COVID-19 Guidance for Long Term Care Facilities

News Update

Updated March 20, 2020 9:00 AM

Consejos de COVID-19 para centros de larga estancia

• COVID-19 is a respiratory disease caused by a new strain of coronavirus now spread globally.

• While anyone can be infected, most people experience mild symptoms and do not need a hospital.

• Symptoms are fever, cough, and difficulty breathing.

• People most at risk for severe disease are older adults and those with underlying conditions such as heart disease.

• Multiple cases of COVID-19 have been reported in Kansas

• Sedgwick County Health Department is closely monitoring this issue and is coordinating with the state health department, Kansas Department of Health and Environment (KDHE).

• We anticipate more cases of COVID-19 in Sedgwick County in the coming days or weeks.

Sedgwick County Health Department monitors and investigates reports of disease every day, from whooping cough and chickenpox to tuberculosis and HIV. Staff are trained in methods to reduce the spread of disease. You can help, too. COVID-19 is a new disease but it spreads the same as the flu, through respiratory droplets (ex. coughing and sneezing).

CDC Recommendations for Long Term Care Facilities in Areas with No Cases:

• Limit people from entering the facility

  1. Ask visitors about travel, fever, respiratory symptoms, and any contact with COVID-19 Persons Under Investigation or COVID-19 cases

     • If a person responds yes to any of these questions, restrict them from your facility

  2. Document who is visiting the facility and the person they are visiting. Contact tracking can help limit spread if COVID-19 is introduced into the facility.

  3. Post signs at the entrance instructing visitors not to visit if they have symptoms of respiratory infection

• Stop all external outings and consider cancelling communal dining

• Clean more

  1. Create a daily cleaning schedule and make sure that EPA-registered, hospital-grade disinfectants are available to allow for frequent cleaning of high-touch surfaces and shared resident care equipment.

  2. Refer to the EPA-registered disinfectants that have qualified under EPA’s emerging viral pathogens program for use against coronavirus

• Check PPE supplies daily to ensure adequate supply. Purchase extra in case demand increases

• Do not allow vendors in the building

• Ensure sick leave policies allow employees to stay home if they have symptoms of respiratory infection

• Assess a resident’s symptoms of respiratory infection upon admission to the facility and implement appropriate infection prevention practices for incoming symptomatic residents.

• Create a plan for cohorting residents with symptoms of respiratory infection, including dedicating HCP to work only on affected units.

How to Prevent the Spread of Respiratory Germs Within Your Facility:

• Keep residents, employees, and families informed

  1. Describe what actions the facility is taking to protect them, including answering their questions and explaining what they can do to protect themselves and their fellow residents.

  2. Describe what actions will occur if a resident or staff tests positive for COVID-19.

• Monitor residents and employees for fever or respiratory symptoms.

  1. Restrict residents with fever or acute respiratory symptoms to their room. If they must leave the room for medically necessary procedures, have them wear a facemask (if tolerated).

  2. In general, for care of residents with undiagnosed respiratory infections use Standard, Contact, and Droplet Precautions with eye protection unless suspected diagnosis requires Airborne Precautions (e.g., tuberculosis).

  3. Healthcare personnel should monitor Sedgwick County Health Department and Kansas Department of Health and Environment websites to understand COVID – 19 activity in their community. This will help inform their evaluation of individuals with unknown respiratory illness. If there is transmission of COVID – 19 in the community, in addition to implementing the precautions described above for residents with the acute respiratory infection, facilities should also consult with Sedgwick County Health Department (316-660-7300) for additional guidance and follow the guidance listed under “What To Do When COVID-19 Cases are in Sedgwick County”

• Support hand and respiratory hygiene, as well as cough etiquette by residents, visitors, and employees.

  1. Ensure employees clean their hands in accordance to CDC guidelines, including before and after contact with residents, after contact with contaminated surfaces or equipment, and after removing personal protective equipment (PPE).

  2. Put alcohol-based hand rub in every resident’s room (ideally both inside and outside of the room).

  3. Make sure tissues are available and every sink is well stocked with soap and paper towels for hand washing.

• Identify dedicated employees to care for COVID – 19 patients and provide infection control training.

  1. Guidance on implementing recommended infection prevention practices is available in CDC’s free online courses which includes resource checklists for facilities and employees to use.

• Provide the right supplies to ensure easy and correct use of PPE

  1. Post signs on the door or wall outside of the resident room that clearly describes the precautions needed and required PPE.

  2. Make PPE, including facemasks, eye protection, gowns, and gloves, available immediately outside of the resident room.

  3. Position a trash can near the exit inside any resident room to make it easy for employees to discard PPE.

Prevent the Spread of Respiratory Germs Between Facilities:

• Notify facilities prior to transferring a resident with an acute respiratory illness, including suspected or confirmed COVID – 19, to a higher level of care

CDC Guidance for What To Do When COVID-19 Cases are in Sedgwick County:

• Report any possible COVID – 19 illness in residents and employees to the Sedgwick County Health Department Disease Reporting Hotline, 316-660-5555. Use KDHE’s document below when contacting KDHE in regards to a possible case

• Actively monitor all residents at least daily for fever and respiratory symptoms

• Policies and Procedures for Visitors

  1. Visitation should be limited further to only those who are essential for the resident’s emotional well-being and care. Your facility can communications to families advising the COVID-19 has been identified in the community and re-emphasizing the importance of postponing visitation

  2. The facility should facilitate remote communication between the resident and visitors (e.g., video-call applications on cell phones or tablets), and have policies addressing when and how visitors might still be allowed to enter the facility (e.g., end of life situations).

• Healthcare Personnel Monitoring and Restrictions

  1. Restrict non-essential personnel including volunteers and non-essential consultant personnel (e.g., barbers) from entering the building.

  2. Screen all HCP at the beginning of their shift for fever and respiratory symptoms.

     • Actively take their temperature and document absence of shortness of breath, new or change in cough, and sore throat. If they are ill, have them put on a facemask and self- isolate at home.

     • HCP who work in multiple locations may pose higher risk and should be asked about exposure to facilities with recognized COVID-19 cases.

  3. Consider implementing universal use of facemasks for HCP while in the facility.

• Client Activities

Long Term Care Online Resources:

Centers for Disease Control and Prevention

Kansas Department of Health and Environment