Coronavirus Update #192
HFAM Update
New Maryland Department of Health Guidance


Friends:

Governor Hogan just finished a press conference where he re-iterated that most key metrics have considerably worsened in the last week. In addition, the Governor released a new executive order, as well as amended directives and orders, listed below.





I know you are likely tired of hearing it because you and your teams are living it, but we are just starting this new most unfortunate COVID-19 surge. While we hoped it would not come, we have helped prepare leaders and teams in our sector. 

As you know, research from Brown, Harvard, and the University of Chicago indicates that a higher positivity rate in the community often results in higher positivity rates in nursing homes and assisted living campuses. So, the more prevalent COVID-19 is in a community, the more prevalent COVID-19 will be in a nursing home or assisted living center in that community. 

The difficult task for you and your healthcare heroes remains: follow infectious disease protocols, stop the spread, reduce the mortality. No small task when you consider that nursing homes care for people who by definition are more sick with pre-existing chronic conditions, and as a result are highly vulnerable to COVID-19.

We all have COVID fatigue. Teams must remain vigilant in mask-wearing and social distancing outside of work, and diligent with PPE use and donning/doffing at work. This is also a time to be especially vigilant with infectious disease protocols relative to visitation.

Report from HFAM:
 
  • First, it is not all doom and gloom. The Pfizer vaccine is incredibly encouraging, as are the other vaccines. Remember, you only get those vaccines if you signed up for the federal program. We understand that vaccines to local LTC pharmacy’s will be run through state government allotment.

  • Admissions to hospital ICU’s are increasing; many of the people being admitted to ICU’s are 25-50 years old.

  • Hospitals, skilled nursing and rehabilitation centers, and others are experiencing increased RN and aid callouts due to team members not feeling well, those being cautious because of possible exposure, and people who have tested positive.

  • We have re-initiated contact with UMMS and the Maryland Hospital Association (MHA) on new rounds of N95 Fit Testing, and to begin again the ask of RN training resource support.

  • We will work with MHA to bring together via video conference next week the HSCRC/SNF grant hospitals to explore bridging and resource support—we will invite, coordinate, and co-lead this work with our colleague partners at LifeSpan and LeadingAge Maryland.

NOTE: All of healthcare is trying to recruit from the same pool of RNs; it is challenging. The shortage of nurses’ aides remains real, and some skilled nursing centers are considering augmenting care staff with RTs and OTs.

Reminders:

  • As we previously advised the Board on October 14, and the sector later, the State of Maryland’s expectation is that our sector will self-bridge during this fall and winter COVID-19 surge, we’ve been preparing and we must take care of our own. Unlike the first surge in March and April, state bridge teams of RNs, nurses’ aides, and physicians will be VERY limited.

  • On testing: Cautious nursing homes might consider serial weekly point of care (POC) testing of all staff, POC testing of all visitors and vendors, and weekly PCR commercial testing of patients and residents. In addition, we remain very concerned about the critical need for the testing of ambulance personnel, dialysis employees, and state health inspectors, which has not been ordered.

  • Chesapeake Registry Program - The Chesapeake Registry Program, an affiliate of The Maryland Hospital Association’s shared services subsidiary PRIME, was developed in response to concerns regarding the quality and availability of supplemental staff.

We will continue coordinating with our sector, government leaders, and our hospital partners. Onward together, marathon and not sprint! 
As always:

  • People first, quality counts.
  • Our sector MUST double our efforts on infectious disease protocol, staffing, PPE, observation, and testing.
  • Train, train, and train teams again on infectious disease protocol.
  • Recognize that COVID-19 fighting fatigue is an issue across the county, not just in our sector.
  • Overcommunicate with residents, patients, families, staff, and government partners.
  • Work with your hospital partners, and coordinate with local and state regulatory partners.
  • Take and document your action; keep a timeline
  • CLICK HERE for the Dr. Katz Video, and please see the Donning and Doffing Checklist we first distributed a couple of months ago.

Be well,
Joe DeMattos
President and CEO
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Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.