskamed.com/resources/

According to your feedback, visitor screening tools have been created. These are optional for your use and will be updated frequently. Plan a process to check for updates regularly.

Visitor Stop Sign: https://icap.nebraskamed.com/wp-content/uploads/sites/2/2020/03/STOP-Help-Protect-Our-Residents.pdf

Visitor Screening Questions: https://icap.nebraskamed.com/wp-content/uploads/sites/2/2020/03/Visitor-Screening-Questions-3.6.2020.pdf

Visitor Screening Log: https://icap.nebraskamed.com/wp-content/uploads/sites/2/2020/03/visitor-screening-LOG.xlsx

If you have feedback on these forms or have other needs, then please email Kate Tyner or Mounica Soma:

ltyner@nebraskamed.com
msoma@nebraskamed.com 

Thank you, The Nebraska DHHS HAI-AR and Nebraska ICAP teams.