Coronavirus (COVID-19)

Important Resources

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.

What’s New

2/10/2021 – Two Guidance Updates from the CDC

Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic

  • 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:

  1. 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
  2. Are within 3 months following receipt of the last dose in the series AND
  3. 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 samc@nchcfa.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 cerickson@gothams.com for additional information.

10/08/2020 – NC Healthcare Preparedness Vaccination Planning

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 samc@nchcfa.org or call the Association office at (919) 782-3827.

07/21/2020 – AHCA Revised PPE Supplier List

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.

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.

IMPORTANT NOTE on behalf of AHCA/NCAL: Beware of scams when working with vendors offering PPE supplies

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 erick@nchcfa.org.

NCHCFA Email Communications

AHCA/NCAL 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.

Childcare

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

NC DHHS Coronavirus Resources

NCHCFA Webcasts

Update From NCTracks

CMS Communications

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

Guidance for both healthcare workers and facility owners/operators

Questions

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.

Statewide Program for Infection Control and Epidemiology (SPICE)