SKILLED NURSING & SENIOR LIVING COVID-19 MANAGEMENT AND REOPENING RESOURCE CENTER
Ensuring residents are cared for in a safe and healthy environment is a priority for all senior care and living communities. To assist our clients, managed communities, and other providers in preparing for and responding to COVID-19, as well as planning for reopening, Health Dimensions Group has created a COVID-19 Skilled Nursing & Senior Living Resource Center.’
Monitoring & Implementation of CMS, CDC, State & Local Health Departments, & State & Trade Association Guidance
Ongoing monitoring on guidance related to:
- Testing and screening
- Personal Protective Equipment (PPE) use
- Infection control surveys
- Waivers and regulatory updates
- Stimulus and funding programs
- Reopening requirements and timelines
Resources:
- https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-responding.html
- https://www.cms.gov/files/document/qso-20-30-nh.pdf
- https://www.ahcancal.org/facility_operations/disaster_planning/Pages/Coronavirus.aspx
- https://leadingage.org/coronavirus-resources
- https://www.argentum.org/coronavirustoolkit/
- https://www.cms.gov/files/document/covid-toolkit-states-mitigate-covid-19-nursing-homes.pdf
Communication, Media and Public Relations
- Frequent written, text, voice and e-mail communication for visitors, families, residents, staff & vendors
- Meeting of CMS requirements for COVID-19 positive communication under QSO-20-29
- Updated and clear signage for building entries for visitor guidelines
- Frequently updated websites & social media sites
- Informative inbound phone & voice messages
- Updating of media statements & train local staff on media interaction related to cases, employee and resident wellness, testing and reopening
- Support and use of technology to support virtual communication
Resources:
- https://www.leadingage.org/coronavirus-communication-and-media-tools
- https://www.ahcancal.org/facility_operations/disaster_planning/Pages/Coronavirus.aspx
- https://www.cms.gov/files/document/qso-20-29-nh.pdf
Surveillance & Preparedness Plans
- Emergency preparedness plans
- Visitor restrictions & screening guidelines and processes
- Employee, resident and provider screening & illness tracking
- Staff education & auditing on infection control, safety, PPE and other items as required
- Adherence to admission and cohorting guidelines for positive or unknown COVID-19 status
- PPE & supply management including sourcing, cleaning and reuse guidelines
- Review and audit of policies & procedures around infection control
- Intensified plant operations & housekeeping activities
- Clinical monitoring for symptom identification and risk management
- Inclusion of preparedness plan in Quality Assurance Performance Improvement (QAPI)
Resources:
Workforce Planning & Support
- Tracking of State & Federal programs to support workforce, including leave policies
- Updating recruiting & job postings to recruit hospitality workers
- Utilizing paid & organic social media to support recruiting
- Defined training processes to train and competency test new employees quickly
- Offer support for childcare, sick leave, & employee support services
- Interview processes to include web meetings
- Development of contingency staffing plan
- Develop food service crisis plan for staffing and meal preparation
- Track state-level waivers and guidelines on staff screening and trainer
- Review paid leave requirements and eligibility
- Offer mental health, emotional and grief support services
- Implement a Hero’s Pledge for staff and leaders to pledge to provide necessary resources, follow infection control and PPE guidance, and commit to caring for residents during challenging times
Resources:
- https://www.cdc.gov/coronavirus/2019-ncov/hcp/managing-workplace-fatigue.html
- https://www.shrm.org/resourcesandtools/pages/communicable-diseases.aspx
- https://jamanetwork.com/journals/jama/fullarticle/2764380
Financial Resource Review and Planning
- Review current & projected cash positions of communities
- Explore loan, line and government resources for COVID-19 expenses
- Detailed tracking of lost revenue and increased expenses related to COVID-19
- Accurate reflection of relief and loan funds in financial statements
- Work with vendors on extended payment terms
- Identify backup personnel for billing & collections to ensure stable cash flow
- Proactively communicate with lenders who are seeking updates on assets
- Adjustment of expenses to census decline when appropriate
Resources:
