The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) issued new recommendations to long-term care facilities to help mitigate the spread of the 2019 Novel Coronavirus

While some of this guidance is new, some of it reinforces previous guidance issued.  Nursing Homes should continue to ensure that they are complying with all CMS and CDC guidance related to infection control, including but not limited to:

• Adherence to appropriate hand hygiene as set forth by CDC.
• Reviewing the recently issued extensive infection control guidance, including a self-assessment checklist that long-term care facilities can use to determine their compliance with these crucial   infection control actions.
• Following the CDC’s guidance to long-term care facilities on COVID-19 and also use the guidance on conservation of personal protective equipment (PPE) when unable to follow the long-term care facility guidance.
• Long-term care facilities should ensure all staff are using appropriate PPE when they are interacting with residents, to the extent PPE is available and per CDC guidance on conservation of PPE
  If you have a COVID-19 (+) resident, staff must be in full PPE when caring for the resident. If there is transmission in the building, full PPE is required for all residents.
• Nursing homes should immediately implement the Screening Tool for Symptoms of COVID-19, screening every individual regardless of reason entering a long-term care facility (including residents, staff, visitors, outside healthcare workers, vendors, surveyors etc.) should be asked about COVID-19 symptoms and they must also have their temperature checked. An exception to this is Emergency Medical Service (EMS) workers responding to an urgent medical need. They do not have to be screened, as they are typically screened separately.
• All residents should have mouth and nose covered when staff are in their rooms, if resident is COVID (-) this can be done with a tissues, if COVID (+) the resident needs to have a surgical mask on. Residents should not use medical facemasks unless they are COVID-19-positive or assumed to be COVID-19-positive. They could also use cloth, non-medical masks when those are available.
• Residents who must regularly leave the facility for care (e.g., hemodialysis patients) should wear facemasks when outside of their rooms.
• Designate ONE entrance for all individuals entering the facility, and have screening center set up at this entrance. Have signs posted on all other doors directing individuals to entrance point. Do not bring the individual through the building.
• To avoid transmission within nursing homes, facilities should use separate staffing teams for residents to the best of their ability, and, nursing homes should work with State and local leaders to designate separate facilities or units within a facility to separate COVID-19 negative residents from COVID-19 positive residents and individuals with unknown COVID-19 status. 
• Facilities should also consider using designated staff for these units, limiting the interaction of these staff members with each resident and other staff members NOT on the COVID unit.

Jodi Eyigor from LeadingAge National reviewed these recommendations today on the daily webinar. Coronavirus Daily Member Update Recording (4/3/20) (NEW) if you would like to listen to this again.

Laura Hofmann, MSN, RN
Director of Clinical and Nursing Facility Regulatory Services
c: 360-691-9281