COVID-19 Letters
Covid-19 Prevention
April 20, 2020
COVID-19 Letters Archive
September 29, 2020
The Greens at Cannondale
March 30, 2021
Dear Cannondale Campus Resident, Family, Friend or Community Partner,
COVID-19 statistics among our local community are showing an increase in infection and The Cannondale Campus has experienced solid infection control. The Connecticut positivity and hospitalization rates are currently 3.88 % and 434, respectively. The Fairfield County positivity rate is 5.3%. Local and State Health officials inform us that much of the new COVID-19 infection is occurring among the young adults. The disproportionate number of young adult infection seems related to the vaccine rollout strategy (oldest and most frail vaccinated first) and; in some cases, lack of adherence to infection control measures among younger adults.
All Greens at Cannondale staff tested negative based on surveillance testing from last week and COVID-19 infections for Greens at Cannondale resident’s remains at a zero-percent since April.
Our current focus on public health measures and vaccination remains our best strategy. With nearly all residents and only a small proportion of staff unvaccinated, we are vigilant in pursuing “cleanup” vaccination among partially vaccinated staff and new staff / residents. To this end, we have made arrangements with Griffin Health to administer the Johnson and Johnson vaccine to these groups – our first visit is anticipated within a week or so. We shall continue our existing infection control restrictions including the more liberalized visitation practice described in my update from March 9th (repeated below).
Indoor visitation continues without concern. Primary indoor visits will continue to occur in designated areas to minimize the chance of exposure between residents and visitors. Indoor visitation is scheduled between the hours of 9:00 am - 5:00 pm and 7-days per week by calling the main number at (203) 761-1191. We will continue to also arrange outdoor visitation in our heated visitation tent until April 1st. Compassionate care and end-of-life visitation inside resident rooms shall also continue and are not subject to time restrictions.
Neither compassionate care, nor, low-risk visits are allowed in common areas such as our dining room or within a large group activity. Low-risk visit exemptions require vaccination documentation from these visitors.
We feel that our phase of liberalizing infection control measures strikes a balance between promoting socialization and maintaining infection control. It is important to remember that the positive effects of vaccination call for a measured reopening keeping in mind that The Pandemic is not over. Factors such as vaccinated break-through infection and viral variants all require caution. With this in mind, please see COVID-19 infection control practices below:
Changes effective March 9th:
Programs where masks are consistently used may occur without social distancing. Social distanced programs (inconsistent mask use and 6-foot distancing) are also occurring. Programs, including those with paid entertainment, will be increasing overall and residents are being encouraged to socialize.
All contractors, service providers and delivery personnel (not just essential healthcare workers) who adhere to our guidelines may enter.
Mail should be delivered promptly and without “mail jail”.
Resident out trips with family MAY occur. A member of our Wellness team will Risk Assess* the out trip to determine if an observational status is required. Residents; therefore, may be exempted from in-room observational status in low-risk cases.
Although MOST family visits will take place in designated areas between the hours of 9:00 am - 5:00 pm in either The Cafe’ or Evergreen room 129, there are exceptions to this as follows:
1 Compassionate care and end-of-life visitation These occur inside resident rooms and without regard to the aforementioned visitation hours. These visits are authorized by this writer or The Wellness Director and are intended for end-of-life comfort, residents who have a change of condition, residents in need of physical/ psychological support, new move ins and move
out room clearing.
Low-risk room visits These can occur in-room (not is common areas unless a designated visitation room) and are Risk Aassessed and approved by Wellness.
The outdoor visitation tent will be removed on April 1st.
* Risk Assessment involves a member of the Wellness team considering the level of infectious transmission risk associated with the out trip, move-in or visit. Factors such as the resident’s vaccination status, the visitor’s vaccination testing/ vaccination status (or natural disease recovery in the past 90 days) and the likelihood of exposure to others are all used to determine the infection control risk of the out trip/visit. Proof of vaccination or negative test results is required when applicable.
