June 2, 2020
Dear Cannondale Campus Resident, Family, Friend or Community Partner,
As COVID-19 related illness among our Campus and local community declines, I have statistics to share effective June 1, 2020 and our plan moving forward related to testing, as well as, minimizing the negative effects of infection control measures.
Rates of new COVID infection continue to decline in Connecticut and in Fairfield County with 42,201 and 15,549 cumulative cases, respectively. New cases in Wilton and on our Campus are near-zero for two weeks running. As Wilton Meadows continues to admit and treat positive patients from the surrounding community, these new cases may affect Wilton Meadows’ numbers for some time to come. Patients hospitalized from the virus are down by 27 admissions state-wide representing a 75 % decease from the mid-April Connecticut peak. Our State has, sadly, lost 3.944 individuals, with most being our precious seniors. We feel that, having started preparations early and operating within a supportive community, illness has been significantly minimized on The Cannondale Campus. The many benefits of having a 5-star Skilled Nursing Facility in Wilton Meadows on our Campus has been instrumental in us slowing and now, stopping, viral transmission. You should also know that the nimbleness and resources of our family-owned properties has allowed us to operate with ample supplies and full staffing even through the peak of this Pandemic when many other facilities experienced shortages of both.
The Greens at Cannondale has been free of new COVID symptomatic residents since April 13th. One staff member continues to test positive despite remaining asymptomatic. We remain mindful that community cases may increase as businesses re-open state-wide. As such, we must be prepared for, and mitigate, the chances of future cases on our Campus until a vaccine is available. Our vigilance and careful planning shall continue. Greens at Cannondale specific statistics include the following:
All Wilton Meadows residents and staff having been tested and have been cohorted or re-assigned as needed. Regular rounds of testing at Wilton Meadows for residents and staff will continue as they will continue to admit new active cases of COVID from the community at large.
The Greens at Cannondale began testing staff for COVID-19 yesterday and we expect results by the end of this week. Any asymtomatic positive staff member will be excluded from work for 10 days and re-tested before returning. Future rounds of staff testing, per Ned Lamont’s proclomation yesterday, will continue weekly starting June 28th and until further notice. We are fully prepared to replace staff that may need home quarantining if, and when, required.
Resident testing will shape decision making regarding the relaxation of infection control measures such as enhancing family visitation and communal activities/ meals. To comply with Governor Lamont’s mandate of weekly staff testing, we may have to delay resident testing until July.
As part of a state-wide initiative, The Department of Public Health (DPH) surveyed the Cannondale Campus five times including participation from the National Guard. These inspections include observation of care, staff screening compliance, cleaning techniques, training competency, hand wash proficiency, proper PPE usage, inspection of PPE supplies and review of policies. Each survey has been deficiency-free.
As we collaborate with the Connecticut Association of Assisted Living to devise best practices as it relates “re-opening” strategies, two changes are upcoming at The Greens. Effective today, we are allowing group activities in large areas such as our dining room where staff will ensure mask use and social distancing for residents able to tolerate and abide by our infection control protocols. Also, our Beauty Shop is re-opening on June 17th. Our licensed stylist has been tested and received training on our protocols and PPE use. She will be wearing a mask, face shield, gloves and disposable apron. Our team will be making one appointment at a time and all supplies will be disinfected in between each client. Most of our Evergreen clients are unlikely to tolerate our infection control measures; therefore, many of these changes cannot occur for severely memory impaired residents until facility-wide testing is completed.
The management of chronic conditions affecting our seniors is another current initiative. We are aware that vigilant infection control measures have a downside. Optimizing resident independence, reducing falls, maintaining optimal nutritional status, managing non-covid illness and ensuring that residents are feeling good by averting depression and anxiety have all been negatively affected to some degree. Our 120-day assessment processes have been ongoing; however, we feel that a more specialized approach is in order given the duration of Pandemic and the abeyance of wellness visits from outpatient health providers. We are making arrangements for each resident to be screened by a therapy professional (PT or OT), a Registered Dietitian and a mental health professional. Residents requiring specialized strength / balance training, nutritional intervention or treatment of depression and anxiety will be referred for services accordingly.
