"Connecticut's nursing home operators and their employees provide an incredible service to the people of our state, including the 22,000 residents receive direct care in nursing homes on a daily basis. I want to extend my profound gratitude to them, particularly during this unprecedented global pandemic that is having a particularly adverse impact on the elderly and individuals with disabilities residing in long-term care settings." Governor Ned Lamont, April 19, 2020 

       LeadingAge COVID-19 Information Page

 

COVID-19 Information and Resource

Information from CT DPH

Information from CT DSS

Information from CDC

LeadingAge COVID-19 Information Page

HUD Resources

CDC Long Term Care, Nursing Homes

CDC Criteria for Return to Work for HCP with Confirmed or Suspected COVID-19

CDC Guidance for HCP Exposed to Covid19

CMS Guidance for Nursing Homes March 13

CMS Guidance on Prioritization of Survey Activities (3/23/20)

CDC Guidance for Retirement Communities and Independent Living

DPH, CDC and CMS Revised Guidance on Visitors, Infection Control, Etc. March 13

CMS QSO-20-20-All, Prioritization of Survey Activity March 20

CT DPH COVID-19 Guidance for Long-Term Care Facilities - March 26

DPH FAQ’s on LTC Guidance - April 1

CDC Webinar: Preparing Nursing Homes and Assisted Living Facilities for COVID-19

CMS Updated Guidance for LTC Facilities - April 2

DPH Updated Guidance to Healthcare Practitioners – April 4

CDC Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Positive Diagnoses

CDC Evaluating and Testing Persons for Coronavirus Disease 2019 

CDC Discontinuation of Transmission-Based Precautions and Disposition of Patients with COVID-19 in Healthcare Settings 

CDC Clinical Care Guidance

CDC Guidance for Healthcare Providers about Hand Hygiene and COVID-19

Key Strategies to Prepare for COVID-19 in Long-term Care Facilities 

DPH Updated COVID-19 Guidance for Healthcare Professionals - April 21

DPH COVID-19 Testing Guidance for LTC Facilities and Congregate Setting Updated – April 22

CDC Return to Work Guidance - Updated 

DPH Updated Guidance on Return to Work – April 24

CDC Strategies to Mitigate Healthcare Personnel Staffing Shortages

CDC Updates Healthcare Infection Prevention and Control FAQs

CDC Portal Registration

CDC Issues Interim Updated Guidance on Worker Exposure - May 29

CMS Guidance Issued April 24 through QSO 20-28-NH 

Updated OSHA Guidance - May 26

Recordings of Nursing Home and Assisted Living Call with DPH

Recording of the DSS Call Reviewing the State Coronavirus Relief Fund (CRF) Grant Payments to Qualifying Nursing Home Providers
Nursing homes can access a recording of the DSS statewide call with nursing homes on June 29 that reviewed the process for obtaining the state CRF Grant Payments.
Website with information on the Coronavirus Relief Fund (CRF) Grant Payments to Qualifying Nursing Home Providers
New Chart on Available Funding Sources by Blum Shapiro

LeadingAge Isolation and Precautions Quick Sheet
CDC has updated guidance on isolation and precautions in adults with COVID-19. LeadingAge has created this quick sheet to give you the information you need to make sense of the new information and how you can operationalize it for your organization. Link to Quick Sheet

Governor Signs Executive Order Strengthening Workers' Compensation Claims for Essential Workers Impacted by COVID-19
Governor Lamont announced that he has signed an executive order creating a rebuttable presumption that workers who contracted COVID-19 in the early days of the pandemic contracted it on the job and are eligible for workers' compensation benefits. The order covers the time period of March 10 through May 20, 2020. Governor Lamont's Executive Order No. 7JJJ

DPH Infection Control and Testing Guidance Update – June 5
DPH has provided updated COVID-19 Infection Control and Testing Guidance for Nursing Homes - June 5, 2020.

DPH Revised Covid-19 Infection Control Guidance for Nursing Homes – June 22
DPH has issued revised guidance on Covid-19 Infection Control for Nursing Homes. This guidance is dated June 22, 2020 and updates the June 5, 2020 guidance document.

Staff Testing Mandate Executive Order Modified on June 17
Governor Lamont issued Executive Order 7AAA which  modifies the mandatory staff testing program for nursing home and other congregate setting staff originally established in Executive Order 7UU, to set conditions for testing to cease after 14 consecutive days without a positive case and to require resumed testing if any staff member or resident tests positive.

DPH's Testing Algorithm
The Department of Public Health has created a helpful algorithm chart related to mandatory staff testing. You can find the chart here: Testing Algorithm

DPH Blast Fax on Testing Contractor Assignments
DPH has issued Blast Fax 2020-71: Nursing Home Staff Testing Care Partner Assignments (June 22, 2020) which provides additional information regarding the care partner assignments given to nursing homes for the purpose of conducting nursing home staff and resident testing. Information regarding assisted living community testing will be forthcoming.

