Latest COVID-19 Long-Term Care Facility Guidance from CMS
Jeannine LeCompte, Compliance Research Specialist
The Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) have issued new recommendations to long-term care facilities to help mitigate the spread of the 2019 Novel Coronavirus (COVID-19). CMS and the CDC are now recommending the following immediate actions to keep patients and residents safe:
- Nursing homes should immediately ensure that they are complying with all CMS and CDC guidance related to infection control. In particular, facilities should focus on adherence to the guidelines dealing with appropriate hand hygiene, infection control guidance, and the conservation of personal protective equipment (PPE) when unable to follow the long-term care facility guidance.
- State and local health departments have been mandated to work together with long-term care facilities in their communities to determine and help address long-term care facility needs for PPE and/or COVID-19 tests.
- Long-term care facilities should immediately implement symptom screening for all. In accordance with previous CMS guidance, 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. An exception to this is Emergency Medical Service (EMS) workers responding to an urgent medical need. They do not have to be screened, as they are typically screened separately.
- Facilities should limit access points and ensure that all accessible entrances have a screening station. In accordance with previous CDC guidance, every resident should be assessed for symptoms and have their temperature checked every day. Patients and residents who enter facilities should be screened for COVID-19 through testing, if available.
- Long-term care facilities should ensure all staff are using appropriate personal protective equipment (PPE) when they are interacting with patients and residents, to the extent PPE is available and per CDC guidance on conservation of PPE.
For the duration of the state of emergency in their state, all long-term care facility personnel should wear a facemask while they are in the facility. Full PPE should be worn per CDC guidelines for the care of any resident with known or suspected COVID-19 per CDC guidance on conservation of PPE.
If COVID-19 transmission occurs in the facility, healthcare personnel should wear full PPE for the care of all residents irrespective of COVID-19 diagnosis or symptoms. Patients and residents who must regularly leave the facility for care (e.g., hemodialysis patients) should wear facemasks when outside of their rooms.
When possible, all long-term care facility residents, whether they have COVID-19 symptoms or not, should cover their noses and mouths when staff are in their room. Residents can use tissues for this. They could also use cloth, non-medical masks when those are available. Residents should not use medical facemasks unless they are COVID-19-positive or assumed to be COVID-19-positive.
Resources:
Hand Hygiene Guidance
https://www.cdc.gov/handhygiene/providers/guideline.html
Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and/guidance-infection-control-and-prevention-coronavirus-disease-2019-covid-19-nursing-homes
CDC Guidance to Optimize the Supply of PPE and Equipment
https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html