Our current level of new activity programs has been a huge hit! Outdoor family visits, our Spring concert series on the green, enhanced fitness on the putting Green, social distanced sing alongs, large-scale word games, our hero week festivities and parade, I believe, are the prudent way to gradually and safely “open up”. Please remember to plan your outdoor family visit (see details attached) and mark your calendar for “The Sedgwick Sisters” and “Deuces Wild” outdoor concerts this Thursday, June 4th and Sunday, June 7th – both on the putting green at 3 pm. You are welcome to plan your visit accordingly.
May this message find you in good health and give you piece of mind regarding the safety and well-being of our residents. For your reference, our infection control measures and current enhanced activity programs are listed in the following attachment. Thank you all for your ongoing support, kindness and the opportunity to care for your loved ones and for getting to know you.
Yours very truly,
Ronald V Bucci
Senior Executive Director
The relaxation of infection control measures remains a deliberate process balanced with the negative effects associated with reduced social engagement. Plentiful human interaction, including live visitation from you, group programs, social dining and the power of human touch cannot be overstated as it relates to the overall physical and mental health of our seniors. Our transition from programs such as 1:1 visits, Face-time sessions, mobile happy hour and overhead music to social distanced programs outside of resident rooms with some programs modified to suit our memory care Evergreen population include:
To learn more about visiting your loved one, Face-Timing or how to participate in our weekly Town Hall conference call, please contact us as follows:Face-Time - Call 203-761-1191 or email Elanit Linder at firstname.lastname@example.org.
June 2, 2020
Dear Families and Friends:
Since I last updated you on the status of COVID-related illness among our Campus and local community, I have an optimistic message for you today and including data effective May 25, 2020. We will review the phases of “Opening Up Wilton Meadows Again” and a review of the week ahead.
June 1, 2020 CT DPH reported 160 new cases in Fairfield County. Laboratory-confirmed cases totaled 15,003. Probable cases totaled 706. Wilton had 202 cases, 177 confirmed and 25 probable cases. Fairfield County hospitalizations decreased by 6 to 157 . Total deaths in Fairfield County rose by 11 to 1,277, 990 laboratory-confirmed and 298 probable deaths.
Statewide, CT DPH reported 539 new cases for a total of 42,740 laboratory-confirmed cases and 2,070 probable cases, as of 8:30 p.m. yesterday. 233 cases have not yet been assigned to a municipality. 9,274 new tests were performed for a pandemic-to-date total of 259,320 in Connecticut. Statewide deaths rose by 20 to 3,964, (1,495 in Nursing Homes) 3110 laboratory-confirmed and 854 probable deaths. Statewide hospitalizations decreased by 27 patients to 454 patients with a laboratory-confirmed positive test.
“Out of respect for each other, as Americans that care for each other, we need to be wearing masks in public when we cannot social distance.” Dr. Deborah Birx, Coronavirus Response Coordinator for the White House Coronavirus Task Force.
We remain in contact with State and Local health officials to ensure that our infection control measures are optimal. These officials remain confident that our campus policies are effective and were implemented swiftly.
We have received guidance from CMS and state and local officials regarding recommendations to determine the level of mitigation needed to prevent the transmission of COVID-19 in nursing homes. Their recommendations cover the following items: Criteria for relaxing certain restrictions and mitigating the risk of resurgence, visitation and service considerations and restoration of survey activities. Each individual state may choose to implement the recommendations either requiring all facilities to go through each phase at the same time; allowing facilities in a certain region within a state to enter each phase at the same time or permitting individual nursing homes to move through the phases based on each nursing home’s status for meeting the criteria for entering a phase.
