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 How Providers Should Document Calls for Help During COVID-19 Crisis

The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) has developed brief guidance for facilities facing personal protective equipment (PPE) and staffing shortages, as well as other challenges in receiving assistance.

The association said most long term care providers do not have access to the adequate supplies or staff to provide the level of care needed to contain the virus. Documenting requests for assistance is a critical part of managing the long-term consequences of the lack of supplies and testing—and preparing for future surveys, AHCA/NCAL said.

“Unfortunately, also due to this crisis, many long term care providers are unable to fulfill requests for help made to regular contacts (e.g., suppliers, morgues, staffing agencies, etc.) and through traditional communication channels,” the group said.

To help remedy this situation, long term care providers need to regularly call for help and need to document these calls were made. Continue to reach out to these entities:

--Contact the local AND state health departments.

--Contact the state survey agency.

--Consider contacting local government officials such as the mayor, state representative, or state senator.

AHCA/NCAL guidance also has information on how to properly document calls for help and the importance of requesting a facility-level waiver.

In separate developments, the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network has announced two upcoming webinar trainings for the new LTCF COVID-19 Module, which is expected to be a new requirement by the Centers for Medicare & Medicaid Services (CMS). The final rule from CMS on this requirement is still pending. However, CDC is making the module available to nursing facilities now, AHCA/NCAL said. 

The training webinars will be recorded and posted to the 
LTCF COVID-19 Module webpage with a PDF of the slide presentation, and are:

First Topic: COVID-19 Module Overview for Long-term Care Facilities. Thursday, April 30, from 1:30-3:00 p.m. (EDT)

Second Topic: COVID-19 Enrollment Guidance for Long-term Care Facilities. Friday, May 1, from 1:30-3:00 p.m. (EDT)

Learn how to join these webinars on the CDC website

If providers have any questions, email CDC at 
NHSN@cdc.gov and include LTCF COVID-19 in the subject line.

In other developments, CDC this week made changes to its priority classifications for COVID-19 testing and has now modified its priority classifications into two categories: high priority and priority, and both health care facility workers with symptoms and residents in long term care facilities with symptoms are classified as high priority. 

In addition, CDC states that health care workers in contact with a person with known or suspected COVID-19 should be considered for testing. Residents and health care workers in long term care facilities without symptoms may also be prioritized by state or local health departments or clinicians, for reasons including public health monitoring, sentinel surveillance, or screening of other asymptomatic individuals.

Previously, CDC had identified three priority levels for testing. Patients in long term care facilities with symptoms were identified as priority two for testing, while health care workers with symptoms were identified as priority one and health care workers without symptoms as priority three. 

This update represents a positive step in continuing the push for better access to testing for both long term care residents and staff, AHCA/NCAL said. Providers should use this guidance when seeking testing from hospitals, physicians, labs, and local officials and advocating for faster turnaround times, the association said.

For more information, see 
AHCA/NCAL’s recent guidance on testing. Facilities can refer to AHCA/NCAL’s list of vendors that provide testing in the nursing facility setting and are Food and Drug Administration-approved.

On another front, AHCA/NCAL addressed ombudsmen and their role during the COVID-19 crisis. The ombudsman program’s primary focus is to protect and promote the health, safety, welfare, and rights of long term care residents, the association said, and are a community resource. “Their outreach can help to calm fears by providing information and resources to residents, their families, and center staff,” AHCA/NCAL said.

The following are just a few examples of how the ombudsman program can assist center staff: 

--Answering questions from a resident’s family, who may have additional concerns because they are not able to visit their loved one in person;

--Providing information and assistance to staff regarding individual resident and family concerns related to dementia care and ideas on providing individualized activities; 

--Serving as a resource to facilitate communications between the facility and other agencies, such as public health, the Aging & Disability Resource Center, and Centers for Independent Living to facilitate resident transitions to home;

--Assisting with virtual resident and family councils, or similar meetings, when possible; and

--Educating the public through the media on the importance of the work of care providers, reminding in a public way to show gratitude and kindness to staff.

Administrators and/or directors of nursing should talk with their ombudsman program to identify together what is most helpful for the facility needs during this unprecedented pandemic, AHCA/NCAL said.

To find a program nearby, visit this 
website, or call the Eldercare Locator: 1-800-677-1116. More information about the ombudsman program is online.

On how to help employees during the pandemic, CDC has developed resources for frontline staff in long term care facilities. These short webinars are all published on the Key Strategies to Prepare for COVID-19 in Long-term Care Facilities (LTCFs) webpage at the bottom under a “Webinar Series” section.

The direct links to each webinar:

--Sparkling Surfaces

--Clean Hands

--Closely Monitor Residents

--Keep COVID-19 Out! 

--PPE Lessons

And the new additional resources are:

--Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings 

--Additional Guidance for Nursing Homes and Long-Term Care Settings 

--Preparedness Checklist for Nursing Homes and Other Long-Term Care Settings 

Finally, CDC updated its list of COVID-19 symptoms. The symptoms now include cough and shortness of breath or difficulty breathing or at least two of the following symptoms: fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, vomiting, diarrhea, and new loss of taste or smell.  

With the addition of these symptoms, AHCA/NCAL has updated its relevant resources, including a 
screening checklist for essential personnel and visitors, as well as a sample daily log for personnel.

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