Associations' Guidance on Collaborating with Contractors to Meet Staff Testing Mandate
LeadingAge Connecticut has worked together with CAHCF, CT Association for Health Care at Home and CALA to produce a guidance document to assist our members in meeting the staff testing mandate. The guidance document and other helpful resources are linked here:
Collaborative Guidance
Nursing Home Staff Testing Blast Fax 2020-71
Nursing Home Guidance - June 22
Assisted Living Staff Testing Tool Kit - Updated
Executive Order 7AAA

DPH Nursing Home Testing Guidance Documents
COVID-19 Testing: Recommendations for the Use of Nucleic Acid Tests to Diagnose Persons with Current Infection with SARS-CoV-2 Virus (6-16-2020)
FAQs on State Testing Strategy - Updated (6-17-2020)
Nursing Home Staff and Resident Testing: Summary of State Support for Initial Implementation (6-17-2020)
CMS May 18, 2020 Reopening Recommendations
DPH June 25, 2020 Blast Fax 2020-69 on Covid-19 Testing Requirements
DPH June 22, 2020 Guidance Document Updating June 5 Guidance

CDC Testing Guidelines for Nursing Homes
CDC updated guidelines for COVID-19 testing in nursing homes. The guidance is available here: link. CDC recognizes the recommendations from CMS announced in CMS memo QSO-20-30-NH, which details initial baseline and repeat testing of residents and nursing home staff.

Staff Testing Employer Guidance for LeadingAge Connecticut Members from Wiggin and Dana
Wiggin and Dana has provided LeadingAge Connecticut members with an update to their previous memo regarding COVID-19 testing for employees by long-term care providers.
Wiggin and Dana June 25, 2020 Memo on COVID-19 Testing for Employees

Recording of CDC COCA Webinar on Infection Prevention and Control Strategies in Nursing Homes
CDC Clinician Outreach and Communication Activity (COCA) June 16 presentation focused on applying infection prevention and control strategies in nursing homes. Link to the recorded webinar.

DPH PPS Testing and Cohorting Guidance for Nursing Homes – May 11
Please find below the Point Prevalence Survey Testing and Cohorting Interim Guidance that was issued by DPH on May 11. This document contains important information for your upcoming point prevalence survey testing, cohorting strategy, and considerations on testing of staff.
Template Testing and Cohorting Letter for Families and Residents
DPH Interim Guidance on Point Prevalence Survey Testing and Cohorting May 11
DPH Guidance on COVID-19 Testing for LTC Facilities and Congregate Settings April 22 

Staff and Resident Testing Questions
Nursing homes and assisted living communities were asked to refer questions related to resident and staff testing to the following email address at DPH: [email protected] 

Video Instruction on Nasopharyngeal Swab Technique
In response to a question raised on today's call with DPH, Dr. Leung has sent the following link to a NETEC instructional video on nasopharyngeal swabbing. 

Health Care Practitioner Guidelines Update – June 11
Find the guidance here. - Note: This guidance contains out of date information on interstate travel quarantines and RTW guidelines.

State's Travel Advisory Exemption Removed
There has been a change in the state's travel advisory which directs travelers to self-quarantine for a 14-day period when entering or returning to Connecticut from one of the identified states. While this travel advisory used to exempt essential health care workers from the quarantine requirement, it no longer does.

DPH Blast Fax on Resident Doors
Blast Fax 2020-61 clarifies that there is no policy that states that resident rooms must remain closed.

Do Not Use State Issued Non-Medical Use PPE
We have been asked by DPH to advise our members not to use any of the PPE that was distributed by the state and that has a label indicating it is not for medical use. Please put those supplies aside and wait for additional guidance from DPH.

Distribution of PPE to Home Health Care Agencies
Please find attached the new schedule for the JDPH distribution of PPE to home health care agencies.

DPH Issues Changes to Disclosure of Nursing Home Survey Results
On May 28, DPH issued a memo regarding changes to the manner in which survey results will be posted to the elicensure site. Here is a link to the site where you can download the findings: Public link to survey findings

DPH Guidance on N95 Fit Testing and Use
DPH has issued the attached guidance document on respirator use and fit testing.

DPH Alert Regarding PrimeStore Test Kit Vials
On Thursday, May 28, DPH issued an alert for hospital laboratories and nursing homes that received SARS CoV2 testing sample collection vials made by PrimeStore. This transport media contains guanidine thiocyanate which produces a dangerous chemical reaction releasing cyanide gas when exposed to bleach (sodium hypochlorite). More information can be found here.

Creation of Temporary Nurse Aide Position
Executive Order 7SS permits the creation of a temporary nurse aide position to assist health care providers managing the COVID-19 pandemic and other health-related services during the pandemic.
Link to DPH site.

Transmission-based Precautions Sign
Please find attached the transmission-based precaution sign designed by another state that the Connecticut DPH has recommended for use when such posting is necessary on a resident door.

For Posting: Room Signs for Droplet Precautions
DPH is expecting signs to be posted on the outside of resident doors when transmission based precautions are in place. Examples of signs can be found at the bottom of the CDC article at this link.

National Healthcare Safety Network Groups
DPH has suggested that nursing homes register for their group on the NHSN system.
How to Join a Group
• Group Name: CT-DPH
• Group ID: 49299
• Group Joining Password: LTC1234
• Group Type: CT Long Term Care Facilities (CT LTC)

DPH Issues FAQ on NHSN Reporting – June 22, 2020
DPH has issued an FAQ document on the NHSN LTCF Covid-19 Module. Here is a copy of the FAQ document for your reference.

Is CMS saying your Nursing Home didn't report into NHSN?
Here is a quick tool to help if your nursing home is told by CMS that they didn't report to the CDC National Healthcare Safety Network, even though the nursing home thinks it reported. The tool describes what might have gone wrong and offers links for help correcting the errors.
Note: The DPH staff person who can assist you with reporting questions is Adora Harizaj - [email protected].

