Visit this website daily for the latest information that NCHCFA has to share about COVID-19. As concerns arise with the emerging coronavirus, officially named COVID-19, we are working with our state partners, including the NC Division of Public Health to ensure nursing centers receive necessary guidance to prevent the spread of this disease. NCHCFA President & CEO Adam Sholar is also serving on the Governor’s Coronavirus Task Force.
2/10/2021 – Two Guidance Updates from the CDC
- We continue to recommend use of appropriate PPE including NIOSH-approved N95 respirator (or equivalent or higher level respirator), gown, gloves, and eye protection when caring for patients with suspected or confirmed SARS-CoV-2 infection.
- For source control, we / CDC continues to recommend universal use of well-fitting source control for everyone in a healthcare setting. Healthcare personnel options for source control include:
– N95 respirators or equivalent or high-level respirators
– A respirator approved under standards used in other countries that are similar to NIOSH-approved N95 filtering facepiece respirators OR
– A well-fitting facemask (e.g., selection of a facemask with a nose wire to help the facemask conform to the face; selection of a facemask with ties rather than ear loops; use of a mask fitter; tying the facemask’s ear loops and tucking in the sides pleats; fastening the facemask ear loops behind the wearer’s head; use of a cloth mask over the facemask to help it conform to the wearer’s face)
Updated quarantine guidance for vaccinated persons. This guidance states that vaccinated persons with an exposure to someone with suspected or confirmed COVID-19 are not required to quarantine if they meet all of the following criteria:
- Are fully vaccinated (i.e., ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine) AND
- Are within 3 months following receipt of the last dose in the series AND
- Have remained asymptomatic since the current COVID-19 exposure.
- These updated quarantine criteria could be applied when considering work restrictions for fully vaccinated healthcare personnel with higher-risk exposures as a strategy to alleviate staffing shortages.
- Residents/patients: Vaccinated inpatients and residents in healthcare settings should continue to quarantine following an exposure to someone with suspected or confirmed COVID-19. This exception is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings.
– This applies to new admissions.
1/6/2021 – CMS Adds Six New COVID-19 ICD-10 Codes Effective January 1, 2021
In an off-cycle update to the 2021 ICD-10-CM Coding Guidelines posted in December in response to the COVID-19 pandemic, the Centers for Disease Control and Prevention’s (CDC) National Center for Health Statistics (NCHS) implemented six new diagnosis codes into the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), effective January 1, 2021. The new codes are:
• J12.82 – Pneumonia due to COVID-19
• M35.81 – Multisystem Inflammatory Syndrome
• M35.89 – Other specified systemic involvement of connective tissue
• Z11.52 – Encounter for screening for COVID-1 (Note: Per ICD-10-CM coding guidelines, this code should NOT be used during the pandemic)
• Z20.822 – Contact with and suspected exposure to COVID-19
• Z86.16 – Personal History of COVID-19
See pages 28-33 of the update to the 2021 ICD-10-CM Coding Guidelines for specific details related to COVID-19 diagnosis coding situations and sequencing guidance. In addition, the files located in the Downloads section of this CMS 2021 ICD-10-CM webpage contain additional details to the updated codes.
AHCA analysis of the new codes and updated coding sequencing guidance suggests that these new codes are typically expected to be used as secondary diagnosis codes to describe COVID-19 status or secondary or associated manifestations of COVID-19. When COVID-19 meets the definition of the principal diagnosis on the claim or reason for SNF stay in MDS item I0020B, then code U07.1 should continue to be used for that purpose.
AHCA notes that at this point, the Patient Driven Payment Model (PDPM) ICD-10 Mappings file has not been updated to include these new ICD-10 codes, and using them in MDS item I0020B – Primary Reason for SNF stay may create problems with MDS locking and submission with some software vendors.
Additionally, case-mix assignment for Medicare PPS and some state OBRA PDPM assessments may be impacted. Until CMS updates the PDPM mappings file, if a provider needs to use one of these new codes for stays beginning January 1, 2021 as a primary or secondary diagnosis, AHCA recommends that provider MDS and billing staffs contact their software vendors for guidance.
12/09/2020 – NCHCFA Grant Applications
- The North Carolina Health Care Facilities Association (NCHCFA) received grant funds through House Bill 1105. In order to more accurately address the varying needs of nursing facilities, NCHCFA is administering the grant to reimburse facilities for their properly documented and supported expenses, up to a maximum allowed amount. The deadline for grant requests was November 20th. In order to maintain transparency, NCHCFA has posted a list of grant requests that we have received. Click here to view this file. If you submitted a grant request and do not see the facility name on the list, please contact Sam Clark at firstname.lastname@example.org.
