Post-Acute Care News

Last week, the Centers for Medicare and Medicaid Service (CMS) issued a COVID-19 Nursing Home Visitation Memorandum consistent with the Centers for Disease Control and Prevention (CDC) guidance. This is good news in addressing ongoing concerns about the psychosocial well-being of residents who've been disconnected from families due to COVID-19. 

Understanding that this is yet another change for you to review and revise your policies around, we've summarized the recommendations and at-a-glance infographic and included it below. 

The memo also explains that compassionate care does not just refer to end-of-life and may include residents:

• Recently-admitted/struggling with transition
• Grieving recent friend/family death
• Needing encouragement to eat/drink
• Experiencing emotional distress, seldom speaking or frequently crying

The goal of the memo goes beyond guidelines to encourage person-centered caregiving during this time. SNFs should consider the residents’ physical, mental, and psychosocial well-being, and support their quality of life.

To save you from reading the whole 186-page report from the Coronavirus commission for nursing homes, we've pulled out some focus areas and highlights that are most relevant to SNFs right now. 

Our primeCLOUD managed IT services and data-driven apps can help you address some of these focus areas.

Get in touch to learn more!

Don't have time to review CMS' 158-page Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes? No problem, we've done it for you. This week, we're covering best-of-best practices from various states related to Cohorting, Housing, and Sheltering.

COVID-19 Intermediary Care - CT, MS, NM

A few states have taken action to relieve nursing homes of the post-acute demands of recovering COVID patients.

• Athena Health Care Systems in Connecticut operates four for patients still impacted, but no longer acute -- taking the pressure off of nursing homes to accept them.
• Similarly, medical shelters are available statewide in New Mexico for medical monitoring and self-isolation of COVID-19 positive individuals.
• Likewise, the Mississippi Department of Health arranges COVID-19 convalescence in between hospital and nursing home care. 

Transportation is also covered in this toolkit. The overarching best practice there is to allocate special vehicles for transporting COVID-19 patients to/from hospitals or intermediary centers. 

Healthcare Worker Housing - NE, PA

Other states have opted to focus on healthcare workers, as the COVID-19 battle continues. 

• The Nebraska Department of Health and Human Services is offering temporary housing tp health care workers, emergency medical services, and law enforcement personnel who are concerned about exposing loved ones in their own homes.
• Likewise, the Pennsylvania Health Care Association is offering hotel rooms to staff needing distancing due to possible exposure. 

Transportation

Transportation is also covered in this toolkit. The main take-away there is to possibly allocate special vehicles to COVID-19 patients being transported to/from hospitals or intermediary centers. 

At-A-Glance Infographics from Other Sections

While there were just two big take-aways from the Cohorting, Housing, and Sheltering, other sections were full of great ideas. In case you missed them, here are the At-A-Glance Infographics for your convenience:

• Best Practices for Infection Control
• Best Practices for Communications and Visitors
• Best Practices in Workforce and Staffing

We know you're busy! So we've combed through CMS' 158-page Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes for best-of-best practices from various states in the area of Workforce and Staffing.

Read on and download/print our At-A-Glance infographic to share among your peers.

Adaptive Training and Licensing

Several states developed temporary training programs for nurses aides/assistants and personal care attendants to deliver willing individuals quickly to the workforce.

A couple of states got adaptive, allowing registered medical technicians (RMT) and certified home health aides (HHA) to function as certified nursing assistants (CNAs). South Carolina recruited Emergency Medical Technicians (EMTs) to perform tasks that nurse aides generally perform (personal hygiene, nutrition, ambulation, and elimination, as well as taking vital signs). And in Kansas, hours worked as a CNA Trainee II count toward hands-on hours required for CNA training.

Arizona relaxed continuing education requirements and extended licenses. Florida extended licenses for health practitioners, while also allowing reactivation for those whose license lapsed within two years.

Supportive Workforces

Delaware opened options by removing restrictions on out-of-state health care workers, while Ohio significantly enhanced Medicaid’s telehealth policy.

Massachusetts and Michigan are backed up by Rapid Response Programs developed to provide short-term support to those in staffing crisis. New York continues to utilize Air National Guard pararescuers trained as EMTs to support city hospitals.

Illinois is one of eight states to partner with the American Medical Association (AMA) for 
volunteer health care professionals.

Staff Incentives and Relief

In DC, the government is partnering with licensed child care providers to extend vouchers to healthcare professionals in need of emergency care. 

The National Nursing Home Social Work Network through the University of Iowa offers online support group meetings to its healthcare workforce.

Massachusetts enacted a 10 percent MassHealth rate increase (approximately $50 million) for all nursing facilities. Meanwhile, the New Hampshire Employment Security is incentivizing front line, direct-care workers to remain or rejoin the workforce.

Last week, CMS released a 158-page Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes to include 15 sections of best practices from various states. We've pulled out some of the best of best in Nursing Home Communications and Screening/Visitors for your quick scan this week. 

Read on and download/print our At-A-Glance infographic to share among your peers.

Technology

One of your best defenses in mitigating COVID-19 is technology to help residents stay connected. This can be as simple as investing in tablets or seeking out generous partners. 

FutureCare invested in a robust new telecommunication system that enables each patient to have remote face to face communications with their loved ones via iPads. 

Meanwhile, Massachusetts Senior Care with the help of the attorney general continues to secure donations of tablets -- 800 and growing -- from companies like Amazon, Walmart, Teel Technologies, and Acer.

Visitation Creativity

If connecting to family using technology is still leaving your residents feeling let down, here are some ideas that may help.

Arkansas Greenhurst Nursing Center created glass booths to allow residents to visit with loved ones. Avera Prince of Peace Retirement Community in South Dakota also created a visitation booth using plexiglass.  

The Lincoln Home in Newcastle, Maine divided their porch in half for safe family visitation, with residents entering from the inside, and guests from the outside. "We can truly see that she's doing ok," says one popular resident's family. 

Communications Centers

COVID-19 is placing a heavy demand on you to communicate with not just families, but many government agencies. Some facilities have hired or designated staff members strictly for communications as a means of efficiency. Here's how some others are tackling communications. 

As a liaison between residents and family, the New Mexico Ombudsman Program is conducting regular Town Hall meetings to hopefully reach more people at once, as they answer COVID-related questions and educate on resident rights, family councils, technology innovations, etc.

PruittHealth set up an Emergency Operations Center (EOC) that is active 24 hours a day, seven days week to answer questions or to schedule a video chat with loved ones.

Lastly, Tieszan Memorial Home in South Dakota is simply using its social media page to keep the community and resident's families informed of all things COVID-19.