- https://www.sba.gov/funding-programs/loans/coronavirus-relief-options/paycheck-protection-program
- https://home.treasury.gov/policy-issues/cares
Survey Readiness
- Review existing infection control policies, procedures & tracking
- COVID-19 specific training & tools implemented
- Detailed QAPI notes for infection control areas of focus or audit failure
- Document COVID-19 response, training & tracking actions
- Review updated CMS survey guidelines, timelines and penalties
Resources:
- https://www.cms.gov/files/document/qso-20-12-allpdf.pdf-1
- https://www.cms.gov/files/document/qso-20-31-all.pdf
COVID-19 Testing
- Understand types of testing available, those used for diagnosis, and accuracy
- Secure testing partnerships for supplies and lab services
- Procedures for proper collection, storage and delivery
- Partnerships with testing resources like health systems, drive through clinics, walk-in testing and the National Guard
- Talking points for staff and residents on testing procedure and consent
- Understand payment responsibilities by state and payor, and create internal process to properly bill and communicate billing information to third parties
- Develop testing strategy and timeline for completion and retesting
- Proper testing practice and PPE use during testing
- Detailed monitoring of test status, results and return to work plans
- Reporting of positive cases
Resources:
- https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-testing.html
- https://www.fda.gov/consumers/consumer-updates/coronavirus-testing-basics
COVID-19 Positive Case Management
- State and Local Health Department collaboration on testing and positive case management
- Required family, staff and resident notifications
- PPE requirements & room signage for positive cases
- Review hospital transfer documents & procedures
- Care-in-place management plan
- Ongoing education on precautions for positive patients
- Outbreak control including plan for COVID-19 treatment area and dedicated staff
Resources:
- https://www.cdc.gov/hai/state-based/index.html
- https://www.cdc.gov/longtermcare/pdfs/LTC-Resp-OutbreakResources-P.pdf
Supplies & PPE Planning
- Collaborate with suppliers on ordering & shipping timelines
- Partner with hospitals & health coalitions for critical supplies if needed
- Attend supplier education to understand ordering processes & allotments
- Monitoring & storing of supplies for loss prevention
- Staying current with PPE guidance on use, cleaning and reuse
Resources:
- https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html
- Health Dimensions Group PPE Usage Guide
Resident Life
- Utilization of technology for e-visits – tablets, tools & training
- In-room & hallway activities like overhead speaker games & interaction
- 1:1 activities with social distancing
- Collaboration with mental health, spiritual and social work partners
- Collaboration with families who want to do on-site visits outdoors or through windows to ensure social distancing and precautions
Resources:
Rapid Response Team
- Identify a team (not currently working in communities) to be trained to provide direct care, housekeeping & dining services in the case of an outbreak & staffing shortages
- Train & competency test this team to provide side-by-side support to on-site teams
- Reduce exposure risk of this team by utilizing a remote workforce & social distancing to ensure they are healthy if team is deployed
Resources:
Tracking of Policy Changes
- 3 Day stay Medicare waivers
- MDS and assessment timing changes
- Payor appeal timelines
- Telemedicine waivers and reimbursement
Resources:
- https://www.cms.gov/files/document/covid19-emergency-declaration-health-care-providers-fact-sheet.pdf
- https://www.cms.gov/files/document/covid-long-term-care-facilities.pdf
Reopening of Communities
- Review of White House Reopening Phases
- Review of CMS reopening guidelines
- Review of State reopening guidelines
- Ensure proper testing capabilities to move toward reopening
- Communication with acute care providers on capacity
- Understand resident preferences on reopening timelines
- Develop new policies and procedures related to screening and monitoring of visitors
Resources:
- https://www.whitehouse.gov/openingamerica/
- https://www.cms.gov/files/document/qso-20-30-nh.pdf-0
- https://www.cms.gov/files/document/covid-nursing-home-reopening-recommendation-faqs.pdf
- Health Dimensions Group Roadmap to Reopening America Again
Contact Us
If you have any questions, or HDG can assist you in your preparedness or response, please contact us at info@hdgi1.com or 763.537.5700.