10/30/2020 – AHRQ ECHO National Nursing Home COVID-19 Action Network
- Click here to register two of your staff for the UNC ECHO telementoring COVID-19 sessions. This is an opportunity for your facilities to join a weekly Zoom conference and connect with infectious disease experts and geriatricians at UNC to fight COVID-19. Your team gets access to world class experts plus a $6,000 stipend from the federal CARES act once you complete the 16-week training.
10/22/2020 – Grant Funds Through House Bill 1105 for Rapid Testing
- The North Carolina Health Care Facilities Association (NCHCFA) received grant funds through House Bill 1105. One portion of this money can only be used for the purchase of COVID-19 rapid tests. The other funds can be used for the purchase COVID-19 related supplies, equipment and PPE. In order to more accurately address the varying needs of nursing facilities, NCHCFA will reimburse facilities for their properly documented and supported expenses, up to a maximum allowed amount. Purchases on or after July 1, 2020 can be included. Click here for the NCHCFA Reimbursement Request Form and additional details.
10/15/2020 – New Rapid Testing Resource for Nursing Homes
- Curative Offers Testing Option to North Carolina Nursing Homes
- Curative is an innovative testing company, that has accomplished over 4.9 million tests across the United States since April. Curative currently conducts in excess of 75,000 tests per day, and has capacity to handle well over 100,000k tests.
- Curative has deep experience working with Nursing Homes, and has conducted a similar task on behalf of the Florida Skilled Nursing Homes/Assisted Care Facilities. Curative trained over 3,000 facilities via Zoom in 4 days and shipped over 300,000 test kits to these facilities. All tests were processed in under 48 hours from time of collection. A “Case Study” of the work with the Florida facilities can be found here. Please contact email@example.com for additional information.
10/08/2020 – NC Healthcare Preparedness Vaccination Planning
- CDC’s COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations
- This is the main operational guidance from CDC and contains information about CDC’s phased approach to COVID-19 vaccination as well as some hypothetical vaccination scenarios.
- Operation Warp Speed (OWS) Vaccine Distribution Graphic
- Describes the goals, tenets, and architecture of Operation Warp Speed
- From the Factory to the Frontlines
- A more detailed report about the OWS strategy for distributing COVID-19 vaccine
- Vaccination Planning Assumptions
- A detailed list of the planning assumptions CDC has provided to inform state and local planning
- Vaccination Program Action Items
- A checklist of action items to assist jurisdictions in early vaccination planning.
- Local Public Health COVID-19 Vaccine FAQs
- This is the first installment of this document that will be updated regularly by NC DHHS throughout the vaccine response.
09/28/2020 – NC DHHS Sec. Cohen Issued Secretarial Order No. 6 Updated Guidance for Visitation
09/28/2020 – NC DHHS Releases Updated Guidance for Visitation
09/11/2020 – CDC Guidance: Considerations for Interpreting Antigen Test Results in Nursing Homes
08/27/2020 – AHCA Public Relations Toolkit (New Updates)
08/25/2020 – Questions Received – NCHCFA Seeking Bids for Certain PPE for NC Nursing Facilities
08/20/2020 – NC PPE Classification System has been Updated – Moving all Respirators with Exhalation Valves to Tier II
08/17/2020 – NCHCFA Seeking Bids for Certain PPE for NC Nursing Facilities
NCHCFA has received a grant that will be used to purchase certain PPE for nursing facilities. NCHCFA is seeking bids on the purchase of significant amounts of gowns and/or N-95 masks. Please refer to the grant documents below for additional information:
If you have any additional questions please email firstname.lastname@example.org or call the Association office at (919) 782-3827.
07/21/2020 – AHCA Revised PPE Supplier List
- AHCA has developed a PPE supplier list that members may want to refer to when shopping for PPE here. The PPE vendors on the AHCA list have successfully served LTC providers and were recommended by providers.
06/18/2020 – Additional PPE Resources Now Available
05/04/2020 – NC Governor Signs Important Bills Passed by Legislature
04/27/2020 – NC Medicaid Special Bulletin COVID-19 #68
04/27/2020 – Waiver for Temporary Nurse Aide Services
04/11/2020 – Reporting COVID-19 to State Survey Agency
04/10/2020 – HHS Releases a Portion of the $100B COVID-19 Health Care Fund
04/09/2020 – CMS Accelerated Payment Program
04/03/2020 – CMS Issues COVID-19 Long Term Care Facility Guidance
04/01/2020 – CMS Updates PDPM ICD-10 Mappings for New COVID-19 Diagnosis Code
04/01/2020 – Change in Resource Request Process for Personal Protective Equipment in SNFs
On April 1st, the resource request process for EMS Systems changed and will no longer be submitted through your county emergency managers. This process change only relates to supplies for healthcare providers in the Hospital, EMS, and Long Term Care sectors. Their prioritization plan calls for fulfillment of scarce supplies in order to ensure urgent needs are met for those actively engaged in providing care for COVID-19 patients. This prioritization plan includes providing up to 7 days of inventory, when possible, for those that have only 96 hours of inventory remaining.