Our programming calendar continues to grow including a return of live music and other paid entertainers. These professionals must comply with our infection control measures such as pre-entry screening, regular testing, social distancing and strict face covering.
As a Pandemic related reality, we have found that many of our residents continue to remain in their rooms despite the re-introduction of many previously popular programs. As such, we are now (daily if needed) personally inviting and encouraging our residents to attend programs – this is best accomplished room to room. I have attached our current activity programming calendar for your reference – please feel free to call Carmela or Sue should you have any questions or concerns.
If you have not yet already done so, please see “Community Vaccination” at the end of this document for information about receiving your COVID-19 vaccination.
Hoping this message finds you healthy, happy and well informed.
With Warmest Regards,
Ronald V. Bucci
Senior Executive Director
Do COVID-19 Stimulus Checks Impact Eligibility for Persons on Medicaid? In Nursing Homes? Or Spouses?
Last updated: April 16, 2020
Table of Contents
Overview
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
Overview
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.
Stimulus Check Impact for Medicaid Applicants
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.
- Individuals who earn up to $75,000 / year will receive a $1,200 check.
- Married couples, filing jointly who earn up to $150,000 / year, will receive a $2,400 check.
- Individuals who earn up to than $99,000 / year will receive a check, but it will be for less than $1,200.
- Married couples, filing jointly who earn up to $198,000 / year, will receive a check, but it will be for less than $2,400.
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.
The Greens at Cannondale
October 12, 2020
Dear Cannondale Campus Resident, Family, Friend or Community Partner,
With the State of Connecticut relaxing public restrictions to phase three, the COVID-19 infection rate remains 1.4 % – 1.8 and 155 residents hospitalized. A large portion of Connecticut patients hospitalized for COVID-19 reside in New London County. The Connecticut Travel Advisory remains for more than half US states. Travel advisories are updated each Tuesday at: www.ct.gov/coronavirus “Connecticut Travel Advisory in Effect”
In national news, The New England Journal of Medicine published an article last Thursday regarding Remdesivir. This antiviral medication was clinically shown (no longer anecdotally) to reduce recovery time and mortality in treated patients. This is significant news as no other antiviral has been confirmed effective against the disease in a clinical trial.
The Cannondale Campus COVID-19 statistics remains unchanged and summarized below:
- There are zero (0) positive cases of residents with COVID-19 ‘in house’.
- Eight (8) residents are “COVID recovered” and have returned to The Greens.
- The Department of Public Health (DPH) has conducted twelve (12) campus COVID-19 infection control surveys.
- The current rate of staff infection (including regularly scheduled contracted staff) remains at zero percent.
- To date, staff surveillance testing of at least one COVID-19 test per month continues to demonstrate a zero percent staff infection rate.
The Greens at Cannondale and Wilton Meadows began allowing indoor family visitation last week and this relaxation of strict exclusion has gone very well. All visitors are carefully screened and are scheduled by appointment by calling the main number at (203) 761-1191. Indoor visitation is permitted between the hours of 9:00 am – 5:00 pm and 7-days per week. All visitors must wear a facemask before entering the building and throughout their visit – we can supply you with one before you enter if you need. Indoor visits occur in designated areas while outdoor ones remain available as an alternative to indoor. Specialized visits such as compassionate care for end-of-life visits and/or significant changes in medical condition will be allowed inside of residents’ rooms and require approval from myself or the Director of Wellness. As with all activities outside of your homes or personal gatherings, we ask that you wear a well-fitting mask at all times. Please come visit us soon!
Group dining in our main dining room remains hugely successful. Evergreen and “The Residence” residents will continue to enjoy semi-social group dining in their areas. Our carefully planned programming calendar is also growing more robust each week and our residents are starting to attend in greater numbers – safely. Please see “Programming Highlights” below for details.
Please remain aware of “every day actions you can take” to minimize your chance of contracting COVID-19. This remains a highly contagious virus with very serious risks to the health and welfare of high risk individuals such as our precious seniors. Many thanks to all of you whom are already adhering to our infection control protocols and staying healthy.
