E-News Update Articles

The CARES Act includes funding for a small business loan program called the Paycheck Protection Program. The program is a loan designed to provide a direct incentive for small businesses to keep their workers on the payroll. SBA will forgive loans if all employees are kept on the payroll for eight weeks and the money is used for payroll, rent, mortgage interest, or utilities. The Paycheck Protection Program will be available through June 30, 2020 and the application process starts today, April 3rd.

Memorandum To: Mass Senior Care Members From: Tara Gregorio, President Re: COVID-19 Updates: CMS Issues New Recommendation to Nursing Homes and DPH Releases Guidance on Verbal Consent for MOLST and Revised Guidance for HCP with Known Exposure to COVID-19 Date: April 3, 2020 In this memo we are providing you with several updates related to CMS' new recommendations to nursing homes, DPH guidance on verbal consent for MOLST, DPH revised guidance on health care personnel with known exposure to COVID-19

Resources to help support your front line staff

The Centers for Medicare and Medicaid Services (CMS) has announced another measure to free up the attention of providers as they respond to the COVID-19 pandemic.

MassHealth has issued the following COVID-19 related information for MassHealth members and applicants. In response to COVID-19, and to support the health and safety of our members and staff, all MassHealth Enrollment sites will be closed for walk-in visitors until further notice. If MassHealth members or applicants need support or have any questions they should contact the Customer Service Center at (800) 841-2900; TTY: (800) 497-4648. In addition, applicants can apply for benefits online at www.mahealthconnector.org

The state of Massachusetts is working with local providers and boards of health across the Commonwealth to find places where health professionals could volunteer to support their community.

It is widely predicted by public health authorities that despite all of our collective mitigation efforts, the number of COVID-19 cases among nursing home residents and frontline caregivers will surge along with the statewide surge. Our number one priority is to provide you with the support and resources necessary to keep our facility staff safe and our residents well cared for.

We appreciate the support of our Associate Members who are providing critical information on COVID-19 related financial and workforce laws and regulations. Please click on the individual links to register for these complimentary webinars.

Although the Office of Medicare Hearings and Appeals (OMHA) office space is closed to the general public, OMHA hearings and appeals processing measures are proceeding as scheduled.

In this memo we are providing you with several updates related to today’s CMS Call with Nursing Homes, user fee payments, and the SBA Paycheck Protection Program. Please continue to visit our dedicated COVID-19 webpage for resources and updates.

Today we are providing you with several updates related to training and certification of nurse aides and a revised screening checklist for visitors and staff. Please continue to visit our dedicated COVID-19 webpage for resources and updates.

CMS has issued several blanket waivers for long term care providers in pages 9-12. These blanket waivers are in effect, with a retroactive effective date of March 1, 2020 through the end of the emergency declaration.

Today we are providing you with several updates related to onsite COVID-19 testing programs in nursing homes and rest homes, MassHealth update on coverage and N95 fit testing guidance. Please continue to visit our dedicated COVID-19 webpage for resources and updates.

Talking Points for Crisis Communications: COVID-19 Outbreak COVID-19 Specific Talking Points Skilled nursing facilities care for the most vulnerable residents of the Commonwealth and their health and safety is always our top priority. We are staying in very close communication with local and state health officials to ensure we are taking all the appropriate steps to keep our residents and staff safe. We are following the recommended preventative actions issued by the CDC and the Massachusetts Department of Public Health

Today we are providing you with several updates related to Department of Labor’s guidance on leave exemptions, recent media articles on COVID-19 recovery SNFs and a virtual town hall to support frontline healthcare workers.

Today we are providing you with several updates related to PPE, Telehealth and Media Relations. Please continue to visit our dedicated COVID-19 webpage for resources and updates.

MassHealth requires that nursing facilities and chronic disease and rehabilitation inpatient hospitals account for the balances of personal needs allowance (PNA) account funds.

We are looking forward to seeing our members in June when we have rescheduled two of our major programs and we hope you can join us.

On March 22, the Centers for Medicare & Medicaid Services (CMS) announced administrative burden relief for providers participating in various quality programs during the COVID-19 outbreak.

We are looking forward to seeing our members in June when we have rescheduled two of our major programs and we hope you can join us.

The Centers for Medicare and Medicaid Services (CMS) announced that they are delaying the Minimum Data Set (MDS) 3.0 v1.18.1 release, which had been scheduled for October 1, 2020.

With enhanced visitor restrictions now in place, staff members at long term care communities across the Commonwealth are using creative approaches to keep residents engaged and socially active during this extremely challenging time. Whether it be playing hallway bingo, window visits, hallway noodle baseball, or virtual visits and hugs, all levels of staff have taken extraordinary efforts to continue providing a safe, healthy and connected community for their residents.