Reopen Connecticut Report
The Reopen Connecticut report, which contains recommendations from the Reopen Connecticut Advisory Group - the panel of local health, business, workforce, and education experts who provided his administration and legislative leadership with recommendations on the reopening of Connecticut's economy and education system as the nation emerges from the unprecedented public health emergency caused by COVID-19

Phase 2 Reopen Rules
Please find the following link to DECD's Sector Rules and Certification website which shows the Phase 2 Reopen Rules by Sector beginning June 17. Link to DECD Sector Rules Phase 

CDC Nursing Home Guidance
CDC has updated guidance to nursing homes since CMS’s new recommendations on reopening were released on May 18. Testing Guidance for Nursing Homes; Performing Facility-Wide SARS-COV Testing in Nursing Homes; Preparing for COVID-19 in Nursing Homes.

DPH Commissioner’s Order Modifies Some Nursing Home Regulations
DPH Commissioner issued the following Order on May 22 that modifies the following nursing home regulations during the remainder of the public health emergency:
• Medical Staff Meetings
• Feeding Assistants
• Physician Visits
• Medical Examinations
• Bed Placement
• IV Therapy

DPH Commissioner and LTC Ombudsman Provide Letter regarding Outdoor Visitation
The Long-Term Care Ombudsman and the Commissioner of the Department of Public Health have provided the attached letter to residents, family members and responsible parties that provides an overview and explanation regarding the guidance and restrictions around outdoor visitation. We hope that you will find the letter useful to you and your residents and families.

DPH Commissioner Issues Order Mandating Alternative Means of Communication Copy of Commissioner's Order

CDC - Considerations for Memory Care Units in Long-term Care Facilities

CDC Issues New Guidelines For COVID-19 Antibody Testing
On May 24, the CDC released new Interim Guidelines for COVID-19 antibody testing in clinical and public health settings. The new guidelines can be found here.

DPH Releases Updated COVID-19 Guidance for Healthcare Providers – May 20
On Wednesday, May 20, DPH released updated guidance related to: healthcare provider reporting for laboratory-confirmed COVID-19; clarification on provider order required for COVID-19 testing; Multisystem Inflammatory Syndrome in Children (MIS-C); COVID-19 Serologic Testing and; release from isolation guidance. The DPH document can be found here.

Nursing Home State Funding Details
Executive Order 7NN grants the necessary authority to OPM to implement the financial relief for nursing homes outlined in the letter sent to LeadingAge Connecticut and CAHCF.

State Funding for Home Health and CTHCPE
Through the use of additional federal funding the State has received for COVID-19 related expenses, the State is expected to provide Home Health Care providers and Medicaid waiver services providers (such as CTHCPE providers) additional state funding in the amount of what will equate to a three-month, 10% rate increase. This funding is intended to address the additional expenses related to the COVID-19 public health emergency and will be considered grant funding, similar to the program being implemented for nursing home funding. More information will be forthcoming. Link to the COVID-19 Funding Chart

Mary Wade PPS Testing Experience
The recent point prevalence survey resident and employee testing experience was published in the attached article.

CT Medical Surge Plan for Nursing Home Residents
The details of the plan can be found on the attached grid. 
Gov. Lamont EO 7Y - Nursing Home Surge Plan: Click Here 
CT DPH Nursing Home Surge Plan FAQ 2020.04.11: Click Here

Hospital Discharges to Nursing Home Guidance Revised
The DPH guidance on hospital discharges to nursing homes during the Covid-19 pandemic has been revised effective April 17. The revised guidance can be found here and clarifies that a nursing home can accept a patient without testing and that they should not refuse a patient that has been tested.

CDC: Strategies for Optimizing the Supply of PPE
Link to Strategies for Optimizing the Supply of PPE

LeadingAge Communication Tools Updated
LeadingAge Coronavirus Communication and Media Tools page

State Begins Site Visits to Every Nursing Home in Connecticut to Extend Additional Support
The Governor has announced that the state will provide additional support to the state's nursing homes and long-term care facilities through on-site visits by DPH staff to all of Connecticut's nursing homes and long-term care facilities over the next seven to ten days. The DPH's Healthcare Quality and Safety Branch, with guidance from CMS, will conduct infection control surveys during each visit. The form that will be used during these site visits will be the survey tool contained in CMS QSO 20-20 All. Click here for the survey tool

Nursing Home Data Released
On April 16, the Governor's office released the first DPH weekly report on the number of COVID-19 positive residents and COVID-19 associated deaths in Connecticut nursing homes.

LeadingAge Connecticut and CAHCF Press Release

Coronavirus Communication and Media Tools

DPH Guidance for Online Individual Practitioner Reporting of COVID-19 Cases – May 5

Nursing Home and Assisted Living Weekly Data

Point Prevalence Survey Testing Data
The test results among nursing home residents included in the point prevalence survey testing are reported in the June 11 state data release found here.

State Covid-19 Daily Nursing Home FLIS Reporting System Changes - May 6
DPH Blast Fax 2020-51 provides information regarding the newly re-designed LTCF COVID-19 Daily Reporting System.

Correcting Your Data
We have been told that nursing homes can request a correction of their data by contacting Surjit Sethuraman the IT Supervisor/ CT QIES-ASPEN Coordinator at DPH, 860-509-7134, [email protected]

Community LTSS COVID-19 Dashboard
Please find attached the dashboard for COVID-19 cases in the state's community network of long term services and supports as of May 29.

State Map of Cases
Please find attached the state map illustrating the concentration of identified COVID-19 cases.

Stressing the Importance of Transparency
LeadingAge released a statement underscoring our recommendation that members maintain transparent communication about positive COVID-19 cases with staff, residents, and families.  They have also provided templates to help you communicate with staff, residents, and families.

Governor Orders Assisted Living Provider to Report through LTC-MAP
Today, through Executive Order  7EE , Governor  Lamont mandated that all assisted living providers begin to report their COVID-19 status daily through the Long Term Care Mutual Aid Plan (LTC-MAP).

