Coronavirus Update #66
Thank You Message from Congressman Harris, Post-Acute Webinar Today, CDC Return to Work Guidelines, Updated Steps to Limit Spread, Resources for Staff
Thank You Message from Congressman Harris

Please watch and share with your teams this  special message  from Congressman Andy Harris as he shares words of encouragement to caregivers, residents, and families of the Maryland long-term and post-acute care sector during the unprecedented COVID-19 pandemic. Congressman Harris thanks staff in nursing homes and assisted living communities and reassures residents and families of those in long-term care centers. 
TODAY: Webinar on Post-Acute Daily Bed Reporting via CRISP

As we shared recently, our partners at the Maryland Hospital Association (MHA) and CRISP have been working with post-acute providers and hospitals to streamline nursing home daily bed availability reporting.  There will be a webinar today, April 22 from 1:00 - 2:00 PM EST to go through the process of using this tool. Please see the call details below.

Post-Acute Daily Bed Reporting via CRISP

Date:  Wednesday, April 22
Time:  1:00 - 2:00 PM EST

Meeting number (access code)  : 316 561 900

Join by phone   
+1-415-655-0001  US Toll 
+1-202-860-2110  United States Toll (Washington D.C.) 
Access code: 316 561 900 

Who should attend: Post-acute and hospital personnel and others interested in post-acute daily bed availability.

What: The CRISP team will demonstrate detailed instructions on how to complete the daily bed reporting form and how to access summary reports. They will also cover anticipated changes to the reporting and distribution of information, and how to access summaries through CRISP’s public health reports. There will be time for Q & A.

More Background: The hope is that this reporting tool will be an easier and more comprehensive way to understand bed availability than current processes. The intent is to ask nursing home for key pieces of information that will not be overly burdensome and still provide enough information for hospitals to streamline post-acute care placement. Facilities will be allowed to enter data more than once per day if bed availability changes from first entry, but daily submissions will need to be completed by 10:00 am each morning.

All entries will be processed to provide a single source capacity directory that discharge planners and care managers can use to locate needed beds. Initially, this will be in the form of a spreadsheet emailed back to the discharge planners. Over time, it will also include display in CRISP.

Facilities that submit data will also be able to see daily bed availability across the state. You will need to be credentialed in CRISP to view data, but no credential is needed to submit.

Nursing homes can input information via this link:
CDC Return to Work Guidance: Contingency & Crisis Strategies

Per CDC Return to Work Criteria guidance , health care facilities must be prepared for potential staffing shortages and have plans and processes in place to mitigate them, including considerations for permitting health care providers (HCP) to return to work without meeting all return to work criteria outlined.

CDC refers to the Strategies to Mitigate Healthcare Personnel Staffing Shortages document for information which provides both contingency and crisis strategies. Contingency strategies apply when staffing shortages are anticipated and crisis strategies apply when staffing shortages are happening.

Facilities can activate these strategies based on their staffing situation and should document when they are activating these strategies with the reason why they were activated. Also, notify the local or state health departments of these actions.

For both scenarios below, a facemask instead of a cloth face covering should be used by all people in the building for source control during this time period while in the facility. After this time period, these staff should revert to their facility policy regarding universal source contro l during the pandemic.

  • A facemask for source control does not replace the need to wear an N95 or higher-level respirator (or other PPE) when indicated, including for the care of patients with suspected or confirmed COVID-19. Of note, N95 or other respirators with an exhaust valve might not provide source control.

Health Care Provider Asymptomatic with Unprotected Exposure to COVID-19

If not already done, allow asymptomatic HCP who have had an unprotected exposure to the virus that causes COVID-19 to continue to work.

  • These HCP should still be screened and also report temperature and absence of symptoms before starting each shift. 

  • These HCP should wear a facemask (for source control) all the time while at work for 14 days after the exposure event. 

  • If HCP develop even mild symptoms consistent with COVID-19, they must cease patient care activities and notify their supervisor or occupational health services prior to leaving work. These individuals should be prioritized for testing.

Health Care Provider with Suspected or Confirmed COVID-19 

If staffing shortages continue despite other mitigation strategies, consider implementing criteria to allow HCP with suspected or confirmed COVID-19 who are well enough to work but have not met all Return to Work Criteria to work. 

  • If HCP are allowed to work before meeting all criteria, they should be restricted from contact with severely immunocompromised patients (e.g., transplant, hematology-oncology) and facilities should consider prioritizing their duties in the following order:

  1. If not already done, allow HCP with suspected or confirmed COVID-19 to perform job duties where they do not interact with others (e.g., patients or other HCP), such as in telemedicine services.
  2. Allow HCP with confirmed COVID-19 to provide direct care only for patients with confirmed COVID-19, preferably in a cohort setting.
  3. Allow HCP with confirmed COVID-19 to provide direct care for patients with suspected COVID-19.
  4. As a last resort, allow HCP with confirmed COVID-19 to provide direct care for patients without suspected or confirmed COVID-19.