While in phase one we will continue the following visitation and service considerations:
To enter phase two we must:
We will review phase three as we move forward. We are awaiting direction from CT DPH as to the ability to move into phase three after we successfully complete phases one and two. We completed 100 % testing of residents and staff. Retesting will be scheduled in consultation with our Medical Director, Dr. Alan Radin and the State Epidemiologists taking into consideration the CDC guidance. Testing will not include those residents or staff who previously tested positive.
On June 1, 2020 Governor Lamont issued and executive order requiring staff of Nursing Homes, managed residential communities and assisted living services agencies weekly with no further guidance relative to the CMS guidance presented last week. We will keep you appraised weekly of updates as they are presented to us. Weekly testing of people who live and work at Wilton Meadows has commenced and results will be shared with you.
Data as of June 1st at Wilton Meadows:
We continue to have full schedules of zoom calls and window and courtyard visits. The weather has been favorable, but we have added pop-up tents for both sides of the fence to accommodate for rainy days. Please remember when visiting, we must maintain source control, a mask must be worn by both the person who lives here and the visitor. A six-foot physical distance must be maintained. No items can be passed during the visits and any gifts must be brought to the front desk and either disinfected or held for 72 hours to ensure there is no passing of virus.
Thank you to all who participated in our HERO WEEK parade. It was a wonderful celebration for staff and an emotional time for the team to receive thanks and to reflect on the events since the beginning of March. We will continue to support and celebrate our dedicated staff as we work in a very different way.
The Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act allows a one-time stimulus check from the IRS of $1200. Checks are arriving. Think about how you can best spend these funds for our residents. Think smart TV with ZOOM Capability! We are told these additional funds will not affect Medicaid eligibility for 12 months. Feel free to reach out for more information. Information is attached.
For your reference, our infection control measures, and current enhanced activity programs are listed in the following attachment. Thank you all for your ongoing support, kindness and the opportunity to care for your loved ones.
Zoom meetings will continue Wednesdays at 11:00 am and 4:00 pm. Login information included in this communication.
As always, please stay well and contact us if you have any questions or concerns.
Wilton Meadows Health Care Center
Plentiful human interaction, including live visitation from you, group programs social dining and the power of human touch cannot be overstated as it relates to the overall physical and mental health of our seniors. With this in mind, we are slowly transitioning from in-room activity programs such as 1:1 visits, face time sessions, mobile happy hour and strolling music and overhead music to social distanced programs outside of resident rooms with modified to suit our population. These newly implemented programs include:
To schedule window visits, courtyard social distance visits or Facetime calls: Call 203-834-0199 or email Jessica at email@example.com for instructions.
Weekly “town hall” conference call – Dial in Tuesday at 2:00 pm and 6:00 pm Phone number: 475-277-2700 Access code: 922537
Last updated: April 16, 2020
Stimulus Check Impact for Medicaid Beneficiaries
Nursing Home Residents
Spouses of Nursing Home Residents
Medicaid Waiver Beneficiaries
Aged, Blind and Disabled Beneficiaries
Stimulus Check Impact for Medicaid Applicants
Other Questions about the Stimulus Checks
The Coronavirus Aid, Relief, and Economic Security Act, also known as the CARES Act (passed on March 27, 2020) is a $2 trillion economic relief package intended to help offset the huge financial crisis caused by the Coronavirus (COVID-19) pandemic. As part of the CARES Act, the majority of Americans, including those who are elderly and on fixed income, will receive a one-time stimulus check from the Internal Revenue Service (IRS).
Many Medicaid beneficiaries who live at home, assisted living, adult foster care, or nursing homes are concerned the money will put them over the Medicaid income or asset limit, and therefore, disqualify them from Medicaid benefits. In addition, Medicaid applicants express the same concern that the additional money will cause them to have income or assets over Medicaid’s limits, and as a result, prevent them from becoming eligible for Medicaid.