LTC-MAP Reporting Guidance
The LTC-MAP has issued the following guidance document to  assist providers who might be unfamiliar with the reporting process.

DPH COVID-19 Email Address for Non-Urgent Questions
DPH has an email address for non-urgent questions from health care facilities: [email protected]. This is an email account for leadership in healthcare facilities, EMS, and local health departments. It is meant for organizational inquiries only. More information is on the attached memo. 

Urgent matters should continue to be directed to agency staff you routinely communicate with during business hours for weekend and evenings: 860-509-8000.         

Questions from the general public can be found by calling 211 or texting CTCOVID to 898211.

DPH Recommendations for PPE in Home Health Care
The following is a memo released by DPH providing recommendations on the use of PPE in the home health care setting.

Link to all DPH Blast Faxes
All DPH blast faxes are posted on their website at the following link: Link to DPH Blast Faxes

Recordings for CMS National Stakeholder Calls on COVID-19
You can access recordings of the calls along with transcripts on the following link. 

CMS 3 Day Qualifying Stay Waived
CMS is waiving the requirement for a 3-day qualifying hospital stay for coverage of a skilled nursing stay. There had been some confusion at the state level as to whether the state needed to obtain a waiver to take advantage of this, but CMS has clarified that this and several other blanket waiver provisions are automatically in place.

PASRR Screening to Continue
Connecticut has chosen not to take advantage of the CMS waiver of Pre-Admission Screening and Annual Resident Review (PASRR) and therefore the PASRR screening will continue to be required for admission to the nursing home. See DSS notice.

DPH COVID-19 Testing Guidance for LTC Facilities and Congregate Setting Updated – April 22

State Lab Testing for Health Care Workers
Nursing home patients are given priority status for COVID-19 testing at the State Public Health Laboratory in Rocky Hill. The attached COVID19 Test Requisition Form must accompany the testing specimen which can be delivered to the lab via medical courier. Your commercial laboratory vendor may also be willing to deliver it.

CDC: Strategies for Optimizing the Supply of PPE
Link to Strategies for Optimizing the Supply of PPE

CDC Guidance on PPE Burn Rate Calculation
The CDC has released a Personal Protective Equipment (PPE) Burn Rate Calculator which is a spreadsheet-based model that provides information for healthcare facilities to plan and optimize the use of PPE. 

Personal Protective Equipment (PPE) Burn Rate Calculator App

Donning and Removing PPE
The following link is to an instructional chart by CDC on the proper method to put on and remove PPE.

FEMA Provides Guidance On PPE Preservation
On April 12, FEMA released a document on PPE Preservation Best Practices. The document can be found here.

Blast Fax on Coveralls and KN95 Masks
DPH issued Blast Fax 2020-50 on the use of coveralls and KN95 Masks.

Information on DOL Temporary Guidance on N95 Fit Testing
Department of Labor: Temporary Enforcement Guidance - Healthcare Respiratory Protection Annual Fit-Testing for N95 Filtering Facepieces During the COVID-19 Outbreak
We have been told by DPH that a "just in time" fit testing standard is in place. We will continue to seek additional guidance and information on this topic.

CDC Guidance on the Use of Cloth Face Covering
New guidance for the public.

Decontamination Services for N95s
Battelle is a not-for-profit research and development firm based in Ohio that has received an Emergency Use Authorization (EUA) from the FDA to decontaminate N95 masks (non-cellulose based) for reuse. They have recently stood up a mobile decontamination facility in New Haven and are currently decontaminating masks for healthcare clients. The cost of the decontamination is currently free as Battelle has secured federal funding to offset the cost. Providers interested in using Battelle's service are responsible for the internal provider workflow (mask preservation, mask redistribution, etc.) and transportation of the masks to and from the Battelle decontamination site in New Haven. The easiest way to begin the enrollment process with Battelle is through their Battelle CCDS website (you  can find an enrollment link in the upper right hand corner of the site).
Battelle Presentation
Battelle CCDS Fact Sheet
Battelle Instructions for Healthcare Facilities
Fact Sheet for Healthcare Personnel

CDC LTC Frontline Staff Training Webinars
CDC has established new resources for frontline staff. These short webinars are all published on the Key Strategies to Prepare for COVID-19 in Long-term Care Facilities (LTCFs) web page at the bottom under a "Webinar Series" section.
Here are the direct links to each webinar:
Sparkling Surfaces
Clean Hands
Closely Monitor Residents
Keep Covid-19 Out!
PPE Lessons

Guidance Issued by the Funeral Directors Association
DPH has issued Blast Fax 2020-37 clarifying the licensed practitioners other than physicians who are authorized to certify deaths, including Registered Nurses. The blast fax also includes a guidance document from the Connecticut Funeral Directors Association written to Facilitate the Transfer of a Deceased Patient from Hospice, Nursing Homes and Home Care Settings.

CDC Guidance and Webinar on Certifying Deaths Due to COVID-19
The CDC/National Center of Health Statistics has provided the attached guidance for certifying deaths due to Coronavirus 2019 (COVID-19).

Blast Fax: Recommendations for the Deceased in Nursing Homes
DPH has issued Blast Fax 2020-21 regarding recommendations for the deceased in nursing homes. It contains guidance to prevent the need for the funeral director to enter the hallways of the facility as well as reminding homes to have a physician's order in the clinical record that permits an RN pronouncement. The Funeral Directors Association suggests contacting the funeral director now to discuss your plans ahead of time to avoid any confusion. 
Note: DPH has also issued Blast Fax 2020-15A regarding How to Certify Confirmed and Suspected COVID-19 Deaths

DPH to Allow Out-Of-State Providers to Provide Services in Connecticut
DPH Commissioner order allowing the temporary suspension for a period of sixty days of the requirement of the licensure, certification or registration of certain out-of-state healthcare providers.  The order can be found here.