If HCP are permitted to return to work before meeting all Return to Work Criteria , they should still adhere to all Return to Work Practices and Work Restrictions recommendations described in that guidance. These include: 

  • Wear a facemask for source control at all times while in the healthcare facility until all symptoms are completely resolved or until 14 days after illness onset, whichever is longer. 

  • They should be reminded that in addition to potentially exposing patients, they could also expose their co-workers. 

  • Facemasks should be worn even when they are in non-patient care areas such as breakrooms, laundry, and kitchen. They should adhere to social distancing as much as possible including during breaks outside the facility.

  • If they must remove their facemask, for example, in order to eat or drink, they should separate themselves from others (e.g. follow social distancing guidelines as much as possible).

Self-monitoring for symptoms and seeking re-evaluation from occupational health if respiratory symptoms recur or worsen.
Updated: Steps to Limit COVID-19 Spread and Outbreaks in Long Term Care

COVID-19 spreads principally person-to-person, and often is spread by asymptomatic individuals who do not realize they are sick. Every interaction between people increases the risk of spread. This includes staff to staff, staff to resident and resident to resident. It’s a simple formula for how spread happens – the more interactions that happen with a variety of people, the greater the likelihood of spread.

AHCA/NCAL has updated this resource on action steps to take and continually reinforce to limit the spread of COVID-19 with all staff and residents.
Resource for Staff to Embrace Social Distancing

The actions of frontline staff in and outside long term care facilities can make an impact in mitigating the spread of COVID-19. Staff can also be strong ambassadors for best practices when in the surrounding community. It is important to arm your staff with knowledge they can implement at work and home as well as share with their own family and friends. 

AHCA/NCAL has drafted a template message for frontline staff on social distancing both while in and outside the facility. This document is intended to be distributed to or posted for frontline staff, to empower and encourage them to maintain social distancing and good hygiene. Tailor this message as needed, including any specific program(s) you are offering to staff members to make social distancing easier, such as assistance with acquiring groceries, offering transportation, etc.
Innovation Works - Locally Made PPE

We wanted to share and additional PPE resource. Local individuals and businesses in the Baltimore area are crowd-sourcing to manufacture and produce PPE for frontline healthcare and human services professionals.

CMS COVID-19 Stakeholder Engagement Calls

CMS hosts varied recurring stakeholder engagement sessions to share information related to the agency’s response to COVID-19. These sessions are open to members of the healthcare community and are intended to provide updates, share best practices among peers, and offer attendees an opportunity to ask questions of CMS and other subject matter experts.

Call details are below. Conference lines are limited so you are encouraged to join via audio webcast, either on your computer or smartphone web browser. Calls recordings and transcripts are posted on the CMS podcast page here.  

COVID-19 Office Hours Calls (Tuesdays and Thursdays at 5:00 – 6:00 PM Eastern)
Office Hour Calls provide an opportunity for hospitals, health systems, and providers to ask questions of agency officials regarding CMS’s temporary actions that empower local hospitals and healthcare systems to:Increase Hospital Capacity – CMS Hospitals Without Walls; Rapidly Expand the Healthcare Workforce; Put Patients Over Paperwork; and Further Promote Telehealth in Medicare.

Thursday, April 23
5:00 – 6:00 PM EST
Toll Free Attendee Dial In: 833-614-0820
Access Passcode: 5899488
Lessons from the Front Lines: COVID-19 (Fridays at 12:30 – 2:00 PM Eastern)
Lessons from the Front Lines calls are a joint effort between CMS Administrator Seema Verma, FDA Commissioner Stephen Hahn, MD, and the White House Coronavirus Task Force. Physicians and other clinicians are invited to share their experience, ideas, strategies, and insights with one another related to their COVID-19 response. There is an opportunity to ask questions of presenters.

Friday, April 24
12:30 – 2:00 PM EST
Toll Free Attendee Dial-In: 877-251-0301
Access Code: 5096006

Weekly COVID-19 Care Site-Specific Calls
CMS also hosts weekly calls for certain types of organizations to provide targeted updates on the agency’s latest COVID-19 guidance. One to two leaders in the field also share best practices with their peers. There is an opportunity to ask questions of presenters if time allows.

Nursing Homes Specific Calls (Wednesdays at 4:30 PM Eastern)
Wednesday, April 22
 4:30 – 5:00 PM EST
Toll Free Attendee Dial-In: 833-614-0820
Access Passcode: 2672118

Dialysis Organizations (Wednesdays at 5:30 PM Eastern)
Wednesday, April 22
 5:30 – 6:00 PM EST
Toll Free Attendee Dial-In: 833-614-0820
Access Passcode: 1796168
Nurse Specific Calls (Thursdays at 3:00 PM Eastern)
Thursday, April 23
 3:00 – 3:30 PM EST
Toll Free Attendee Dial-In: 833-614-0820
Access Passcode: 6004019
Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
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.