Navigating COVID-19 in Long-Term Care Facilities

March 19, 2020

Authors: Noelle K. Sheehan, Lori Rosen Semlies

In light of recently published guidance to help prevent and control the spread of coronavirus disease 2019 (COVID-19) issued by the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare & Medicaid Services (CMS), we at Wilson Elser have mobilized to help our senior care clients reduce the likelihood of spread of the illness to our most vulnerable population.

Written Protocol for Containment and Prevention of Spread
As a first step, each facility must immediately enact a written protocol on how to prevent and contain the spread of the virus. The protocol must be disseminated to staff, residents, and more importantly, family members and visitors.

Educate Health Care Personnel
Education starts with informing the health care personnel (HCP) and all staff about the actions the facility is taking to prevent the spread of COVID-19, advising residents and visitors of actions they can take to protect themselves, and reinforcing sick leave policies. Providing proper supplies, including gloves, hand sanitizer and soap, to HCP and residents will help reduce risks. Residents who display symptoms should be quarantined and consideration should be given to designating a particular unit for those with symptoms who do not need hospitalization or those who have tested positive and are not displaying symptoms. HCP should be given Personal Protective Equipment (facemasks, gloves, eye protection, etc.) while caring for those in need.

Prohibit Visitors
Most states as well as President Trump have advised against allowing visitors at a senior living facility at this time. However, facilities should offer alternate means of staying connected with friends and family members, such as videoconferencing.

Signage should be posted at the entrance to facilities and screening should be conducted for anyone who may have been exposed.

For those residents in end-of-life care, facilities should encourage visitors to use proper hand hygiene and Personal Protective Equipment, and to limit their movements around the facility.

HCP with Symptoms of Respiratory Illness
Facilities should implement flexible sick leave policies in line with public health policies to permit those HCP and staff who are ill to stay home. All employees should be encouraged to monitor themselves for signs of respiratory illness and fever. All HCP need to be screened at the start of each shift for fever and signs of respiratory symptoms. If illness is detected, the person should put on a facemask and leave the workplace.

If an HCP or staff member develops symptoms while at work, they should immediately put on a facemask, minimize interactions with others, inform their supervisor and leave the workplace. Facilities concerned that HCP may be suffering from COVID-19 should immediately contact their state health department for additional information.

Stay Informed
Facilities should stay informed of the latest developments and recommendation from the CDC and their local health department during this pandemic to ensure the safety of their residents, staff and visitors.


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