Stimulus checks will not be counted as income and therefore will not impact Medicaid beneficiaries or applicants. However, should the stimulus money not be spent within 12 months, it may be counted as an asset, and therefore could impact eligibility in the year ahead.
Stimulus Check Impact for Medicaid Beneficiaries
Nursing Home Residents
The receipt of a stimulus check by Medicaid beneficiaries who reside in nursing homes will not impact these individuals’ Medicaid benefits. Stated differently, the receipt of the check will not disqualify them from Medicaid nursing home care. This is because Medicaid will not count the money as income, which means it cannot push one over Medicaid’s income limit, and hence, result in the loss of Medicaid benefits.
While Medicaid-funded nursing home residents are required to surrender all of their income except for a personal needs allowance and a monthly maintenance needs allowance for a non-applicant spouse (if applicable) to Medicaid, the money from the stimulus check will not have to be surrendered to Medicaid. This is because, as mentioned above, the stimulus check is not considered as income by Medicaid. Rather, it can be thought of as a tax refund.
Furthermore, the stimulus check will not count as assets, given the money is spent within 12-months of receiving it. So, within this timeframe, a nursing home Medicaid recipient can have possession of the money and it will not impact one’s Medicaid eligibility. However, it is imperative that the money, in its entirety, be spent within one year. If not, the money will count towards Medicaid’s asset limit and can potentially push one over the limit, resulting in Medicaid disqualification.
The money can be spent by nursing home residents in a number of ways. For example, one might buy new clothing, purchase a television for his / her room, stock up on extra snacks, or purchase an irrevocable funeral trust. What one does not want to do is to buy assets that are counted towards Medicaid’s asset limit. For instance, collectors coins would most likely be considered an investment and the value of them would be counted towards the asset limit, potentially causing one to be over the limit and lose Medicaid benefits.
The stimulus check will either be directed deposited in the nursing home resident’s bank account or be mailed to the address on one’s 2018 or 2019 tax return. To further clarify, if a refund was issued via direct deposit for one’s tax return, the stimulus check will be directed deposited in the same bank account. If not, the check will go in the mail. Persons who do not have to file tax returns, such as Social Security recipients, will receive stimulus checks in the same manner in which they receive their Social Security benefits. Therefore, if one receives his / her Social Security payment by direct deposit, the stimulus check will automatically be received via direct deposit also.
Spouses of Nursing Home Residents
Spouses of nursing home residents on Medicaid (called Community Spouses), who are not on Medicaid themselves will receive a stimulus check. The receipt of this check will not impact their spouses’ Medicaid eligibility in any manner. First, and foremost, the money from the stimulus check is not considered income by Medicaid, and even if it were, the income of a non-applicant spouse is not considered in the continuing Medicaid eligibility of his / her nursing home spouse.
For Medicaid beneficiaries, the entire check needs to be spent within 12-months of receiving it or the remaining funds will count as assets towards Medicaid’s eligibility. However, the same rule does not hold true for community spouses. To be clear, there is no time limit in which a spouse of a nursing resident must spend his / her stimulus check. Furthermore, non-applicant spouses can spend the stimulus check in any manner they choose, such as paying rent or mortgage, utility bills, food, or even on a splurge, such as a pricey piece of jewelry.
No matter how long it takes for the community spouse to spend the funds, and regardless of how they are spent, it will not impact the institutionalized spouse’s Medicaid eligibility. In other words, a community spouse can be rest assured that it will not cause the nursing home resident to lose his / her nursing home Medicaid benefits. This is because the assets of the non-applicant spouse are not considered for the continuing Medicaid eligibility of his / her Medicaid beneficiary spouse. (The community spouse’s assets are only considered when determining initial eligibility).
The community spouse will receive the stimulus check either via direct deposit or in the mail. Exactly the manner in which it will be received will be based on one’s 2018 or 2019 tax return and how a refund was issued. For instance, if one received a refund via the mail, the address on file will be used and the stimulus check will be mailed to that address. For those who are not required to file tax returns, such as recipients of Social Security, the check will be received in the same way in which their monthly Social Security benefit is received. This means that if it is deposited directly in one’s bank account, the stimulus check will also be directly deposited.
