On April 2nd, CMS released additional COVID-19 Long-Term Care Facility Guidance to help mitigate the spread of the 2019 Novel Coronavirus (COVID-19) in skilled nursing facilities (SNF).
The new recommendations included:
- SNFs should immediately implement symptom screening for all staff, residents, and visitors
- SNFs should exercise consistent assignment (meaning the assignment of staff to certain residents) for all residents regardless of symptoms or COVID-19 status
- SNFs should use separate staffing teams for residents to the best of their ability
- SNFs should work with State and local leaders to designate separate facilities or units within a facility to separate COVID-19 negative residents from COVID-19 positive residents and individuals with unknown COVID-19 status
- SNFs should immediately ensure that they are complying with all CMS and CDC guidance related to infection control
- SNFs should ensure all staff are using appropriate PPE when they are interacting with residents
- CMS urges State and local leaders to consider the needs of long term care facilities with respect to supplies of personal protective equipment (PPE) and COVID-19 tests
Symptom Screening For All
The specifics related to implementing symptom screening for all were very detailed, including the following:
- Every individual regardless of reason entering a long-term care facility (including residents, staff, visitors, outside healthcare workers, vendors, etc.) should be asked about COVID-19 symptoms and they must also have their temperature checked.
- Facilities should limit access points and ensure that all accessible entrances have a screening station
- EVERY RESIDENT should be assessed for symptoms and have their temperature checked EVERY DAY
- New residents who enter facilities should be screened for COVID-19 through testing, if available.
These additional recommendations were preceded by guidance issued by CMS on March 13 that advised nursing homes to restrict visitors, helping prevent introduction of the virus into these facilities.
“Not So Good” Focused Infection Control Surveys
On March 23, CMS announced new focused infection control surveys would be conducted to assess facilities’ compliance with infection control requirements to ensure they were prepared to address the COVID-19 threat.
The results of the focused infection control surveys conducted during the week of March 30 were not promising, and are the reason for the additional recommendations above:
- 36 percent of facilities inspected did not follow proper hand washing guidelines
- 25 percent failed to demonstrate proper use of PPE
Both of these areas are longstanding infection control measures that all nursing homes are expected to follow per Federal regulation regardless of the pandemic. CMS is continuing to conduct targeted infection control inspections to ensure nursing homes are prepared to confront COVID-19 and keep their residents safe.
Keeping Our Residents Safe
The Administrator for CMS, Seema Verma, stated, “The Administration is calling on the nursing home industry and state and local leaders to take action now to ensure the safety of their residents, who are among our most vulnerable citizens. The Administration urges them to carefully review our recommendations, and implement them immediately.” The Administration encourages State and local governments to consider creative ways to stop the spread of the virus, such as designating units within facilities – or entire facilities – solely for residents with confirmed COVID-19. A Wilmington, Massachusetts SNF was used as an example, in which a 142-bed facility was designated as a solely COVID-19-positive facility. Residents across the region who are infected with COVID-19 can be moved to this facility to receive appropriate care and avoid transmitting the virus within their facilities. This approach also eases the challenges of preventing transmission, like extensive PPE usage and isolation practices, for individual facilities.
CMS will continue to focus on the SNF setting and safety of each resident.
If you have any questions about the above information or changes in SNF therapy Medicare Part A or Part B practice related to COVID-19, please let us know at the JustAsk Q&A Forum.
To all the therapy professionals in the SNF setting, thank you for everything you are doing to keep residents safe!
In Your Corner,
Dolores Montero, PT, DPT, RAC-CT, RAC-CTA
MonteroTherapyServices. com | SNF Rehab and MDS Compliance