- Skilled Nursing Facility administrators submit all resource requests directly to the State Emergency Operations Center here
Requests will be vetted by ESF8 staff and the appropriate course of action will be taken based upon priority and available supply at the state’s Healthcare Preparedness Coalitions. No other processes have been revised at this time. As supplies continue to arrive in North Carolina, they will work towards fulfilling resource requests for all agencies. Healthcare providers are vital partners in our communities and will still require coordination and collaboration with Local Emergency Managers. It is not their intent to usurp the mutually beneficial relationships developed locally over the years but to help make the process more streamlined.
04/01/2020 – Memo on Eligibility Requirements for New SBA Loan Program Created by CARES Act
- As a way of addressing some of the questions about the SBA sections of the CARES Act, James Segroves with Reed Smith wrote a memo for members of the American Health Care Association (AHCA). You can read this memo by clicking here.
04/01/2020 – Office of the Assistant Secretary for Preparedness & Response – U.S. DHHS
03/31/2020 – Palmetto GBA Revised Request for Accelerated/Advance Payment Form
03/30/2020 – Enhanced Medicaid Rates
In March, Medicaid increased nursing facility rates by 5% in recognition of the cost increases related to COVID-19. The enhanced rates have been posted here.
The March rate file also includes the enhanced April rates. NCTracks should have these rates as well. If providers bill at the higher rates, they should be paid at these rates in the next checkwrite.
03/29/2020 – Guidance – Testing for Healthcare Workers & Residents/Patients in Long Term Care Settings
Local Industries Shifting Manufacturing to Assist with the PPE Shortage in North Carolina
NCHCFA continues to work with county emergency management officials to get much needed Personal Protective Equipment (PPE) to our members. In the interim, as we are made aware of any additional PPE availability that could benefit you, we will let you know.
We are exploring ways hospitals, SNFs, and other healthcare providers may be able to bulk order in various areas of the state, and more on that concept should be available soon. The NC Hospital Association (NCHA) has also made available to our members their resource list, which can be found here.
Several reputable sources have also informed NCHCFA of local industries that have/are shifting manufacturing to assist with the PPE shortage in our state. IMPORTANT NOTE – NCHCFA in NO WAY recommends, endorses, or approves specifications of ANY PPE and/or manufacturers.
AHCA has developed a PPE supplier list that members may want to refer to when shopping for PPE here. The PPE vendors on the AHCA list have successfully served LTC providers and were recommended by providers.
Click here to see companies that are now manufacturing PPE to help those in the healthcare community.
If you are aware of any additional manufacturers that could assist our membership with PPE needs, please email Eric Kivisto at email@example.com.
NCHCFA Email Communications
- April 9, 2021 – Updates | COVID-19 Update: COVID Testing Payments to Nursing Facility Providers
- April 6, 2021 – Updates | COVID-19 Update: List of NC DHSR’s COVID-19 Updates from Last Week
- April 6, 2021 – Updates | COVID-19 Update: OSHA National Emphasis Program (NEP) Follow Up
- March 17, 2021 – Updates | COVID-19 Update: NC DHHS Released Updated Guidance on Visitation & Related Matters in LTC Settings
- March 10, 2021 – Updates | COVID-19 Update: CMS Updates Nursing Home Guidance with Revised Visitation Recommendations
- February 19, 2021 – Updates | COVID-19 Update: NC Questions About P&P Co-Administration of COVID and Other Vaccines
- February 16, 2021 – Updates | COVID-19 Update: Medicaid Published Special Bulletin: Final Reconciliation of Nursing Home Staff Testing Payments
- February 12, 2021 – Updates | COVID-19 Interim Infection Prevention and Control Recommendations for Healthcare Personnel
- January 20, 2021 – Updates | Issues with November and December Medicaid COVID Rates
- January 20, 2021 – Updates | COVID-19 Vaccine-Related Updates
- January 14, 2021 – Updates | COVID-19 Update: Vaccination Update
- Click here for previous email communications
AHCA/NCAL Email Communications
- April 9, 2021 – Updates | COVID-19 Update: CMS Announces Changes to 1135 Waivers
- April 5, 2021 – Updates | COVID-19 Update: CMS Updates Guidance for Emergency Preparedness Regulations
- March 30, 2021 – Updates | COVID-19 Update: CDC Provides Updates on Interim Infection Prevention and Control Recommendations
- March 26, 2021 – Updates | COVID-19 Update: U.S. Senate Passes Medicare Sequester Relief Language
- March 24, 2021 – Updates | COVID-19 Update: AHCA/NCAL Unveils COVID-19 Honors Program
