ATTENTION: NC SENIOR LIVING ASSOCIATION COVID-19 UPDATE 3/24/20
Below are recent developments regarding COVID-19. Providers are encouraged to check the
NCDHHS COVID-19 webpage
for the latest updates regarding the virus and the state's response.
- Governor Cooper issues Executive Order 120 - As communicated in yesterday's NCSLA COVID-19 update, Governor Cooper announced Executive Order 120 to close K-12 public school statewide through May 15, bans mass gatherings over 50 people, closes some businesses such as spas, gyms and other settings. A Press Release was also issued which explains the Executive Order in detail.
- NCTracks to hold COVID-19 Question and Answer Webinar for Providers today - DHHS will host a question and answer webinar to discuss new guidance for all health providers related to COVID-19.
- Tuesday, March 24, 2020, from 5:30-6:30 p.m.
- Questions can only be taken during the webinar through the Q&A function for those accessing the webinar through their computers.
- Those with audio access only (calling in) will not be able to ask questions during the webinar.
- Questions can be submitted in advance through questionsCOVID19forum@gmail.com.
- Pre-registration is not required; the webinar can be accessed:
- Through computer or smart phone at https://zoom.us/j/478662233
- Audio-only access on a mobile phone by dialing: +1 (646) 558-8656 and entering Webinar ID: 478 662 233#
- Audio-only access on a land line phone by dialing: (646) 558-8656 and entering Webinar ID: 478 662 233#
- Additional information on COVID-19 is available at https://www.ncdhhs.gov/coronavirus.
- CDC Updates List of Who is High Risk - On March 22, the Centers for Disease Control and Prevention updated who is at high-risk for more severe illness from COVID-19. This is a new disease and we continue to learn about it as new information becomes available. The new guidance can be found at the CDC's website Here. Based upon available information to date, those at high-risk for severe illness from COVID-19 include:
- People aged 65 years and older
- People who live in a nursing home or long-term care facility
- Other high-risk conditions could include:
- People with chronic lung disease or moderate to severe asthma
- People who have serious heart conditions
- People who are immunocompromised including cancer treatment
- People of any age with severe obesity (body mass index [BMI] >40) or certain underlying medical conditions, particularly if not well controlled, such as those with diabetes, renal failure, or liver disease might also be at risk
- People who are pregnant should be monitored since they are known to be at risk with severe viral illness, however, to date data on COVID-19 has not shown increased risk
- Governor Cooper asks for health care volunteers to assist with COVID-19. In addition, the memorandum (click here), it also states that:
- Local Health care Facilities affected by COVID-19 and in need of support can request assistance through their local (county) Emergency Management program. Local (county) Emergency Managers may have the ability to fulfill the support requested within the county. State operated facilities should work through their state agency to route staffing support through their agency to the State Emergency Operations Center. Health care facilities seeking assistance should work with their local county Emergency Managers and be prepared to provide detailed information of the need (avoid requesting specific assets to allow maximum flexibility and increase the likelihood that the request can be filled). Depending upon the type of request and the scope of the event, an affected facility may receive help from any or all of the HCCs. All requests for assistance, including supplies, equipment or personnel, are reviewed by the HCCs, Office of Emergency Management Services (OEMS) and North Carolina Emergency Management (NCEM).
- Medicaid PCS Update - Yesterday, NCSLA sent out information regarding PCS services and COVID-19. Since the information was disseminated, NCSLA has heard from a number of providers regarding the following issues:
- 80-hour cap (will negatively affect special care unit residents and those with exacerbating conditions),
- Interviewing facility staff in addition to residents/guardians,
- Problem of getting physicians to see and sign off on the need for PCS.
- NCSLA communicated the above concerns to Medicaid this morning and they are working on addressing these issues. Regarding the issue of getting physicians to see and sign off for the need for PCS, Medicaid recommended physicians use the new Telehealth policy which will allow physicians to evaluate residents and get paid without having to conduct a face-to-face visit. Medicaid is in the process of crafting a detailed Medicaid Bulletin, which NCSLA will notify providers after it is issued.
- Face-to-Face Assessments: All face-to-face assessments from Liberty Healthcare (LHC) are cancelled.
- Annual Assessments: For beneficiaries due for their annual assessment, prior authorization (PA) will be extended for 90 days. Face-to-face assessments will be scheduled at a later date.
- Initial Requests: Beneficiaries may continue to submit initial requests Personal Care Services; LHC will conduct a mini-assessment by phone with the beneficiary or legally responsible person and beneficiary may receive up to 80 hours. The questions asked on the mini-assessment are those currently used for expedited requests.
- Change of Status (COS) Assessments: Beneficiaries and providers may continue to submit COS requests. LHC will process and conduct an assessment by phone. LHC will then walk the beneficiary through the assessment and complete the COS. This will allow those who have a change in condition to receive the support needed.
- Expedited Requests – Expedited requests from beneficiaries in the process of being discharged from a hospital or Skilled Nursing Facility (SNF), under Adult Protective Services, or are served through transition to community living (TCLI) will process as normal; however, LHC will work to process in one business day instead of two.