Please join the Centers for Medicare and Medicaid Services (CMS) for a call on COVID-19 with Nursing Homes today at 4:30 PM. CMS leadership will provide updates on the agency’s latest guidance. There will be audience Q&A and an opportunity for you to share best practices with your peers.

On March 23, CMS released guidance prioritizing and suspending most federal and state survey agency (SSA) surveys, and delaying revisit surveys, for the next three weeks beginning on March 20, 2020, for all nursing homes. For non-IJ related onsite surveys that are currently in process, survey teams are instructed to end the survey and exit the facility.

Healthcare facilities, including workers of nursing homes, rest homes and assisted living residences, have been designated as ‘COVID-19 Essential Services’ and are exempt from Governor Baker’s emergency order issued today to require all businesses to close their close their workplace by March 24th at noon.

Mass Senior Care provides an update on testing of persons with suspect COVID-19, utilizing non-direct care staff to support needs, making decisions on essential staff entering your building, resident laundry guidance with COVID-19 and when families want to do residents’ laundry and important webinars/conference calls this week.

Mass Senior Care is providing a brief update on the following 3 issues: (1) Approved list of Exempt Emergency child care programs which prioritize children of health care workers; (2) federal Small Business Administration (SBA) Disaster loans for small businesses and (3) Applicability of the New Paid Leave Provisions in the federal Families First Coronavirus Response Act.

Over the past week, it has been incredibly uplifting to witness the extraordinary efforts our long term care facility staff have undertaken to care for residents during the COVID-19 outbreak. With CMS and CDC guidance changing at a rapid pace, all levels of staff have demonstrated their commitment to keeping our residents safe, healthy and emotionally and socially connected to their loved ones and their communities during this uncertain time.

Memorandum To: Mass Senior Care Members From: Tara Gregorio, President Re: Supply and Vendor Resource List Date: March 20, 2020 During the COVID-19 pandemic, Mass Senior Care members are encouraged to find long term care products, supplies and services through our list of Associate Members/Preferred Vendors. These are companies that share a genuine interest with Mass Senior Care in furthering the quality of long term care and are dedicated to the success of the profession. In addition, Mass Senior Care

To: MSCA Members From: Tara Gregorio, President RE: Attorney General Healey Issues Emergency Regulation Prohibiting Price Gouging of Critical Goods and Services During COVID-19 Emergency Date: March 20, 2020 Over the past week, Mass Senior Care has received reports from members of alleged price gouging activities, which we have immediately reported to the Attorney General’s Office and other government agencies. Today, Attorney General Maura Healey promulgated an emergency regulation that addresses price gouging of necessary goods and services during the

Today the Department of Early Education and Care had established a process to approve Exempt Emergency Childcare Programs to serve vulnerable children and the children of families who are required to work to maintain the health, safety and welfare of all commonwealth citizens.

Memorandum To: Mass Senior Care Members From: Tara Gregorio, President Re: Exempt Emergency Child Care Programs Date: March 20, 2020 The Department of Early Education and Care (EEC) has established a process to approve Exempt Emergency Childcare Programs to serve vulnerable children and the children of families who are required to work to maintain the health, safety and welfare of all commonwealth citizens. This approach prioritizes public health and safety while maintaining critical service for vulnerable children and the children

Today, the DPH released guidance on “HCP with Potential Exposure to Patients with COVID-19”. The Department’s guidance is issued in accordance with guidance from the Centers for Disease Control and Prevention (CDC), Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19).

To: Mass Senior Care Members From: Tara Gregorio, President Re: Guidance to Nursing Homes on Admissions from and Discharges to Hospitals Relating to COVID-19 Date: March 18, 2020 In order to address member concerns related to accepting patients being discharged from the hospital, Mass Senior Care Association has developed “Guidance to Nursing Homes on Admissions from and Discharges to Hospitals Relating To COVID-19” . This guidance is consistent with the current CDC guidance and has been reviewed and discussed with

In an effort to maintain the availability of first responders and health care workers during the COVID-19 pandemic, Governor Baker today issued an Emergency Order closing all Massachusetts early education and child care centers and the state will instead open exempt emergency child care programs with priority access for children of health care workers.

