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 AHCA/NCAL Unveils System For How to Test and Cohort Residents

The American Health Care Association/National Center for Assisted Living (AHCA/NCAL) said it has created an algorithm for testing and cohorting nursing home residents that incorporates the latest guidance from the Centers for Disease Control and Prevention (CDC) on the coronavirus (COVID-19).
The algorithm walks through three primary entry points for testing prior to deciding on who and how to cohort individuals. “The entry points include testing residents who develop symptoms, testing all residents simultaneously, and testing new admissions. The algorithm also walks through how to cohort if the person(s) tested are in a single-person room or with roommates,” the group said.
On a separate front, AHCA/NCAL said it now has a resource to help providers continue to keep residents connected with their loved ones. As visitation restrictions and social distancing continue, the long term care profession needs to find ways to keep people connected in person when possible. Using an infection prevention and control mindset can help generate innovative methods to engage residents, families, and fellow residents, the association said.

“This resource is a starting point and intended to kick off additional ideas each center or community is able to try based on the status of COVID-19 in their building and in their community as well as the availability of necessary resources to support these innovative efforts,” AHCA/NCAL said.
In another area of concern to providers during the pandemic, AHCA/NCAL said in its guidance on Where to Turn for Help, the association shared information and a customizable template for requesting a facility-level 1135 waiver from the Centers for Medicare & Medicaid Services (CMS). AHCA/NCAL said it has updated the template due to CMS blanket waivers and guidance provided since the group first  shared the template. 

“Remember that while using this check-box format, it is still important that you customize your waiver request to reflect your center’s needs and circumstances, as this will aid in CMS’ review and approval of your requests,” AHCA/NCAL said.
“This is a Word document, so you can make edits to include the items you need and to provide any additional explanation or rationale for your requests.” 
Lastly, AHCA/NCAL said CDC on May 19 updated several of its webpages to be reflective of the CMS updates on reopening guidance. The three webpages that were updated include:  
Below is a summary of what was changed. Review your infection prevention and control procedures to ensure they are consistent with the latest guidance. 
--Tiered recommendations to address nursing centers in different phases of COVID-19 response.
--Added a recommendation to assign an individual to manage the facility’s infection control program (ICP). CDC feels that “facilities should assign at least one individual with training in IPC to provide on-site management of their COVID-19 prevention and response activities,” because of the breadth of activities for which an IPC program is responsible. This includes developing IPC policies and procedures, performing infection surveillance, providing competency-based training of health care personnel, and auditing adherence to recommended IPC practices.
--Added guidance about new requirements for nursing centers to report to the National Healthcare Safety Network (NHSN).--Added a recommendation to create a plan for testing residents and health care personnel for SARS-CoV-2. Note, AHCA/NCAL provided recent guidance on testing that incorporates the latest from CDC.
--Additional descriptive information for such areas as universal source control, hand hygiene, optimization of personal protective equipment (PPE), and the COVID unit section based on common questions received, including:
1. Removed language to move residents with symptoms or suspect COVID to an observation unit, if one was available, as this has been a point of confusion and has not been feasible for most facilities.
2. CDC recommends creating a COVID unit for residents with confirmed COVID and, if possible, an observation area for new admissions with no known COVID history (those with known COVID would go to COVID unit), but recommend that if possible, those with symptoms or suspect COVID-19 go to a private room. Testing should be prioritized for these individuals, and, if positive, they would move to a COVID unit. PPE should be worn.
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