WebBanner 

What needs to be done when there is a suspected or confirmed COVID-19 case in the organization? 

Updated 5-12-2020 

Everything already being done to prevent, and control should continue with some additional measures.  

To review key actions view the COVID-19 101 for Nursing Homes tool.  

Important Notifications

  • If you have a suspected case, contact local health officials and follow their guidance for testing and follow-up measures on suspected cases.
  • If the possible case (or confirmed case) is in a resident, contact their primary care physician and DPOA.  
  • If the infected or potentially infected person is an employee, 
    • contact work comp carrier to determine compensability protocols. 
    • COVID 19 infections are recordable on your OSHA 300 log IF IT IS DEEMED TO BE WORK RELATED.  In addition, OSHA must be reported within 24 hours IF THE WORK RELATED INFECTION RESULTS IN HOSPITALIZATION.  OSHA must be reported within 8 hours IF THE WORK RELATED INFECTION RESULTS IN A FATALITY.
    • contact employee health plan, if staff member is covered. Insurance companies must cover testing at 100% but may have procedures or processes that need to be followed.  
    • follow-up with the employee to stay current on testing process, findings and recommended follow-up actions. Check out an example from one of our members. 

Reporting Requirements:

Currently you are REQUIRED to report to 1. CDC (per CMS Guidance), 2. KDHE 3. your local health officials and 4. KDADS.

NOTES: Some reporting requirements also include reporting to residents and their families. Reporting methods and what is reported vary by entity being reported to.

1. Center for Disease Control (per CMS Guidance)

Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes – The final provides details on where to report, what to report, and how often to report.
Data will be reported through the CDC’s National Health Safety Network (NHSN) system. Webinar training for the LTCF Covid-19 Module is located on their website under the training tab.
This requirement is currently in effect. There is a grace period until 5/24 after that date not reporting can result in financial penalties.
2. Kansas Department of Health and Environment 
3. Local Health Department

You should be working closely with local health officials on COVID-19 prevention and management plans. They should be contacted if you have suspected cases in the organization.

4. Kansas Department for Aging and Disability Services

Reporting Guidance for Nursing and Long-Term Care Facilities Concerning 2019 Novel Coronavirus Illness states 

  • positive cases must be reported directly to KDADS through their hotline 800-842-0078
  • and reiterates requirements to report to KDHE/local health department and CDC through NHSN system.
  • Includes discussion of resident/family reporting.

Communication

CMS and KDADS reporting requirements specify the need to report a positive case or onset of respiratory systems in a group of three or more residents or staff members within a 72-hour period. These requirements and resources are provided in the Interim Final Rule Updating Requirements for Notification of Confirmed and Suspected COVID-19 Cases Among Residents and Staff in Nursing Homes.

Note: As of 5/11/2020 the resident/family reporting timeframe differs between CMS and KDADS guidance. These are expected to be aligned soon so KDADS will follow CMS.

Provide staff, residents and family members with information about the possible & confirmed case(s). Sample letter templates.  

There may be media requests related to the situation. LeadingAge California has developed tips for communicating with the media.  

Isolation & Development of Resident Cohorts  

PPE Use Changes 

Staff PPE Use: Per CMS Guidance and CDC PPE recommendations. When there is a potential case or confirmed case, staff members should wear full PPE with working with the resident. If a case of transmission within the building occurs, staff should wear full PPE when caring for ALL residents. 
Resident PPE Use: Resident with confirmed or suspected COVID-19 should wear a mask during interactions with staff.  This should be medical mask not cloth. To the extent possible, residents with no symptoms should cover their mouth and nose with a mask (cloth is acceptable) or tissue during cares or when out of their room.   

What do we need to know about N95 mask fitting?

Implement and Maintain Consistent Staffing  

If you haven’t already assigned staff members to consistent work areas, do so immediately. This lessens the number of staff members interacting with each resident. This assignment to a work area means remaining in that work area as much as possible.   
Some things to consider include.  
  • Movement from area to area for supplies, equipment and support should be restricted as much as possible. Look for ways to provide supplies and equipment in or as close to each work area as possible.   
  • Staff members will need to be trained on consistent assignment plans and coached on how to be successful. This might include information about why consistent assignment matters and reminders to do it. Member example.

Reduce Number of Times Staff Enter Resident Rooms 

To lessen the risk of exposure, work to limit the number of times staff members enter resident rooms. This means being more efficient and bundling services.  An example might be the CNA doing housekeeping while in the room and providing activities.  

Staff Training 

Continue staff training on all infection prevention and control topics, consistent assignment, COVID-19 updates and applicable organization specific policies and procedures.   

Screening of Residents & Staff Members 

Routine screening of all employees (and anyone else entering building other than EMS personnel) and residents should continue.  

Social Distancing for Residents 

Residents with symptoms or diagnosis should NOT leave their rooms for the duration of their illness.  

Residents that do not have symptoms should remain in their rooms as much as possible. If they do leave their room encourage the wearing of masks. Reminders by staff members and cues in rooms may be helpful.   

Return to work for employee with suspected or diagnosed COVID-19 

CMS guidance suggests following CDC guidance on risk assessment and return to work.  

When do we discontinue the use of transmission-based precautions for a COVID-19 positive resident?  

CDC has released interim guidance on discontinuation.