Memorandum To: Mass Senior Care Assisted Living Members From: Tara Gregorio, President Re: EOEA Provides FAQs to March 16th Guidance for ALRs Date: March 18, 2020 Today, the Executive Office of Elder Affairs (EOEA) released FAQs for assisted living residences, FAQ #1 – “Visitor” Access, Congregate Dining, Group Activities. This memo is the first set of FAQs by EOEA addressing the March 16th Revised Guidance for Assisted Living Residences – Restrict Visitors, Activities and Communal Dining , and includes answers

CDC issued today new guidance on the use of masks, gowns and face shields including suggestions on what to do if in crises shortages and when your supplies are exhausted.

On March 16th, the Executive Office of Elder Affairs released revised guidance for assisted living residences,Amended Assisted Living Residence Operators Guidance and Policies and Procedures to Protect Residents, Facilities, and Services during the COVID-19 Outbreak. The amended guidance includes changes to restrict all visitors except for certain compassionate care situations, eliminate group activities and cease communal dining.

MassHealth has issued updated LTSS Provider Information guidance related to the Coronavirus Disease 2019 (COVID-19) which outlines certain flexibilities that MassHealth is implementing. The website address is https://www.mass.gov/doc/ltss-provider-updates-for-covid-19/download.

On March 14th, the Centers for Medicare and Medicaid Services (CMS) issued two waivers to both the 3-Day Stay and Spell of Illness requirements retroactive to March 1, 2020 and in place for 60 days with the option for renewal as needed.

There are important conference calls for long term care facilities. CDC will be having a conference call on Tuesday, March 17th at 2pm. Massachusetts DPH will hold a weekly conference calls for nursing homes and rest homes.

Over the weekend, AHCA released Communal Dining Guidance in response to CMS’s S&C Memo Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes (REVISED) dated March 13, 2020. AHCA has reviewed this guidance with the CDC and it is based on their continuing assessment of the COVID-19 outbreak. We recognize the enormous burden being placed on facilities and this, like most guidance needs to be assessed and implemented on a facility-by-facility basis.

Memorandum To: Mass Senior Care Human Resources Committee From: Tara Gregorio, President  Re: Greater Boston YMCA Announces Support Services Date: March 15, 2020 As a follow up to Friday’s brainstorming call regarding child care services for nursing facility staff, we wanted to make you aware that the Greater Boston YMCA has announced that, in response to school closures and for families who utilize their before and after school programs, they will provide day-long programs and meals to for children

Mass Senior Care is updating members on Massachusetts' COVID-19 Command Center, CMS' revised visitor guidance and CMS released guidance on waiving the Medicare 3-day rule, as hospitals work diligently to increase their surge capacity.

At this afternoon’s Press Conference at the White House, Seema Verma, Administrator for the Centers for Medicare and Medicaid Services announced that ALL nursing homes should restrict all visitors and allow only essential personnel into nursing facilities. If you have not implemented this restriction, we strongly urge you to do so immediately! We will continue to review the order and send additional details shortly.

Mass Senior Care is strongly urging all nursing facilities to immediately limit visitation in your facility to essential visits only. We strongly recommend that you review your Continuity of Operations Planning (COOP) as well as surge plans for your facility. This virus is dangerous to our residents and to prevent it from entering our facilities all people who are not needed to meet residents’ needs or keep operations going should be asked to not enter.

This afternoon, the the Department of Public Health released updated COVID-19 related guidance for long-term care facilities in the Commonwealth. We urge each member to review this important guidance and immediately begin restricting visitors in communities with “COVID-19 community spread” and limiting visitors to essential visits only, if your “facility is in a county or is adjacent to other counties where a COVID-19 case has occurred.” The Department’s guidance aligns with CMS’ March 9th recommendation that was released earlier this week and is already being implemented by many member facilities.

Due to the growing concerns presented by COVID-19 (the coronavirus) and out of an abundance of caution for nursing facility staff, Mass Senior Care Association is postponing educational programs scheduled in March 2020. We are attempting to reschedule for a later date and will keep all registrants updated once we have a new date. The following programs will be postponed: PDPM SIX MONTHS LATER: THE MASSACHUSETTS EXPERIENCE (March 12, 2020) MDS 3.0 3-Day Competency Program (March 16-18, 2020) Strategies for

On March 9th, CMS released S&C: QSO-20-14-NH Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes (REVISED). This memorandum includes revised guidance and expanded recommendations for limiting visitors and individuals in nursing facilities. Mass Senior Care Association is in contact with the Executive Office of Health and Human Services and has strongly urged them to issue guidance for nursing facilities to protect the safety of residents and staff. If you have questions, please contact Helen

Mass Senior Care has a dedicated page on our website to share important memos and resources with all members about coronavirus, officially named COVID-19. Updated guidance from Massachusetts Department of Public Health and CMS are also available on the page. As concerns arise with COVID-19, Mass Senior Care members should visit the website daily for the latest information.