2019 Novel Coronavirus Update #8

New Quality, Safety, and Oversight Memos from CMS
Along with our national partner, the American Health Care Association/National Center for Assisted Living (ACHA/NCAL), HFAM has been monitoring the COVID-19 outbreak and has continued to collaborate with federal and state agencies as well as hospital partners.

Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued three new Quality, Safety and Oversight memos about COVID-19. Two apply to nursing homes and a third to hospitals that are listed below.

We strongly recommend facilities review these new guidance and also continue to keep up to date with CDC guidance on CVID-19 at https://www.cdc.gov/coronavirus/2019-ncov/index.html for health professionals and facilities as they continue to update guidance on testing and management of residents with suspected and COVID+ test results. 

This memo provides guidance on:

  • Screening visitors and who should be restricted; 
  • Screening employees and contractors and who should be asked to stay at home;
  • When patients should be managed in the facility vs sent to the hospital;
  • What to do when transferring residents with suspected COVID-19, and; 
  • What criteria to use in accepting patients from the hospital with COVID-19

This memo announces that CMS will re-prioritize surveys to conduct focus surveys about infection control for facilities that have had an infection control deficiency in the past to assure that they are in compliance with the new regulations. Specifically:

  • Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years, and; 
  • Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy. 

The Agency also provided a copy of the critical elements pathway in QSO-20-12-ALL that will be used by the surveyors to assess compliance with current regulations. We encourage you to review and use these guidelines in your facility as a self-assessment tool.  

We also encourage all members to review closely the State Operating Manual's guidance for F-880 related to infection control and take steps to assure consistent hand washing (or use alcohol hand gels) and contact precautions for residents with respiratory infections. 

This memo outlines guidance to hospitals on screening visitors, employees and when to admit and discharge residents. 
General Background and Information
Prudent providers across all healthcare settings continue to review state guidance and operational plans for infection control and best practices for care, food, power, medication and additional needs of residents and staff. As the outbreak of 2019 Novel Coronavirus (2019-nCoV) further develops, we can expect additional federal and state guidance.

COVID-19 spreads mainly between people who are in close contact with one another via respiratory droplets produced when an infected person coughs or sneezes. Some spread might be possible before people show symptoms; there have been reports of this with the coronavirus, but it is not thought to be the main way that the virus spreads.

The symptoms of COVID-19 include mild to severe respiratory illness with fever, cough, and difficulty breathing. Visitors, staff members, volunteers, and vendors who are experiencing these symptoms should not go to skilled nursing and rehabilitation centers, assisted living campuses, or hospitals.
AMDA Guidance
Earlier this week, AMDA released Guidance on COVID-19 in Post-Acute and Long-Term Care Settings. We urge members to view this guidance and continue to implement and assess your infection control procedures.
HFAM, MHA, and UMMS Call - Friday, March 6th at 3:00 PM

Along with the Maryland Hospital Association (MHA) and the University of Maryland Medical System (UMMS), we will be hosting a call for all hospitals and post-acute/long-term care providers. The call will take place this Friday, March 6th at 3:00 PM EST.

Be on the lookout for more information to be provided in advance of this call.
AHCA/NCAL Webinar

AHCA/NCAL recenlty hosted a COVID-19 webinar for all long term care providers. The webinar included an update from Centers for Disease Control and Prevention (CDC) officials and AHCA/NCAL staff. You and your team can view the webinar HERE .
IMPORTANT REMINDER: OHCQ SURVEY

If you haven't already, please complete OHCQ's " Nursing Home Emergency Preparedness Inventory " as soon as possible. It is important for preparation, should the coronavirus become a public health challenge in Maryland.

Note: There are still currently zero confirmed cases of the coronavirus in Maryland.
HFAM continues to monitor the COVID-19 situation with our state and national partners and will keep members informed. Additional information for healthcare professionals can be found on the CDC  and on the MDH websites.