Providers won’t be able to “realistically implement” new guidance from the Centers for Medicare & Medicaid Services until they have enough personal protective equipment and access to testing, advocates warned. Most recently, the administration is asking all workers to wear face masks under pandemic conditions.
Providers already don’t have sufficient supplies of PPE and other resources to adequately protect staff members and residents, according to LeadingAge President and CEO Katie Smith Sloan. A McKnight’s Long-Term Care News reader survey last week found that more than 77% of facilities were experiencing PPE shortages.
The administration’s set of new recommendations also calls for temperature checks for every single person within a nursing home, as well as separate and separate COVID-19 buildings or units.
“We look to [CMS], the members of the White House Coronavirus Task Force, as well as to our partners in state governments, to work with us to make this recommendation feasible by collaborating with our provider members on securing resources — PPE, staff [and] necessary funding to pay for the costs these recommendations will incur — so that they can realistically be implemented,” Sloan said.
“The facts haven’t changed that we desperately need more PPE in nursing homes, priority testing for our healthcare workers and residents, and the ability to quickly recruit and hire more staff,” added David Gifford, MD, chief medical officer for the American Health Care Association / National Center for Assisted Living.
Gifford noted the organization also agrees that collaboration with hospitals on discharge plans is a top priority during the pandemic, and that collaboration also should focus on discharging patients to facilities that can create segregated COVID-19 units and have enough PPE.
He said nursing homes have acted on things it can control, like limiting visitation and implementing social distancing strategies, during the early days of the pandemic. But without sufficient resources, it will be tough for providers to fully comply with the latest guidance.
“We are doing everything we can with the resources we’ve been given to slow the acceleration of the virus for our residents, the most vulnerable. But without PPE, tests and healthy workforce, it is not possible to fully comply with CMS and [Centers for Disease Control and Prevention] directives,” Gifford said.
Providers told to keep staff interaction minimal
A top goal for providers during the coronavirus pandemic should be to limit as many interactions with nursing home residents in order to prevent the spread and potential outbreaks, according to the American Health Care Association / National Center for Assisted Living.
The best ways providers can tackle this is through reducing the number of non-essential people entering the building, which has already been mandated by the federal government.
They can also target interactions by reducing the amount of different staff members that enter resident rooms and increasing efficiency of tasks while in a room, which should decrease the number of times they would need to enter.
Targeted interactions include physical distancing, minimize the staff members working across units and if coronavirus is in the facility, using “source control” masks on residents and staff to prevent additional spread.
“It’s a simple formula for how spread happens – the more interactions that happen with a variety of people, the greater the chance of spread. So, continue to creatively reduce the number of interactions between people and stop the spread of this deadly virus,” the AHCA/NCAL advised.
The organization noted that data shows about 6% to 12% of COVID-19 cases are the result of viral spread from asymptomatic people, and symptom-based approaches for stopping the spread of the disease cannot be used as a sole solution.
Preparing residents for COVID-19’s full dangers
AHCA/NCAL is encouraging long-term care providers to frequently talk with residents, their families and staff members in order to prepare them for the possible death toll of COVID-19.
Providers should ensure residents’ advance directives, end-of-life wishes, physician orders for life-sustaining treatment orders are all documented and updated to date. Staff members also should be prepared for increased resident hospitalizations, visitation from family members in end-of-life situations and use of mortuary services.
“Staff in long term care are well experienced in taking care of people at end-of-life. It is important to refresh and reinforce those skills to provide quality care and support for each resident and their family,” the organization explained.
In other coronavirus related news:
• As of Sunday, more than 7,600 people in the United States have died from COVID-19, with nearly 305,000 total cases, according to the Centers for Disease Control and Prevention.
• The Centers for Disease Control and Prevention has an online document that could prove very helpful to providers: “Strategies to Optimize the Supply of PPE and Equipment.” It offers “options for use when PPE supplies are stressed, running low or absent.”
• In brighter news, a nursing home worker got a sweet surprise from grocery store employees when she went to pick up her curbside order. The workers attached and signed a thank-you card to her groceries; they also paid for all her entire order. The not-so-small gesture by the grocery store employees brought her to tears.