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.

This 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 Cleanliness and Infection Control for your quick scan this week. 

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

N95 Respirator Disinfection

One noticeable trend across various states is funding of the Battelle Critical Care Decontamination System (CCDS)™ for N95 respirator disinfection to address PPE shortages. Noted in the CMS toolkit are Connecticut, Indiana, Massachusetts, Mississippi, Montana, New Mexico, and Ohio. 

Partnerships with Infection Control and Quality Organizations

Another general best-practice trend among states is partnering with formal infection control and quality organizations for weekly calls. Also, know that many states have specially-trained and equipped National Guard teams on-call to disinfect nursing homes. 

Infection Control Surveys - Alaska, Colorado, Florida, Montana, and Nevada

These states are conducting infection control surveys in nursing homes using risk-based criteria to determine facility selection and scheduling. Colorado and Montana are doing these as often as weekly.

Nursing Home Strike Teams - Ohio, New Jersey, and Maryland 

Many states are creating strike teams specific to testing, PPE, and infection control. Ohio, New Jersey, and Maryland have strike teams focused specifically on nursing homes.

In Maryland, the Office of Governor Larry Hogan created statewide strike teams to provide on-site medical triage, supplies, and equipment to overburdened nursing homes. Teams include National Guard, state and local health department representatives, EMS clinicians, and hospital doctors, and nurses. 

The Office of Congressman Josh Gettheimer in New Jersey is sponsoring Outside Support (SOS) Act of 2020 legislation to provide immediate support to nursing homes, long term care facilities experiencing outbreaks of COVID-19 in New Jersey – and across the country.

Advanced Entrance Screening - California and New Mexico 

Two Palm Nursing Center, Inc. in California created a pre-entry, outside screening and infection prevention station for all health care workers and visitors: 

• All are screened one at a time for COVID-19 signs and symptoms
• Following, they proceed to an outside "washing station" where they sanitize their hands and don PPE, including gowns, N95s, and face shields.
• Lastly, they step on a bleaching mat to ensure they do not track contaminants from the outside into the facility.

Similarly, the New Mexico Department of Health is considering mandating three additional requirements for long term care facilities to include:

• Anti-viral shoe spray for all individuals entering facilities
• Clothing changes for all staff upon facility entry and exit
• Reporting deaths in their data collection portal

Secret Shoppers for Hand Hygiene - District of Columbia (DC)

The DCHCA implemented Secret Shoppers for Hand Hygiene program. Understandably, with fatigue comes forgetfulness. But, we can all help each other by monitoring and reminding.

COVID Safety Officers (CSOs) - Florida

Orlando Health System implemented COVID Safety Officers (CSOs), who cover every shift to observe employees donning and doffing PPE, performing appropriate hand hygiene, and assuring that all other infection control and prevention policies/procedures are followed.

Fresh Air - Georgia

The Georgia Department of Health reminds us of common-sense practices like opening windows to let fresh air in and giving residents some outdoor time.

With the extra $600 in unemployment checks, many found it was more economical to NOT work, which only added to the COVID-19 staffing crisis for healthcare providers. Now that the boost is gone, applicants may be lining up for re-employment, providing much-needed relief to senior care facilities.

While you may be tempted to hire fast, we challenge you to hire smart. Why? Because hiring smart versus fast may have caused you to come up short-staffed in the first place. And now is definitely not the time to hire the type of people that will flake out or burn out.

If the pandemic has taught us anything, we’ve learned that our world has changed. Senior care/living facilities drastically changed. Along with chaos, change can bring wisdom. It’s become even more critical for you to hire staff who have good judgment and are ready for the long haul.

If you look at COVID-19 as an opportunity to restart your businesses, you can start by hiring right the first time. When you take time to really assess your applicants before hiring, you intentionally create stronger teams that fit better and are more productive together.

As you hear us say often, technology can help. And our primeFORCE application has some unique screening features you will want to consider for your ‘new’ business.

Here are two webinars to tell you more.

Live Webinar, August 25: Using Data to Fine Tune Your Staffing

• Provides strategies for hiring staff with the goal of retention. These hot tips can reduce turnover by up to 20%!

Webinar On-Demand: When Staffing Takes a 180, Assess Don’t Guess

• Discusses incorporating the Judgment Index (based on the Hartman Value Profile) into your applicant assessment process.

If you would like to find out how our primeFORCE technology can help, get in touch.