Coronavirus (COVID-19) 2020 in Nursing Homes and Hospices – Guidance for Infection Control and Prevention

Coronavirus (COVID-19) 2020 in Nursing Homes and Hospices – Guidance for Infection Control and Prevention

March 11, 2020

Covid-19 and hospice

On March 9, CMS issued guidance for infection and control and prevention of coronavirus (and COVID-19) for both nursing homes and hospices separately.

This quick summary will address the guidance on visitation, which allows hospice workers entry into nursing homes.

  • From CMS Nursing Facility Guidance: “Facilities can allow entry of these visitors as long as they are following the appropriate CDC guidelines for Transmission-Based Precautions. For example, hospice workers can enter a facility when using PPE properly.”
  • From CMS Hospice Guidance: “If hospice care is provided in a nursing home, we have advised nursing homes that hospice workers should be allowed entry provided that hospice staff is following the appropriate CDC guidelines for TransmissionBased Precautions, and using PPE properly.”

Restricting Visitors in Nursing Facilities:
Facilities should actively screen and restrict visitation by those who meet the following criteria:

  1. Signs or symptoms of a respiratory infection, such as fever, cough, shortness of breath, or sore throat.
  2. In the last 14 days, has had contact with someone with a confirmed diagnosis of Coronavirus and COVID-19, or under
    investigation for COVID-19, or are ill with respiratory illness.
  3. International travel within the last 14 days to countries with sustained community transmission. For updated information on affected countries visit: www.cdc.gov/coronavirus/2019-ncov/travelers/index.html
  4. Residing in a community where community-based spread of COVID-19 is occurring.
  5. For those individuals that do not meet the above criteria, facilities can allow entry but may require visitors to use Personal Protective Equipment (PPE) such as face masks (see expanded guidance below).

Recommendation in CMS Guidance for Nursing Homes for Hospice Workers: Facilities should review and revise how they interact with volunteers, vendors and receiving supplies, agency staff, EMS personnel and equipment, transportation providers (e.g., when taking residents to offsite appointments, etc.), other practitioners (e.g., hospice workers, specialists, physical therapy, etc.), and take necessary actions to prevent any potential transmission. For example, do not have supply vendors transport supplies inside the facility. Have them dropped off at a dedicated location (e.g., loading dock). Facilities can allow entry of these visitors as long as they are following the appropriate CDC guidelines for Transmission-Based Precautions. For example, hospice workers can enter a facility when using PPE properly.

Questions regarding this CMS memo should be addressed to QSOG_EmergencyPrep@cms.hhs.gov. Questions about Coronavirus and COVID-19 guidance/screening criteria should be addressed to the State Epidemiologist or other responsible state or local public health officials in your state.

If you are considering Nurse Based telehealth as a long term strategy for better preparedness and improved patient experience, Contact Us today to start a conversation.