Executive Order Regarding Home Health Orders
Governor Lamont signed Executive Order No. 7II authorizes DSS to make it easier for Medicaid members to access home health services by allowing payment for these services to be ordered by advanced practice registered nurses and physician assistants, in addition to physicians.

CMS Guidance Addresses Nursing Home Access for Hospice Health Care Staff
The guidance CMS released addresses the question of allowing access to the nursing home for healthcare staff, such as hospice staff. The guidance states that, "CMS is aware that some providers (nursing homes, assisted living facilities, etc.) have significantly restricted entry for staff from other Medicare/Medicaid certified providers who are providing direct care to patients. In general, if the staff is appropriately wearing PPE, and do not meet criteria for restricted access, they should be allowed to enter and provide services to the patient (interdisciplinary hospice care, dialysis, organ procurement, home health, etc.)."

CMS Guidance to Home Health and Dialysis Providers
On March 10, the Centers for Medicare & Medicaid Services (CMS) released guidance to home health agencies and dialysis facilities. The memoranda were developed from frequently asked questions the agency has received about interacting with patients amid COVID-19. The guidance offers clear, actionable information to healthcare workers on the screening, treatment and transfer procedures to follow when interacting with patients.
To view, CMS's guidance for home health providers, visit: Link
To view, CMS's guidance for dialysis facilities providers, visit: Link

CMS Guidance for Hospice
On March 9, CMS issued guidance on the screening, treatment and transfer procedures healthcare workers must follow when interacting with patients to prevent the spread of COVID-19 in a hospice setting. CMS also issued additional guidance specific to nursing homes to help control and prevent the spread of the virus.
To view CMS's guidance for hospice, visit: https://www.cms.gov/newsroom/press-releases/cms-issues-clear-actionable-guidance-providers-about-covid-19-virus 

New Hospice FAQs
On June 10, CMS issued and answered some new FAQs which among other things, address some hospice related issues. Here is the full article.

Requesting a Provider Tax Extension
Time sensitive information on how to apply for an extension is included in the attached memo. Link  to the memo.

Nursing Home Medicaid Reimbursement Increased
Nursing homes are receiving a 10 percent across-the-board increase for March and April in Medicaid payments to help meet extraordinary costs from the public health emergency. More information on the rate increase can be found on the DSS website fixed. 

Keeping Track of Extraordinary Expenses
We encourage all members to maintain accurate records and to keep track of the extraordinary expenses they are incurring due to the Covid-19 crisis. To assist you, we have attached this Excel template created  by one of our members.

Grants, Loans and Advanced Funding Opportunities
LeadingAge New York has partnered with LeadingAge to create a helpful document tracking the many funding opportunities available to not-for-profits. COVID-19 Grants, Loans & Advance Funding Opportunities for Not-For-Profit Providers

 

Provider Relief Funds Reporting Timelines Announced
The U.S. Department of Health and Human Services (HHS) outlined the timeline for providers to report on their use of Provider Relief Funds (PRF), for those who received $10,000 or more across all PRF payments, in a new PDF document on its website. The first report will be due no later than February 15, 2021. Read the LeadingAge article.

 

Provider Relief Fund Payment Resources and New Attestation Portal Launched
HHS has 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. Providers can find out the status of their payment and an estimated amount using the formula is in the HHS website. Providers can still contact HHS about the fund using the email [email protected].

New HHS FAQs on Provider Relief Fund
There is new FAQ information posted on the HHS website regarding the provider relief fund contained in the CARES Act. LeadingAge will be updating their posted information on the provider relief fund shortly.

DSS Releases Information on Coronavirus Relief Fund (CRF) Grant Payments to Nursing Homes
DSS has released information regarding the additional funding available to nursing homes for Covid-19 related expenses. The information and documents can be found on the DSS website. The downloaded documents need to be completed and returned to DSS in order to receive the grant payments.

Recording of the DSS Call Reviewing the State Coronavirus Relief Fund (CRF) Grant Payments to Qualifying Nursing Home Providers
Nursing homescan access a recording of the DSS statewide call with nursing homes on June 29 that reviewed the process for obtaining the state CRF Grant Payments.
Website with information on the Coronavirus Relief Fund (CRF) Grant Payments to Qualifying Nursing Home Providers
New Chart on Available Funding Sources by Blum Shapiro

DSS Posts FAQ Document on Nursing Home Covid-19 Grants
The Department of Social Services has posted the Frequently Asked Questions (FAQ) document on their website in response to the questions jointly submitted by LeadingAge Connecticut and CAHCF regarding the process and conditions of accessing the Coronavirus Relief Fund Nursing Home Grants. The FAQ Document can be found here and the document contains the link to the revised required documents.

Nursing Home Acuity Rates Postponed
The state has postponed the implementation of an acuity-based Medicaid rate system for nursing homes. While the state had planned to implement the new system on July 1, they postponed that date soon after the pandemic started. A new start date has not yet been set, but we do not expect it to begin this year. Also, another reminder - there is an anticipated 1% rate increase effective October 1, 2020 and another 1% effective January 1, 2021 per Public Act 19-117.

