Resources for Long-Term Care Facilities

 

 

Because we know that older and medically vulnerable adults have significantly increased risk of severe illness and death from COVID-19, it is imperative that we take every effort to prevent introduction of and spread of this infectious disease into residential care facilities an respond quickly to suspect cases within long term care facilities. If a health care worker or resident of a facility is diagnosed with COVID-19, immediately contact your local public health department to receive further guidance on infection control. You can contact the Winnebago County Health Department at 920-232-3000; there is an afterhours answering service for evenings, holidays and weekends.

 

• Please make sure you are frequently checking the Wisconsin Department of Health Services' website under the COVID-19: Long Term Care Facilities section.

• We also suggest frequently checking the CDC website

• Assess supply of personal protective equipment (PPE) and initiate measures to optimize current supply. For example, extended use of face masks and eye protection or prioritization of gowns for certain resident care activities.

• PPE supplies are currently very limited. PPE needs can be reported to the Winnebago County Emergency Management Office at: 920-236-7463 or 920-236-7464 or email LKollmann@co.winnebago.wi.us or Erasmussen@co.winnebago.wi.us

 

Some items worthy of reemphasizing:

• Restrictions on visitors:

• Facilities should restrict all visitors and nonessential health care personnel, except for certain compassionate care situations, such as an end-of-life scenario. 

• In compassionate care situations, visitors will be limited to a specific room only. Facilities should require visitors to perform hand hygiene and use personal protective equipment (PPE), such as face masks. Decisions about visitation during an end-of-life situation should be made on a case-by-case basis, which should include careful screening of the visitor (including clergy, bereavement counselors, etc.) for fever or respiratory symptoms.

• Individuals with symptoms of a respiratory infection (fever, cough, shortness of breath, or sore throat) should not be permitted to enter the facility at any time (even in end-of-life situations).

• Visitors that are permitted to enter must wear a face mask while in the building and restrict their visit to the resident’s room or other location designated by the facility. Facilities should also remind visitors to frequently perform hand hygiene, especially after coughing or sneezing.

• When visitation is allowed, facilities should make efforts to allow for safe visitation for residents and loved ones. Facilities should emphasize that importance of visitors refraining from physical contact with residents and others while in the facility while practicing social distancing with no handshaking or hugging, and remain at least 6 feet apart.

 

• Other actions:

• Cancel communal dining and all group activities, such as internal and external group activities.

• Implement active screening of residents and staff for fever and respiratory symptoms.

• Remind residents to practice social distancing and perform frequent hand hygiene.

• Screen all staff at the beginning of their shift for fever and respiratory symptoms. Actively take their temperature and document the presence of a fever and respiratory symptoms including: new or worsening cough, unexplained myalgia, and sore throat.

 

• If your facility does not have a case of COVID 19 in your facility keep COVID-19 from entering your facility:

• Restrict all visitors except for compassionate care situations (for example, end of life).

• Restrict all volunteers and nonessential health care personnel (HCP), including consultant services (for example, barber).

• Actively screen all HCP for fever and respiratory symptoms before starting each shift; send them home if they are ill.

• Cancel all field trips outside of the facility.

• Have residents who must regularly leave the facility for medically necessary purposes (for example, residents receiving hemodialysis) wear a face mask whenever they leave their room, including for procedures outside of the facility.

• Identify infections early

 

• When COVID-19 is reported in the community, implement universal face mask use by all HCP  when they enter the facility. If face masks 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, restrict all residents to their room and have HCP wear all recommended PPE for all resident care, regardless of the presence of symptoms. Refer to strategies for optimizing PPE when shortages exist.

• This approach is recommended to account for residents who are infected but not manifesting symptoms. Recent experience suggests that a substantial proportion of long-term care residents with COVID-19 do not demonstrate symptoms.

• When a case is identified, public health can help inform decisions about testing asymptomatic residents on the unit and in the facility.

 

Additional Resources: