IHCA COVID-19 member resources available

With reports of up to 13 positive COVID-19 cases reported in Iowa this week, we know that preventing and controlling this potentially deadly virus from spreading to our facilities is critical. This is a top priority for the IHCA as well, and we have activated a response team to provide COVID-19 resources for all providers, regardless of membership status, to address this public health concern. We have been in constant contact with state and federal health officials to ensure providers have access to reliable and accurate information and guidance. Below is a summary of the COVID-19 resources we have compiled for providers:

Weekly Provider Update calls
IHCA is conducting weekly all provider calls to keep providers updated on the latest COVID-19 information and resources available. Calls will be every Tuesday, at 10:00 a.m. The call-in code will be emailed to all members on Mondays prior to each call. If you are receiving this email newsletter, you will be on the email list to get the call-in code information. If you would like others to be added to our email newsletter and call update distributions lists, email info@iowahealthcare.org.

IHCA members can view the recordings and notes from this week’s call here.

The next call will be Tuesday, March 17 at 10:00 a.m. The Department of Inspection and Appeals will be on the next call to discuss visitation policies and answer member questions.

Dedicated COVID-19 resource website – Updated daily
IHCA has set up a dedicated website for sharing the most recent news and updates from IHCA and state and federal officials, including updated guidance, communications, resources and more. This website is being updated daily and does not require a login to access. To view the IHCA COVID-19 Resources webpage, go to iowahealthcare.org and select the Coronavirus banner on the home page.

Enhanced visitor guidance
Both CMS and AHCA/NCAL issued guidance this week recommending care providers implement visitor restrictions to help prevent and control the spread of any viruses. The IHCA encourages all member providers to follow this guidance.

• AHCA/NCAL Visitor Guidance for Nursing Homes
• AHCA/NCAL Visitor Guidance for Assisted Living
• AHCA/NCAL/CMS Visitor Guidance Side-by-Side Comparison

Media statement and guidance
The national visitor guidance issued has generated additional media attention this week, and IHCA has responded to a number of media inquiries. IHCA also issued a media statement to all Iowa media (newspapers, TV and radio) about the new visitor guidance to address any potential concerns families or communities may have about loved ones in long-term care.

• IHCA Media Statement on Visitation Policies
• IHCA Media Guidance for Members

Reporting requirements for positive cases
Should your facility have a positive COVID-19 case, IHCA has drafted new guidance on reporting positive COVID-19 cases:

• IHCA COVID-19 Reporting Obligations Guidance
• IHCA COVID-19 Reporting Obligations – FAQs

Staffing resources
IHCA called multiple staffing agencies this week to visit about how they are educating and preparing their employees who they are sending to long-term care buildings and agencies, and has compiled the following list of nurses available to assist with COVID-19 issues should your facility have an outbreak.

• IHCA Nurse Consultants on COVID-19 Issues

If you use staffing agencies or think you may need to in the future, IHCA recommends reaching out to them now to have conversations around staff that could be sent to your buildings and how you can get consistent assignments.

New survey process details
CMS is responding with other federal agencies to stem the spread of COVID-19 by ensuring that federally certified nursing facilities and home health agencies have adequate infection control policies and procedures in place to protect patients as much as possible from COVID-19 outbreaks in their organizations. As such, CMS is changing the priority of survey activity to the following priority order:

1. All immediate jeopardy complaints and allegations of abuse and neglect. This means cases that represent a situation in which noncompliance has placed the health and safety of recipients of care at risk for serious injury, serious harm, serious impairment or death.
2. Complaints alleging infection control concerns, including facilities with potential COVID-19 or other respiratory illnesses such as influenza.
3. Statutorily required recertification visits.
4. Any re-visits necessary to resolve current enforcement actions.
5. Surveys of facilities that have a history of infection control deficiencies at the immediate jeopardy level in the last three years. (There are none in Iowa currently.)
6. Surveys of facilities that have a history of infection control deficiencies at lower levels than IJ. (Many facilities in Iowa have been cited the last two years for F 880, some for two consecutive survey cycles. If your facility is on this list, please review your previous POC’s to ensure you are compliant.)

For more details review the following informational letter:

• QSO-20-12-ALL

Personal protective equipment (PPE) supply
There is a nation-wide shortage of isolation supplies, and it may last indefinitely. IHCA recommends you take the following steps, if you haven’t already done so:

1. Take inventory of your current supplies. Take immediate action to secure those supplies in a locked closet or area. Think about how you can safely conserve on the use of supplies during an outbreak. There is guidance on this topic on the CDC website. Plan now how you will adjust your practices to conduct multiple activities per visit to an infected patient’s room.
2. IHCA has asked IDPH to develop a method to figure how many supplies would be needed for one COVID-19 patient per day. At this point we do not have that template. You should not wait. Sit down with your team and try to figure out what supplies the average resident who needed to be contact and droplet isolated would require per one 24-hour period. Convert that to a week’s supply for one patient. Then look at your current supply. How long will it last for one patient? It will be unlikely that you will have only one. Try to be prepared with supplies for several patients.
3. Check with your medical supplier first, then your local emergency preparedness coordinator. Try other local health care facilities, such as the hospital or providers like dentists and veterinarians. If you have an outbreak before you can find enough supplies, call IHCA and IDPH immediately. If you do not have enough supplies available, you may have to consider transfer after discussing your situation with the local hospital. AHCA recommends you consider transfer if you have a week or less of supplies per infected patient on hand.
4. CMS has indicated that surveyors will not cite facilities for lack of PPE if there is indication the facility has done due diligence and has exhausted all attempts to find supplies. Make sure that you have documentation of the contacts you have made to acquire needed supplies