On another note, the Medicare Open Enrollment takes place from October 15th through December 7th. During this timeframe, Medicare plan enrollees can reevaluate their coverage – whether it’s Original Medicare with supplemental drug coverage or Medicare Advantage. It’s also the time to make changes or purchase new policies if your situation or healthcare needs have changed. During the designated open enrollment period, options available include:
- Changing from Original Medicare to a Medicare Advantage plan
- Changing from a Medicare Advantage plan back to Original Medicare and a stand-alone Part D prescription drug plan
- Changing from one Medicare Advantage plan to another that better meets your needs.
- Changing from one Medicare Part D prescription plan to another.
- Enrolling in a Medicare Part D plan if you didn’t enroll when you were first eligible for Medicare. (If you haven’t maintained other creditable coverage in the interim, a late-enrollment penalty may apply).
Medicare Open Enrollment can be a confusing time as you want to know all of your options before deciding on the different plans. Fortunately, CT has a designated State Health Insurance Program (SHIP) to offer free, unbiased guidance on Medicare plans and enrollment – you may access these resources as follows:
http://www.ct.gov/agingservices
1-800-994-9422
Let’s stay in touch via this weekly message and Zoom sessions. Information regarding this, resident/family Face Time sessions and outdoor visits with your loved ones is listed below.
May this message find you in good health and give you peace of mind regarding the safety and well-being of your loved one.
Very Truly Yours,
Ronald V Bucci
Senior Executive Director
Everyday actions that you can take to minimize your chance of COVID-19 related infection or illness:
- Avoid contact with people who are sick and keep your distance from others if you are sick.
- Individuals who do not feel well should remain home and contact their Primary Care Physician.
- If you have been in contact with someone suspected of having Covid-19, you must self-quarantine and call your local physician or health department immediately.
- Wash your hands vigorously and often using soap and hot water.
- Use hand sanitizer when available in addition to hand washing but not in place of it.
- Avoid touching your eyes, mouth, or nose with your hands.
- Cover sneezes and coughs with a tissue or your elbow and not your hand.
- Keep home and personal surfaces (especially bedside tables, surfaces in the bathroom, and toys for children) clean by wiping them down with a household disinfectant.
- Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious foods.
- Stay informed through reliable information sources
The Connecticut Department of Public Health – Call 2-1-1 and Text “CTCOVID” to 898211 or visit
www.ct.gov/coronavirus
The Center for Disease Control – www.cdc.gov/ncov
The Greens at Cannondale Infection Control Measures
- Measuring the temperature/ oxygen levels of all residents and patients each day.
- Restricting visitation to essential caregivers only.
- Staff screenings each time an employee enters the building including health and temperature checks.
- All staff members were mandated to wear masks. Direct caregivers had already been doing so prior.
- Ongoing deep-cleaning with EPA- approved agents to kill Corona viruses and a professionally contracted antiviral spray treatment in resident rooms/common areas related to a suspected case.
- Frequent written and verbal (in multiple languages) in-servicing to staff detailing our policies.
- Limiting activity programs to in-room visits for Face-timing and/or one-to-one visits. Small group functions may occur but only when a six-foot social distance arrangement can be maintained.
- Restricting delivery personnel from the building – all essential deliveries are “drop and go” with special arrangements for pharmacies. Deliveries are either treated or staged to minimize the chance of transmission through mail and packages.
- Any resident who is suspicious of COVID infection will be placed on isolation until further instructions are received from their physician. These residents will be cared for by staff using full Personal Protective Equipment (PPE).
- Appropriate cohorting or clustering of staff and residents based on COVID status.
- Live tours suspended, virtual tours only.
- New move-ins must receive two (2) negative COVID tests prior to move in and most be quarantined for a minimum of fourteen (14) days thereafter. This period will be extended should any signs or symptoms of COVID-19 become apparent.
- Regular Staff testing and “asymptomatic positive” home isolation.
