• Governor Evers Declares May 10-16 National Skilled Nursing Care Week
• DHS to Release Names of SNFs with COVID-19 Outbreaks
• NHSN COVID-19 Reporting: Accurately Reporting Staffing and PPE Shortages
• Live Walk-Through of New NHSN LTCF COVID-19 Module
• N95 Decontamination System Up and Running
• COVID-19 Updates for Wisconsin – Evolving Testing Priorities for Asymptomatic People; New CDC Recommendations for Discontinuation of Isolation
• CMS to Fix PDPM Variable Per Diem Glitch

• The public posting will include a lag time of about 48 hours, which should allow facilities time to notify residents and families before the information becomes public.
• The disclosure will only state whether a facility has a current confirmed COVID-positive case in the facility, and will not provide number of cases at a facility.
• This disclosure will include positive cases for either employees or residents, but the information will not identify whether it is a resident or staff.
• DHS will not disclose COVID-positive cases in nursing homes with fewer than 10 residents.
• Just as there is a trigger to be added to the list (COVID-positive test for a resident or employee), there will be a trigger to be removed from the list (presumably confirmation that there are no current COVID-confirmed individuals at the facility, but the details of this have not been made public).
• As of now, this public disclosure will be limited to nursing homes, not assisted living (or other health settings like hospitals).

• A lack of provider input before the decision was made to create this new disclosure policy
• Resident privacy issues
• Unfairly targets nursing homes and does not include other health settings
• The public naming of COVID-positive facilities is a de facto public shaming of these facilities
• Facilities will be more reluctant to accept new admissions from hospitals for fear of a stigma associated with having COVID in the building
• There is a lack of a compelling public health interest for this proposed policy

• The public posting website should include a prefatory statement that a facility's COVID status is not an indication of quality of care provided
• The disclosure should not identify whether the case is an employee or resident, for privacy reasons
• If this policy is going to move forward, it should not just include nursing homes
• There should be at least 48 hours lag time between COVID confirmation and public disclosure, so facilities have proper time to communicate to residents and families before the information is public
• Providers would prefer one weekly update rather than a daily update, as a daily update will allow stories of COVID in nursing homes to be in the press daily
• If there is a trigger to be added to the list, there should also be a trigger to be removed (i.e., no current COVID cases at the facility)
• There should be a special designation for facilities which have created dedicated COVID units/wings to help treat confirmed patients.

• TMJ4: Wisconsin DHS works to release list of nursing homes with COVID-19 investigations
• Journal Sentinel: With more than 40% of coronavirus deaths in long-term care centers, Wisconsin ready to release names of those with positive cases
• Wisconsin Health News: DHS to Name Nursing Homes with COVID-19 Cases

• Staffing less than your facility needs or internal policies for staffing ratios prior to COVID or based on increased needs since COVID
• Employing contingency or crisis strategies for staffing shortage
• Using more agency staff than you used before the pandemic
• Using volunteers for staffing needs more than what you may have used prior to the pandemic
• Using any temporary positions per waiver allowances (such as temporary nurse aide or temporary feeding assistant)

• Employing any conservation strategies for PPE use; if you are not able to use PPE per conventional transmission-based precautions in place before the pandemic you should answer NO
• Using alternative PPE such as cloth masks or other types of face coverings, clothing or other types of coverings instead of surgical gowns, or glasses for eye protection
• Reusing any single use supply item such as gown or masks
• If additional residents in the next week will need to be placed on precautions, it will compromise your PPE supply
• If additional staff in the next week will need to use PPE when returning to work, it will compromise your PPE supply
• If visitors or contractors in the next week need to visit, it will compromise your PPE supply 

• Navigating the LTCF COVID-19 module
• Data entry demonstration
• Review of additional resources, including tables of instructions and data definitions
• Q & A

• NHSN COVID-19 Long-Term Care Facility Module training materials
• NHSN expedited enrollment process for COVID-19 module
• April 19 CMS memo on forthcoming nursing home reporting requirements in NHSN
• May 6 CMS memo on interim final rule requiring notification of confirmed and suspected COVID-19 cases among residents and staff in nursing homes

• All compatible N95 respirators must be free of any visual soiling or contamination (e.g., blood, bodily fluids, makeup).
• Compatible N95 respirators that are visually soiled or damaged should not be collected for decontamination and will be disposed of and not returned after decontamination.
• Masks should be marked with the name of the healthcare professional to whom the mask was issued.

1. Instructions for Healthcare Personnel (mask marking) [pdf]
2. Instructions for Healthcare Facilities [pdf]
3. HCP - Fact Sheet [pdf]

• Wisconsin DHS and CDC now prioritize COVID-19 testing for asymptomatic people in a wider range of scenarios to support the public health response. This change reflects both growing testing capacity and the wider recognition of the importance of asymptomatic and presymptomatic transmission.
• DHS and CDC have revised recommendations about discontinuation of isolation for patients with COVID-19 in health care and non-health care settings. The recommended duration of isolation has been extended to be at least 10 days from the date symptoms first appeared.

• Hospitalized patients with symptoms
• Healthcare facility workers, workers in congregate living settings, and first responders with symptoms
• Residents in long-term care facilities or other congregate living settings, including prisons and shelters, with symptoms

• Persons with symptoms of potential COVID-19 infection, including: fever, cough, shortness of breath, chills, muscle pain, new loss of taste or smell, vomiting or diarrhea, and/or sore throat.
• Persons without symptoms who are prioritized by health departments or clinicians, for any reason, including but not limited to: public health monitoring, sentinel surveillance, or screening of other asymptomatic individuals according to state and local plans.

1. As part of public health investigations, such an outbreak involving multiple cases in a workplace.
2. For individuals in congregate living situations such as nursing homes or assisted living facilities
3. In health care settings, when needed to inform infection control interventions, such as before aerosol-generating procedures.
4. In community settings, when testing of close contacts of confirmed cases would inform local public health interventions, such as contact tracing investigations, or decisions about location of quarantine* or isolation.

• At least 10 days* have passed since symptoms first appeared, AND
• At least 3 days (72 hours) have passed since recovery. Recovery is defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath)

• At least 10 days* have passed since the collection date of their first positive COVID-19 diagnostic test, assuming they have not subsequently developed symptoms. NOTE: patients who develop COVID-19 symptoms during this period should extend isolation precautions for at least 10 days from the date of symptom onset (see above).