If someone you love is a resident of a nursing home, the COVID-19 crisis may be leaving you more than a little unsettled. If being able to see your loved ones isn’t bad enough, hearing about lockdowns, evacuations, and deaths related to the crisis only makes the situation worse. A recent headline in one of our local papers—Nursing Home Nightmare—is every family caregiver’s nightmare.
What should your loved one’s nursing home be doing to keep residents safe? In the last few days, the Tennessee Division of Health Licensure and Regulation and the Tennessee Department of Health (TDH) have answered this question. TDH is working closely with the Office of the Governor, additional state agencies, and the Centers for Disease Control (CDC) to ensure that facilities have the information and guidance they need to prevent the spread of COVID-19. Here’s what TDH is recommending:
Keep COVID-19 Out of the Facility
Facilities are being instructed to keep adequate supplies of personal protective equipment are on hand at all times, create an emergency response plan for meeting increased staffing needs, screen all staff for fever and respiratory symptoms before each shift, and send ill staff home. They’re also being asked to restrict all visitors except for compassionate care situations (e.g., end of life) and restrict all volunteers and non-essential HCP, including consultant services (e.g., barber). They’ve been asked to cancel field trips outside the facility. Residents who must regularly leave the facility for medically necessary purposes (e.g., hemodialysis) are being asked to wear a facemask (if possible) whenever they leave their room.
Identify Infections Early
Facilities are being asked to notify the local health department immediately when:
Any resident develops a severe respiratory infection causing hospitalization or sudden death,
Clusters (≥2 residents and/or HCP) of respiratory infection are identified, or
Individuals with known or suspected COVID-19 are identified.
If you’re interested in contacting the local health department, use this link: https://www.tn.gov/health/health-program-areas/localdepartments.html or call 615-741-7247.
Prevent the Spread of COVID-19
Facilities are being asked to cancel all group activities and communal dining and enforce social distancing among residents. When COVID-19 is reported in the community, the facility should be implementing universal facemask use by all HCP (source control) when they enter the facility. If facemasks are in short supply, they should be prioritized for direct care personnel. All HCP should be reminded to practice social distancing when in break rooms or common areas.
If COVID-19 is identified in the facility, the facility should restrict all residents to their room and have HCP wear all recommended PPE for all resident care, regardless of the presence of symptoms. This approach is recommended to account for residents who are infected but not manifesting symptoms. Recent experience suggests that a substantial proportion of residents could have COVID-19 detected without reporting symptoms or before symptoms develop.
Manage Personal Protective Equipment
Facilities are being asked to assess their current supply of personal protective equipment (PPE) and make the best use of their current supply. This includes ensuring adequate supplies of PPE and considering the extended use of facemasks and eye protection or prioritization of gowns for certain resident care activities: If you’re interested in reading more about the CDC’s guidance for PPE, go here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html.
Identify and Manage Severe Illness
Facilities are being asked to designate a location to cohort and care for residents with suspected or confirmed COVID-19, separate from other residents and closely monitor ill residents at least three times daily to quickly identify residents who require transfer to a higher level of care.
When you’re communicating the management and staff members at your loved one’s long-term care facility, don’t be afraid to ask about how the facility is adhering to these recommendations.
If you want to learn more, visit https://www.cdc.gov/coronavirus/2019-ncov/healthcare-facilities/prevent-spread-in-long-term-care-facilities.html and https://www.tn.gov/health/cedep/ncov.html.
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