- March 16, 2021 – Updates | COVID-19 Update: CDC Study Shows Vaccine Effectiveness in Long Term Care
- March 15, 2021 – Updates | COVID-19 Update: AHCA/NCAL Announces “Care For Our Seniors Act”
- March 12, 2021 – Updates | COVID-19 Update: CMS Revises Memo on Nursing Home Visitors
- March 08, 2021 – Updates | COVID-19 Update: CDC Updates Guidance for Fully Vaccinated Staff Outside of Health Care Settings
- March 04, 2021 – Updates | COVID-19 Update: Accessing the COVID-19 Vaccine in Long Term Care
- February 26, 2021 – Updates | COVID-19 Update: Applying New CDC Quarantine Guidance to LTC Staff
- February 22, 2021 – Updates | COVID-19 Update: Medicare AAP: How to Request an Extended Repayment Schedule
- February 17, 2021 – Updates | COVID-19 Update: Medicare AAP Repayment Dates Begin Soon
- February 11, 2021 – Updates | Changes to CDC Quarantine Guidance for Vaccinated Staff
- February 8, 2021 – Updates | COVID-19 Update: Third Clinic Vaccine Policy
- February 2, 2021 – Updates | COVID-19 Update: CDC Releases Information on Early COVID-19 Vaccination Update in SNFs
- Click here for previous email communications
Visit AHCA/NCAL for the most up to date information regarding COVID-19.
Email any additional questions to AHCA/NCAL staff at COVID19@ahca.org.
Section 1135 Waiver Flexibilities – North Carolina Coronavirus Disease
Ancillary Services Guidance for Feeding Assistance
The document here contains necessary requirements and guidance for allowing non-nursing staff such as housekeepers or business office personnel to provide feeding assistance to persons who DO NOT have any difficulty eating, drinking, or swallowing. The document was approved by both Cindy Deporter, State Survey Director and Becky Wertz, Section Chief, Licensure and Certification Section, NCDHSR.
We know many of our members are worried about ensuring their children have safe care while you and your teams continue providing critical services during this unprecedented crisis. To assist with this challenge, the North Carolina Department of Health and Human Services and the NC Department of Public Instruction are working with their networks of partners across the state to provide child care options to children of essential workers, which includes first responders, hospital staff, front-line healthcare providers, nursing and adult group home staff, child care program staff, food service staff and others working to keep our communities safe and healthy as we respond to COVID-19.
Parents and families with urgent childcare needs may call 1-888-600-1685 to find high-quality, safe childcare for infants through children age 12. We encourage you to share the hotline number and these handouts:
Governor’s Visitation Recommendations
- Governor’s Recommendations March 13, 2020
- NCHCFA Template Door Sign Restricting Visitors
- NCHCFA Visitor Log Template
NC DHHS Coronavirus Resources
- Webcast Recording Friday, March 13, at 11:00 am for NCHCFA Members
- NCHCFA Represents SNFs at Governor’s COVID-19 Task Force Meeting, March 12
- Webcast Recording Friday, March 6, at 10:30 am for NCHCFA Members
Update From NCTracks
- Qualified Medicare Beneficiary (QMB) Crossover Claims Reprocessing Notice
- New Special Medicaid Bulletin Regarding COVID-19 Available
- CMS COVID-19 Partner Toolkit
- QSO-20-14-NH – March 13, 2020
- QSO-20-14-NH – March 9, 2020
- CMS Releases Medicare Fee-For-Service and Medicare Advantage Plan Guidance March 11, 2020
NCHCFA Crisis Communication:
Given the public focus on Coronavirus and COVID-19, we recognize that many of the staff and residents in member facilities and their families are particularly focused on these developments. While we know your focus is rightly on the provision of needed health care services, and protecting your staff and residents, we want to aid in preparing from a communications perspective for the possibility of an occurrence of COVID-19 in your facility. The following information here has been provided to the Association by a crisis communications expert who is available to assist our members if necessary.
NC Division of Public Health
Guidance for Management of Scarce Resources
- NC Healthcare Supply Conservation Considerations
- Healthcare Coalition Partners – Personal Protective Equipment (PPE) Resource Monitoring and Request Algorithm
- Strategies for Scarce Resource Situations
Guidance for both healthcare workers and facility owners/operators
- General Guidance
- Guidance for Healthcare Professionals and Local Health Departments
- Guidance for Non-Healthcare Settings
If members have specific questions about COVID-19 or need assistance with risk assessment for a resident or staff member after talking to your local health department, the Communicable Disease Branch of the Epidemiology Section of the N.C. Division of Public Health, Department of Health & Human Services, has a 24-hour call line. That number is: (919) 733-3419. More information about the Branch is available here.