Please note that the institutionalized spouse will also receive a stimulus check. However, at this time, it is not known if the check will be issued separately from his / her community spouse’s check. It is our assumption that if 2018 or 2019 tax returns were filed jointly, the couple will receive one check (couples who filed joint tax returns are eligible for double the amount of a single filer), while if tax returns were filed separately, each spouse will receive an individual check. Again, for persons on Social Security, there is no need to file tax returns. In this case, checks will automatically be received in the same manner in which Social Security benefits are received.
Medicaid Waiver Beneficiaries
Home and Community Based Services (HCBS) Medicaid Waiver recipients will receive a stimulus check and it will not impact their Medicaid eligibility if spent within 12-months of receiving the check. This is because the money from the check will never be considered as income, but it will be counted towards Medicaid’s asset limit if not spent within the specified 12-month period.
Due to the variance of where HCBS Waiver recipients reside, i.e., in adult family care (also referred to as adult foster care), assisted living residences, or in memory care (specialized care, generally in a wing of an assisted living residence or nursing home, for persons with Alzheimer’s disease or a related dementia) the manner in which one might spend the funds varies widely. For instance, a senior or disabled individual living at home might make home modifications for safety and accessibility purposes or purchase a household appliance, while one living outside of his / her personal home might spend the extra money on smaller ticket items, such as special snacks or a really comfortable pillow.
A word of caution; HCBS Medicaid Waiver recipients need to exercise caution when choosing how to spend the stimulus check. This is because at redetermination, Medicaid will consider all of a Medicaid recipient’s countable assets, and if the individual has assets over the limit, Medicaid benefits will be terminated. Countable assets are generally considered liquid assets, or assets that can easily be converted to cash. As an example, a Medicaid beneficiary should not purchase U.S. Savings Bonds, as this would be counted towards Medicaid’s asset limit.
The stimulus check will be received by the Waiver beneficiary in either one of two ways; It will automatically be deposited into the individual’s bank account or it will be mailed to the address used for his / her 2018 or 2019 tax return. Exactly how it will be received will be determined by how one received a previous tax refund. For clarification purposes, if last year’s tax return was mailed to one’s home, the stimulus check will also be mailed to his / her home. Social Security recipients do not have to file tax returns, but this is no cause for alarm. Persons who receive Social Security benefits will receive the stimulus check in the same method in which Social Security checks are received. This means that if they are received via direct deposit, the stimulus check will be directly deposited in the same bank account.
Aged, Blind and Disabled Beneficiaries
Persons who are on Aged, Blind and Disabled (ABD) Medicaid are no exception from other Medicaid recipients and will be issued a stimulus check. The receipt of this money will in no way impact an ABD beneficiary’s Medicaid benefits, meaning the receipt of this check will not cause one to lose his / her Medicaid benefits.
The money will not be considered as income for Medicaid purposes, nor will it be treated as assets for the first 12-months. However, if the money is not spent in its entirety during that timeframe, any remaining funds will be counted as assets by Medicaid and could possibly cause one to lose his / her Medicaid eligibility. However, as long as the money is spent before the end of the 12-months, there is no need for concern at all.
It is important to mention that, theoretically, the money can be spent however a stimulus check recipient sees fit. That said, when it comes to ABD Medicaid recipients who want to ensure they maintain their Medicaid eligibility, this is not true. If, for instance, a Medicaid beneficiary spends the stimulus check money on assets that Medicaid considers as countable, he / she could potentially be over Medicaid’s asset limit and lose Medicaid eligibility. That said, an ABD recipient would not want to use the money to buy stocks, as that would be considered as a countable asset. Instead, the individual needs to spend the money on non-countable assets, such as an irrevocable funeral trust, rent or mortgage, replacing a water boiler, etc.