DSS Memo on Stimulus Checks
Please find attached a DSS memo`1 dated June 3 regarding the Economic Impact Payments (Stimulus Checks) issued to Medicaid and State Supplement recipients. Reminder, providers are prohibited from seizing stimulus funds from residents. In addition, an Economic Impact Payment (EIP) Card may have been mailed to your residents. The EIP card contains the stimulus money they are receiving as a result of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The EIP Card is sponsored by the Treasury Department's Bureau of the Fiscal Service as part of the US Debit Card Program. The EIP card website contains a great deal of valuable information about these cards, including how to transfer funds into a personal account. Link to EIP website

Adult Day Services Rate for Modified Services
Effective March 23, the state has requested that providers of Adult Day Health Services be permitted to provide and bill for Adult Day  Services for participants who are not able to attend the center in person. In order to bill as a remote service, the provider must contact the client and or a family member and assess the client utilizing a template provided by CAADS. In addition, they must provide a minimum of two meals that would be delivered to the participant. More information can be found on this DSS bulletin or by contacting CAADS at [email protected] 

RCH Information
CDC Guidance: On the DPH call with residential care homes (RCHs), the state epidemiologists recommended that RCHs utilize the CDC guidance for shared congregate housing settings. That guidance can be found here: Link to CDC guidance for shared or congregate housing

RCH Medication Administration Online Course: We were also informed on the call that the Commissioner of DPH has issued an order to allow for the online training, certification and re-certification of RCH Medication Technicians. The executive order can be found here and contains a link to the training course on CT-Train: Link to DPH Order dated June 1

Executive Order Suspends Involuntary SNF and RCH Discharges to Homeless Shelters
Governor Lamont issued Executive Order 7XX on June 5 which suspends the involuntary discharge of residents from nursing homes or residential care homes to homeless shelters for the duration of the declared emergency.

Goals of Care at End of Life
Our colleagues at the Connecticut Association for Healthcare at Home and Hospice have shared the following tools to assist consumers, patients and families with having the difficult conversations about goals of care at end of life.
The Conversation Project's Being Prepared in the Time of Covid-19
In-Patient Script from Washington State, Core Healthcare Group
Out-Patient Script from Washington State, Core Healthcare Group 

CMS COVID-19 Elective Surgeries and Non-Essential Procedures Recommendations
The Centers for Medicare & Medicaid Services (CMS) announced that all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak. You can find a copy of the press release here. You can find a copy of the guidance here.

LTC Ombudsman Issues Letters Reminding Nursing Homes to Post Staffing Levels – July 1, 2020
The State Long Term Care Ombudsman has issued the attached letters reminding nursing homes of the staff posting requirements. One of the letters is to residents and family members and should be considered a formal communication from her office to them.
LTCOP Letter to Residents and Families (7/1/20)
LTCOP Letter to Nursing Homes (7/1/20)

LTC Ombudsman Contact Information for Involuntary Transfer/Discharge Notices
As the state offices begin to move toward a more remote workforce, the LTC Ombudsman wants to inform you that while their phone lines will remain open, they are asking that information regarding involuntary/discharge notices be sent by email rather than by fax. The email address is [email protected]

LTC Ombudsman Letter
Please find attached a April 11 letter to residents, families and responsible parties from the LTC Ombudsman, Mairead Painter.

DPH Clarification of Airplane Travel Screening Requirement for Nursing Home Visitors
In the DPH Commissioner's March 13 order, she states that risk screening to be performed for nursing home entry, "shall include, but not be limited to, recent travel history, contact with a person presumed or confirmed positive for COVID-19, fever of 100 degrees or greater, sneezing, cough, sore throat, shortness of breath and recent travel by airplane." We sought clarification from DPH and were told that this is to include all airplane travel, including domestic travel.

DPH Blast Fax - EMTs Are to be Allowed into the Nursing Home
DPH sent out the following blast fax today regarding the need to allow EMTs into the building.

List of Members’ Meal Delivery Current Practices in Assisted Living
Thattached document lists the responses we received from our assisted living and life plan communities in response to the question posed by a fellow member on how people were delivering meals after closing congregate dining. Thank you everyone!

CMS Expansion of Telehealth Benefits for Medicare Beneficiaries During COVID-19 Outbreak
On March 17, CMS announced expanded Medicare telehealth coverage that will enable beneficiaries to receive a wider range of health care services from their doctors without having to travel to a health care facility. Beginning on March 6, 2020, Medicare-administered by CMS-will temporarily pay clinicians to provide telehealth services for beneficiaries residing across the entire country.
For More Information:
Fact Sheet
Frequently Asked Questions

Telemedicine: CT Medicaid
DSS has circulated two provider bulletins on telemedicine:

PB2020-09 NEW permanent coverage of telemedicine: DSS has developed and will be immediately implementing Medicaid coverage (March 13, 2020) of real-time video conferencing between HUSKY Health members and their health care providers for specific medical and behavioral health services. This reflects new standards for coverage in Medicaid.  

PB2020-10 COVID-19 related expansion of telemedicine: In response to current circumstances related to Covid-19, DSS is also immediately broadening the above coverage to include all evaluation and management services for medical and behavioral health. This will be effective for the duration of the public health emergency.

CT Child Day Care Resources Update (3/20/20)
The state's Office of Early Childhood (OEC) has issued a new memo updating their policy on temporary child day care established on the grounds of a hospital or nursing home. The new policy extends the licensure waiver to these sites. However, nursing homes should not proceed with any child day care plans within the nursing home building without receiving approval from DPH. The OEC dedicated phone line for health care workers remains in operation and the attached poster can be displayed for your employees.