- Other issues - Medicaid has received several questions regarding supervisory visits , errands, and other program allowances that will be addressed in the upcoming Bulletin. Please send questions and policy-related COVID-19 questions to Medicaid.COVID19@dhhs.nc.gov.
- Medication aide testing clarification - As noted in the 3/20/20 NCSLA COVID-19 Update we have heard from a number of providers this week that medication aide testing has been cancelled for some individuals previously scheduled to take the test as required by law and rules. According to DHSR, they are limiting the number of individuals at each test site to 10 people (1 DHSR staff to administer the tests and 9 individuals taking the test) and are having to cancel the tests for some in order to achieve the limit. Please note that General Statute 131D-4.5B(b)(3) allows individuals up to 60 days to take the test (not 90 days as previously reported) but when asked, DHSR informed NCSLA this morning that they would not cite providers if employees go over the limit due to the COVID-19 situation and are working on options to possibly provide more additional testing opportunities. NCSLA will provide more information regarding this issue as it becomes available.
- Medicaid Bulletins on Telehealth - Medicaid released a Bulletin article last Friday specifically addressing Telehealth, which may assist adult care and family care homes with primary care and other services for their residents. There are three telehealth modalities referenced within the bulletin, defined as:
- Telemedicine: Telemedicine is the use of two-way real-time interactive audio and video to provide and support health care when participants are in different physical locations.
- Telepsychiatry: Telepsychiatry is the use of two-way real–time interactive audio and video to provide and support psychiatric care when participants are in different physical locations.
- Virtual Patient Communication: Virtual Patient Communication is the use of technologies other than video to enable remote evaluation and consultation support between a provider and a patient or a provider and another provider. Covered virtual patient communication services include telephone conversations (audio only); virtual portal communications (e.g., secure messaging); and store and forward (e.g., transfer of data from beneficiary using a camera or similar device that records (stores) an image that is sent by telecommunication to another site for consultation).
- Number of COVID-19 cases - According the the NCDHHS COVID-19 website,cases of COVID-19 continue to increase in our state and are now found in 49 counties (counties listed below are east to west and more than 2 cases are denoted in red):
- Pasquotank - 1 case
- Carteret - 4 cases
- Brunswick - 8 cases
- New Hanover - 7 cases
- Onslow - 3 cases
- Craven - 2 cases
- Pitt - 5 cases
- Sampson - 1 case
- Wilson - 3 cases
- Nash - 1 case
- Wayne - 2 case
- Johnston - 4 cases
- Harnett - 9 cases
- Cumberland - 2 cases
- Chatham - 3 case
- Franklin - 5 cases
- Granville - 1 case
- Vance - 2 cases
- Wake - 54 cases
- Durham - 63 cases
- Orange - 11 cases
- Alamance - 3 cases
- Lee - 1 case
- Robeson - 1 case
- Hoke - 2 cases
- Moore - 2 cases
- Scotland - 1 case
- Richmond - 1 case
- Guilford - 16 cases
- Randolph - 2 case
- Montgomery - 1 case
- Stanly - 1 case
- Forsyth - 12 cases
- Davidson - 2 case
- Davie - 1 case
- Rowan - 5 cases
- Union - 13 cases
- Cabarrus - 8 cases
- Mecklenburg - 104 cases
- Iredell - 9 cases
- Catawba - 4 cases
- Gaston - 3 cases
- Lincoln - 1 case
- Watauga - 2 cases
- Henderson - 2 cases
- Buncombe - 5 cases
- Transylvania - 1 case
- Jackson - 1 case
- Cherokee - 4 cases
- The NCDHHS, the CDC and others continue to provide excellent materials and timely guidance related to COVID-19. In addition, the NC Division of Public Health (DPH) and NC Area Health Education Centers (AHEC) will be holding weekly forums for health care facilities, home-based providers and others on Tuesdays from 11:00 AM - 12:00 PM. Forums will be held every Tuesday, and will continue until they are no longer needed. Forums will be recorded and available to the public.
- During the forums, Subject Matter Experts from DPH will provide a quick update on any new developments and will then respond to questions received before or during the forum.
- Send any questions you would like for DPH Subject Matter Experts to be prepared to answer during the forum to questionsCOVID19forum@gmail.com - questions must be received no later than 5:00 on the Sunday prior to the call (3/22 this week).
- The forums will be structured to allow either webinar access through your computer OR traditional audio dial-in. PLEASE NOTE - Questions during the forum can only be submitted using the Q&A function using the webinar access through your computer.
- Click the following link to join the webinar: https://zoom.us/j/988453520
- (NOTE: Use the Q&A function to submit questions during the live webinar. For audio-only access (mobile)
Dial +1-646-558-8656, ID: 988 453 520#
For audio-only access (office telephone)
Dial (646) 558-8656
Webinar ID: 988 453 520
Reducing resident exposure to individuals who are potentially infected with COVID-19 is of paramount importance since our residents are among the highest risk group for infection and mortality from this virus. Thank you and your staff for all you are doing to provide care to our residents during this difficult time in what we all hope will be a temporary event.
If you have questions concerning any aspect of this document, please do not hesitate to contact me at
Jeff Horton, Executive Director
North Carolina Senior Living Association
4010 Barrett Dr., Ste. 102
Raleigh, NC 27609