The receipt of the stimulus money will be either through a direct bank deposit or a paper check in the mail. The method will be determined by the manner in which a tax refund was paid based on one’s 2018 or 2019 tax return. This means that if a tax refund was sent out via mail, the stimulus check will be sent in the mail to the same address. While those who receive Social Security checks do not have to file a tax return, these individuals will still automatically receive a stimulus check. The check will be received in the same manner in which the Social Security checks are received. Stated differently, if one receives his / her Social Security check via direct deposit, the stimulus check will also be received via direct deposit.
When it comes to applying for Medicaid, the stimulus check is not considered towards Medicaid’s income or asset limit (if spent within 12 months of receiving it) in any of the 50 states nor Washington DC. This means that the receipt of the cash payment will not cause an applicant to be over the income and / or asset limit, and hence, be denied Medicaid benefits.
This hold true regardless of what Medicaid program (ABD Medicaid, nursing home Medicaid, HCBS Medicaid Waiver) an applicant is applying for and regardless of marital status. For clarification purposes, if one’s non-applicant spouse receives a stimulus check, it will not impact the applicant spouse’s eligibility. The only exceptions are if a year passes prior to the Medicaid application process and the non-applicant spouse has not spent his / her stimulus check in its entirety or has purchased assets that are counted towards Medicaid’s asset limit. (For the initial application process, a couple’s assets are considered jointly owned).
It is important that Medicaid applicants spend all of the stimulus check money within 12 months of receiving it. This is because after this amount of time, it is counted towards Medicaid’s asset limit. Furthermore, if one is planning on applying for Medicaid, he / she should be careful to spend the money only on non-countable assets (assets that are not counted towards Medicaid asset limit). Persons can pay their rent, buy groceries and medications, pay off debt, and upgrade their televisions. They shouldn’t, however, invest the money in stocks or buy a whole life insurance policy. This is because they would be considered countable assets and could cause an applicant to be over the asset limit, resulting in Medicaid denial.
Another word of caution; a Medicaid applicant, or someone considering applying for Medicaid, should not give away the money from the stimulus check to family members, educational funds, to charity, etc. This is because Medicaid has a 60-month look back period (Medi-Cal in California is 30-months) in which Medicaid considers all past transfers immediately preceding one’s Medicaid application. In a nutshell, if one gives away assets during this timeframe, he / she could be denied Medicaid benefits. Please note that at this time, we are not 100% sure if giving away the stimulus money will in fact be a violation of the look back period. However, to be cautious, gifting the money should be avoided.
Medicaid applicants will receive their stimulus checks either automatically through direct deposit or by receipt of a paper check through the mail. The exact method of receipt will be determined by how tax refunds were received from one’s tax return in 2018 or 2019. This means that if one received his / her tax return via mail, the stimulus check will also be received in the mail to the same address. While Social Security recipients do not have to file tax returns, this is no reason to worry about the receipt of the stimulus check. This is because the check will automatically be received in the same manner in which one’s Social Security checks are received. For instance, if one’s Social Security checks are automatically deposited into his / her bank account, the stimulus check will automatically be deposited into the same account.
Other Questions about the Stimulus Checks
How Much Will the Stimulus Check Be?
The amount of the stimulus check, also called an economic impact payment or recovery rebate, may be for as much as $1,200 / person.
Payments will be based on one’s tax returns from 2018 or 2019. Please note that for disabled persons and seniors who receive Social Security payments, it is not necessary for a tax return to be filed. (Persons who receive Social Security benefits generally do not have to file a tax return). Rather, the IRS will automatically send out economic impact payments to these individuals.
Checks will be received either via direct deposit or in the mail.
What is the Check Intended For?
The cash payment is intended to help persons pay for basic necessities and support the economy during the Coronavirus pandemic. While there is no limitation as to how the money can be spent, for many Americans, it will go towards one’s rent or mortgage, utility bills, food, and other essentials.