Childcare Support for Frontline Healthcare Workers - May
The Office of Early Childhood (OEC) has created a short-term childcare subsidy program for frontline essential employees, including healthcare workers. The program is accepting applications until Friday, May 22, 2020. More information can be found here.

Department of Labor FAQs - COVID-19
The Connecticut Department of Labor has released frequently asked questions about coronavirus for workers and employees. Learn more here

CBIA Employers Guide - COVID-19
The following is a link to the Connecticut Business and Industry Association's publication: Coronavirus: An Employer's Guide. We will be holding a member call soon on this topic.

Business Sector Guidance for May 20 Reopen
The State has issued rules to the business sector for the May 20 first phase of reopening.

Wiggin and Dana Summary of the New FFCRA Regulations
Link to regulations
Link to full Wiggin and Dana summary

Families First Corona Relief Act Q&A Guidance 
March 31 Recording of Member Call 
Dial-in Number: 1-888-203-1112 
Replay Passcode: 518009515 
Wiggin and Dana Advisory

COVID-19 Fact Sheets in 35 Languages
The Health Literacy Project has translated Covid-19 fact sheets into 35 languages. Link to Health Literacy Project

State Covid-19 Daily Nursing Home FLIS Reporting System Changes - May 6
DPH Blast Fax 2020-51 provides information regarding the newly re-designed LTCF COVID-19 Daily Reporting System.

CT Affordable Assisted Living Site Reporting Requirement Clarified
Managed Residential Communities (MRCs) are required to report their Covid-19 status daily through the LTC-MAP site. The expectation for HUD sites which are designated MRCs is that they will report on the cases that they have been made aware of either by the ALSA or by the individual tenants themselves who live in the designated MRC. DPH understands that there may be cases involving independent tenants within the building that are unknown to the housing provider and therefore cannot be reported by them in their daily LTC-MAP report.
On a related note, there are several state congregate senior housing sites whose tenants might receive state funded assisted living services, but these sites are not considered MRCs as they are exempted from that state statute and therefore are not required to report.

New HUD Guidance for Electronic Signatures and Documents
HUD has finalized guidance to allow (but not require) HUD-assisted senior housing communities to use electronic signatures and documents for certain management operations. LeadingAge has developed a summary of the guidance here.

HUD Update
On March 14, HUD published a joint letter from the offices of Public Housing and Multifamily Housing. The letter addresses concerns housing providers and residents may have related to COVID-19 and discusses actions the agency is taking to provide information to stakeholders. The letter contains the following:
Reiterates that REAC inspections have been postponed until further notice due to the virus, and explains how they will handle a health or safety situation where an in-unit inspection may still be required, with more information available in the just released PIH FAQ document, which complements MFH's Q&A document;
Discusses HUD's plan to avoid lapses in housing assistance payments, operations funding, and other HUD actions even in the event of a prolonged agency telework situation; Establishes an email address for multifamily owners and PHAs for submitting questions related to COVID-19.

Updated HUD FAQs
HUD has updated their MFH coronavirus FAQs with key information for housing providers. The new FAQs address residual receipt remittance, carrying over late fees during the eviction moratorium, messaging to residents about confirmed cases on site, delayed CNAs and audits, and more. You can find the LeadingAge summary online here

Housing and COVID-19
Many housing members have asked for updated guidance on whether they can restrict visitors in their communities.  The attached document contains responses to some questions that have been raised.

Employee Cafeteria Guidance and the CT Social Distancing Rules
March 18, This guidance is from DECD Commissioner Lehman on in-house cafeterias in light of the social distancing rules:
"The Governor's Executive Order restricting restaurants and other eating establishments to take out or delivery service does not require onsite workplace cafeterias to close or stop serving food. Employees in general are encouraged to bring their own meals to work if possible rather than using such facilities. To the extent feasible, employers are encouraged to permit or require employees who order food at workplace cafeterias to eat those meals in private work spaces. If employers permit employees to eat food within workplace cafeterias, they should implement appropriate social distancing measures and make every effort to minimize the number of people congregating within a confined space or area."

Governor Issues Order to "Stay Safe, Stay Home"
Governor Lamont has issued an order to Stay Safe, Stay Home effective at 8 p.m. on Monday, March 23, 2020. In the Executive Order, the Governor is encouraging all businesses to employ, to the maximum extent possible, any telecommuting or work-from-home procedures that they can safely implement. This order excludes any essential business or entity providing essential services or functions, such as healthcare, elder care, food service, providers of basic necessities to economically disadvantaged populations and similar critical services. The Governor's press release is printed at the end of this update and you can link to the Executive Order 7H here.

Governor's Executive Order 7F Items of Interest for Aging Services – Telehealth and Critical Legal Functions for Nursing Home Residents
Executive Order No. 7F allows Medicaid  to cover audio-only telehealth services.  It also provides flexibility for critical legal functions that must be carried out in facilities that have limited visitor access due to public health concerns.  The Executive Order permits the nursing home administrator or the administrator's designee to accept personal service on behalf of residents in connection with probate matters involving psychiatric commitment, conservatorships and guardianships and civil court actions.  The administrator is responsible for ensuring that the resident receives the papers that have been served.  The order also allows for hearings, meetings and other proceedings regarding in these matters to be conducted through alternative means such as video conferencing without requiring in-person proceedings with visitor entry into the facility. LeadingAge Connecticut's legal counsel was consulted about the order prior to its implementation and if you have any questions regarding it, please contact me at [email protected].

FAQs on State Actions
Governor Lamont posted a COVID-19 FAQ titled "Frequently Asked Questions on the State of Connecticut's actions related to COVID-19."

