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COVID-19 Updates

HCANJ Emergency Management ALERT

· Health Care Organization of New Jersey (HCANJ)

· American Health Care Association/National Center for Assisted Living (AHCA/NCAL)

· New Jersey Department of Health (NJDOH)

· Center for Disease Control and Prevention (CDC)

· Centers for Medicare and Medicaid Services (CMS)

·  World Health Organization (WHO)

RECENT AMERILERT UPDATES:

Please see the attached recent LINCS documents that may answer many important questions your staff my have during COVID-19 Pandemic:

The Communicable Disease Service (CDS) is providing the following updated guidance to assist healthcare facilities and public health officials with decisions concerning discontinuation of transmission-based precautions and home isolation. CDS is also providing two resources for patients diagnosed with COVID-19 and close contacts who may or may not have been tested. Please note this guidance may be updated as the information changes.

The following three documents have been UPDATED to align with CDC guidance released 3/16/2020 that reflects a change in the home isolation period for confirmed cases. Updates include:

(1) Guidance for the Discontinuation of Transmission-based Precautions and Home Isolation for Persons Diagnosed with COVID-19: Includes guidance for healthcare workers return to work, guidance for persons who tested positive for COVID-19 but remain asymptomatic, guidance for immunocompromised patients with COVID-19. Updated sections are highlighted in yellow

https://files.constantcontact.com/e1419ee3001/4f0313fc-88e5-498e-a9aa-eab42ebcf522.pdf

(2) Sample Discharge Instructions for Persons Diagnosed with COVID-19: Updated to reflect new home isolation guidance. This supersedes previous version.

https://files.constantcontact.com/e1419ee3001/8ce12392-da2c-4cd0-9507-f13581ac5ef8.pdf

(3) Frequently Asked Questions for Close Contacts of COVID-19: Updated to reflect new home isolation guidance. This supersedes previous version

https://files.constantcontact.com/e1419ee3001/1e87af98-e49f-426f-b163-23e8d12bad1a.pdf

(4) Given the congregate nature of long-term care facilities (LTCF) and residents served (e.g., older adults often with underlying chronic medical conditions), this population is at an increased risk of serious illness when infected with COVID-19. LTCF have experience managing respiratory infections and outbreaks among residents and healthcare personnel and should apply those outbreak management principles to COVID-19. Please note this is a rapidly evolving situation and as more data become available this guidance may change.

All LTCFs should remain vigilant with prompt detection, triage, and isolation of potentially infectious persons to prevent unnecessary exposures among residents, healthcare personnel, and visitors at the facility. Please see the attached guidance document for more information and resources. Infection prevention measures include:

  • Implement active screening of residents and staff for fever and respiratory symptoms. Remember that older adults may manifest symptoms of infection differently and that other symptomology should also be. Vital signs should include heart rate, blood pressure, temperature, pain and pulse oximetry. These assessments should happen, at a minimum, daily. The facility staff should have a heightened awareness for any change in baseline in their residents.
  • Stop current communal dining and all group activities such as internal and external group activities.
  • Follow all current CMS guidance regarding the restriction of visitors and non-essential healthcare personnel, except in certain compassionate-care situations -Review the CMS Quality, Safety & Oversight (QSO) Group memo Ref: QSO-20-14-NH at https://www.cms.gov/files/document/qso-20-14-nh-revised.pdf for expanded recommendations.

Remember to:

  • Connect with your ASSOCIATION and monitor NJDOH, CDC, and CMS announcements, at least daily.
  • Conserve personal protective equipment (PPE) in accordance with CDC’s Strategies for Optimizing the Supply of PPE – https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html.
  • Contact your local health department with any questions or concerns. Contact information is available via the local public health directory at http://www.localhealth.nj.gov/.
  • Report any new cases or persons suspected of COVID-19 occurring in or associated with your facility to your local health department.

In addition to actions described above and attached, facilities should consider the following immediate actions when there is a confirmed case of COVID-19 to prevent further spread to their residents and staff:

  • Close the unit to new admissions except as needed to cohort ill individuals or staff.
  • Consider closure of the facility to new admissions.
  • Consider implementing universal use of facemask for HCP while in the facility
  • Encourage residents to remain in their room. If multiple cases are present restrict residents (to the extent possible) to their rooms except for medically necessary purposes.
  • Mask all residents (who can tolerate masks) who are symptomatic when providing direct care: if masks are limited or not tolerated use of a tissue to cover the nose and mouth is appropriate.
  • Adhere to internal environmental cleaning protocols to ensure appropriate measures are being taken to clean and disinfect where appropriate including high-touch surfaces and all shared medical equipment (e.g., lifts, blood pressure cuffs, medication carts). Consider increasing the frequency of cleaning in the facility.

Quarantine and monitor exposed contacts in CDC Has provided this CORRECTED information for their upcoming call.

Corrected Zoom Access Links and Dial-in Numbers: Reminder: CDC COCA Call: Underlying Medical Conditions and People at Higher Risk for Coronavirus Disease 2019 (COVID-19)

Date: Tuesday, March 24, 2020

Time: 2:00pm3:00pm (ET)

You may participate in this COCA Call via the Zoom platform or via Facebook Live.

Please note, the Zoom access links and dial-in information for this COCA Call have been changed. The corrected information is below:

https://www.zoomgov.com/j/1613416798

Or iPhone one-tap:

US: +16692545252,,1613416798# or +16468287666,1613416798# 

Or Telephone:

US: +1 669 254 5252 or +1 646 828 7666

Webinar ID: 161 341 6798

International numbers available: https://www.zoomgov.com/u/acMT9czZKu

  • Including healthcare workers and roommates

https://files.constantcontact.com/e1419ee3001/c3c1a008-adef-4639-beb2-761e99c9518b.pdf

IMPORTANT REMINDER:

When transferring a resident to the hospital please remember to send with them:

Up-to-date Contact Information – Please be certain that the information you are sending with the resident to the hospital is correct. Please update your records so that the resident’s family or responsible party can be contacted.

POLST form – The Practitioner Orders for Life Sustaining Treatment (POLST) form enables residents to indicate their preferences regarding life-sustaining treatment. This form, signed by a resident’s attending physician, advanced practice nurse or physician’s assistant, provides instructions for health care personnel to follow for a range of life-prolonging interventions. This form becomes part of the resident’s medical records, following them from one healthcare setting to another, including hospital, nursing center or hospice. If they don’t currently have one, start the process with the doctor and add to their charts

Advance Directive – An advance healthcare directive (living will), specifying the healthcare interventions a resident wants taken if they are no longer able to make decisions for themselves because of illness or incapacity should always accompany the resident.

Having these documents upon admission to the hospital is important to ensure that the hospital can reach family or responsible parties and make timely and accurate care decisions.

Health Care Association Of New Jersey AAA Drive, Suite 203, Hamilton, NJ 08691-1813 (609) 890 8700