Update: 19a-550(c) and Public Health Emergency
DPH has confirmed that because the Governor has declared a Public Health Emergency, a nursing home can utilize the authority of state statute 19a-550(c) to thoughtfully plan to and/or transfer residents to create the physical space and layouts needed to try to protect the health and safety of the residents.

Nebulizer Treatment Protocols
Thattached guidance regarding nebulizer treatments in long term care facilities for patients with diagnosed or suspected COVID-19 was provided by DPH today.

Fire Safety Code Questions
DPH has provided the following information regarding life safety code issues in response to our inquiry. First, fire drills shall continue. Second, inspections and testing for fire alarm, sprinkler, generators, etc. that are interior where vendors will need to travel through the facility for inspection are waived unless it is an emergency repair. Maintenance staff shall continue to do their weekly checks as usual. Any exterior work needed by vendors is permitted. This guidance also applies to Assisted Living MRCs.

Practical Ideas from Members
Look for Member Ideas & Inspiration at this link to the LeadingAge website.
LeadingAge members face new challenges every day as a result of coronavirus. LeadingAge is gathering examples of the innovative solutions you're deploying to better serve older people and support their staff. Read about how organizations around the country are addressing a range of issues, including:
Communicating with Residents: How  are members helping residents/clients connect with families and friends?
Workforce Challenges: How  are members working to make employees' jobs-and personal challenges-easier? 
Managing Meals: How  are members adapting to social distancing with meal delivery?

Online Cultural and Virtual Learning Resources to Stay Connected
LeadingAge New York and LeadingAge Connecticut have compiled the attached list of online resources for seniors and loved ones to use while practicing social distancing. The resources include online virtual tours of famous museums, live musical performances and more!

Caring for Persons Living with Dementia in a Long-Term or Community-Based Care Setting
The Alzheimer's Association's guidance document for emergency preparedness can be found here. LeadingAge is also working this week with a group of members to develop some helpful guidance.

Connecticut Psychological Association Offers Free Volunteer Services for Caregivers
The Connecticut Psychological Association (CPA) if offering health care workers free video or phone sessions to deal with the stress associated with the COVID 19 pandemic. Please see the attached memo for more details.

Older Adult Mental Health Resources
Mental Health First Aid Training
National Coalition of Mental Health and Aging Resources

COVID-19 Update from Veyo
Veyo will be extending all medical necessity overrides until the end of the year for all nursing homes. You can contact Veyo at [email protected] with  any relevant information or questions. More information from Veyo

National CNA Association Releases CNA Education on COVID-19
The National Association of Health Care Assistants (NAHCA) has created and released the first in a series of courses aimed specifically at providing CNAs education on COVID-19. This content is aimed at helping those who work in senior care to protect themselves and those they serve. NAHCA's goal is to support CNAs and all healthcare professionals to provide compassionate and quality care in these difficult times.
The courses are located on NAHCA's website. They are provided free of charge and can be accessed by anyone.

Published Information on Washington's Kirkland Nursing Home Case
COVID-19 in a Long-Term Care Facility - King County, Washington, February 27-March 9, 2020 Early Release / March 18, 2020 / 69 - CDC Website Link to CDC

NGS Accelerated/Advance Payment Hotline
National Government Services (NGS) is expanding services to support the provider community and has established a Hotline to help with accelerated/advance payment requests related to COVID-19: 888-802-3898.

Medicare Cost Reports
CMS will delay the filing deadline of FYE 10/31/2019 cost reports and FYE 11/30/2019 cost reports until June 30, 2020. CMS will also delay the filing deadline of the FYE 12/31/2019 cost reports until July 31, 2020.

Medicare Appeals
-CMS is allowing Medicare Administrative Contractors (MACs) and Qualified Independent Contractors (QICs) in the FFS program and MA and Part D plans, as well as the Part C and Part D Independent Review Entities (IREs) to allow extensions to file an appeal and to waive certain requirements for timeliness for requests for additional information to adjudicate appeals.
-CMS is allowing MACs, QICs, MA and Part D plans, as well as the Part C and Part D IREs to process an appeal even with incomplete Appointment of Representation forms. However, any communications will only be sent to the beneficiary.
-CMS is allowing MACs, QICs, MA and Part D plans, as well as the Part C and Part D IREs to process requests for appeal that don't meet the required elements using information that is available.
-CMS is allowing MACs, QICs, MA and Part D plans, as well as the Part C and Part D IREs to utilize all flexibility available in the appeal process as if good cause requirements are satisfied.

Health Insurance Plans Waiver Out-of-Pocket Covid Costs
The Governor announced this week that all fully-insured plan health plan members, including those with high-deductible health plans, are now receiving testing and treatment for COVID-19 with no out of pocket costs. Read more.

Utilizing Graduate Nurses
Graduate nurses are those who have just graduated and have yet to take the NCLEX. In normal times, graduate nurses can work for 90 days post-graduation and prior to passing the NCLEX and being licensed. The timeframe for graduate nurses to work post-graduation and prior to licensure has been extended to the end of the emergency. The extension of time for graduate nurses is the only change that has been made at this time and it is applied to both LPNs and RNs. Memo from DPH

OLR Report on Recovery Facilities
The Office of Legislative Research has posted a report on Connecticut COVID-19 Recovery Facilities we thought may be of interest. This report provides a brief overview of Connecticut's COVID-19 Recovery Facilities.

FEMA Pandemic Disaster Preparedness
FEMA has published an exercise starter kit for providers to update emergency response plans during the health crisis. The kit includes samples slides and discussion questions for providers across the continuum to adapt current hurricane (or other) disaster response plans to the pandemic. June 2020