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Closure of Regis Woods in Louisville

The office of Inspector General is seeking assistance for placement of residents do to termination of their provider agreement with CMS. The OIG is seeking  members  with available beds to assist with placement for this involuntary closure within a 50 mile radius of Louisville.

 

Do you have a secured dementia unit on-site (Y/N)

COVID-19 Kentucky Specific Frequently Asked Questions

 

 

Early last week, Governor Andy Beshear “strongly recommend” that Long Term Care Facilities and Assisted Living Facilities throughout Kentucky restrict visitation to all visitors, including immediate family members and volunteers. The exception to this restriction would be under circumstances in which the resident is at the “end of life” and the attending physician recommends that the family be called in. Last Friday, CMS took similar action to restrict all visitors, except in end of life situations.

Employees, Attending Physicians, Hospice Staff and essential contractors are strongly recommended to be screened for flulike symptoms including fever prior to entry into the facility. At no time should anyone be allowed into the facility with a temperature in excess of 100.1 degrees, shows signs or symptoms of respiratory infection such as cough or sore throat, has travelled internationally to restricted countries or has had contact with someone with or under investigation for COVID-19. It is recommended that no vendor sales visits should take place at this time.

Private Family Sitters are not allowed at this time. This restriction would include cosmetology services.

Authorized Public Officials such as the OIG, etc. should continue to be allowed into your facility. However, they should also submit to a screening utilizing criteria outlined above. If they do not, they should be denied entry.

Residents still have the right to access the Ombudsman program. Their access should be restricted per the guidance above (except in compassionate care situations), however, facilities may review this on a case by case basis. If in-person access is not available due to infection control concerns, facilities need to facilitate resident communication (by phone or other format) with the Ombudsman program or any other entity listed in 42 CFR § 483.10(f)(4)(i).

In circumstance where a family member or loved one is denied entry to the facility, it is recommended that phones be made available so that the resident and family or loved one may communicate. Skype, FaceTime and other video conferencing would also be suitable.

These restrictions do not involve admissions, transfers or discharges. However, do care should be taken regarding disclosures of any resident or prospective resident showing signs of fever or respiratory symptoms.

 

Is there a checklist that long term care facilities can use to take steps to assess and improve their preparedness for responding to COVID-19?

Yes, you can find the checklist here.

 

UPDATED: Will inspections be curtailed given this state and national COVID-19 emergency?

It is LeadingAge Kentucky’s understanding that a CMS memo is scheduled to be released today with revised survey activity requirements and we are pleased that these are in alignment with our requests

All survey activity will be suspended for three weeks starting today with the exception of IJs only and IJ revisits.

CMS will re-evaluate in three weeks and consider options

DDPNAs will be lifted to allow for admissions

There will be no targeted Infection Control Surveys

Surveys in process will be completed shortly or suspended.

 

UPDATED: What do I do about staffing challenges related to call offs and school closures?

There are no easy answers. Some of our members are examining establishing onsite day care centers and or offering in home babysitting/childcare.

Governor Andy Beshear ordered all day care centers to close beginning next week. In conversations with the Cabinet, Governor Beshear agreed with us that exceptions to his day care closure order will include onsite day care for healthcare workers.

Medicaid is examining the Nurse Aide Training Lookout provision but given that this is a Federal Statutory Requirement, this may require an act of congress. LeadingAge has a bill filed in congress that would ease some of those restrictions for Rural Areas but was filed prior to the COVID-19 Outbreak.

It is recommended that facilities be as flexible as possible with your leave time policies. As always employees exhibiting signs and symptoms of a fever or respiratory illness should be excused from work until they are no longer symptomatic.

 

Is there suggested signage for posting at all entrances to alert visitors of the visitation restrictions?

Yes, you may access that from the LeadingAge Kentucky website here.

 

UPDATED: What is the definition for end of life for the purposes of visitation?

It is recommended that you defer to the patient’s attending Physician, APRN or PA in consultation with the facility caregiving team when making the decision to call in the family. This is the procedure today and should continue to be the procedure. Please defer to that team for making the decision. Providers should notify family several days, up to one week in advance or when a substantial change of condition occurs. Providers should not wait until active dying.

 

UPDATED: What procedures should I use during end of life situations?

Facilities should require visitors to perform hand hygiene and use Personal Protective Equipment (PPE), such as facemasks. 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. Those 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). Those visitors that are permitted, must wear a facemask while in the building and restrict their visit to the resident’s room or other location designated by the facility. They should also be reminded to frequently perform hand hygiene.

 

UPDATED: Are There Suggested Guidelines for Preventing the Spread of COVID-19?

Yes, the CMS has recently updated guidance regarding the spread of COVID-19 in LTC facilities. Access that document here.

New Guidance

  1. Cancel communal dining and all group activities, such as internal and external group activities.. The OIG will continue to allow therapeutic dinning activities. This would be accomplished in very small numbers over extending dining hours whereby disinfecting would take place between sessions. Social distancing will be followed at all times
  2. Implement active screening of residents and staff for fever and respiratory symptoms
  3. Remind residents to practice social distancing and perform frequent hand hygiene
  4. Screen all staff at the beginning of their shift for fever and respiratory symptoms. Actively take their temperature and document absence of shortness of breath, new or change in cough, and sore throat. If they are ill, have them put on a facemask and self-isolate at home

 

UPDATED: Is there any special visitation guidance from the Department for Aging and Independent Living regarding Assisted Living?

Yes, the DAIL issued Guidance for Assisted Living Facilities Regarding Visitation and you may access that here.

 

What do I do if I have a resident showing signs and symptoms COVID 19?

The CDC has updated the COVID-19 PUI Case Investigation tool with questions and criteria that may assisted you with your screening.

If you do suspect a COVID-19 infection, contact your local health Department. Follow their advice to isolate and sanitize. A reportable disease form may be accessed here.

 

Are there criteria for evaluating transfers among health facilities?

Yes, you may access that here.

 

Do I still allow capable residents to leave the facility?

Yes, a resident evaluated to leave the facility for medical appointments or they are a Personal Care or Assisted living resident that again have been evaluated and approved to be able to leave the facility should continue to be able to do so. However, as with everyone else, returning residents would require screening.

 

UPDATED: What if I have a suspected COVID-19 infection and have little to no Personal Protective Equipment in Stock?

The Kentucky Department for Public Health has advised the following criteria and process for obtaining PPE:

  1. Facility should contact their Local Health Department, their Local Emergency Manager, or their Healthcare Coalition. Whoever receives the request will send a link to an electronic form to the requesting agency/facility.
  2. The requesting agency/facility will complete the form and click “submit” on the bottom of the form.
  3. KY Department for Public Health will receive the submitted form
  4. The KDPH State Health Operations Center will evaluate the request and make a decision about the resources requested. KDPH may reach out to the local Health Department and/or the Healthcare Coalition in the appropriate region to see if the request can be filled from any local sources. If not, KDPH will then consider assets in the state cache and see what can be filled.
  5. The requesting agency/facility will be notified if the request can or cannot be filled.
  6. The LHD/EM/Coalition will also be notified of the decision.
  7. If resources are sent to the requesting agency/facility, a note will be placed in WebEOC for tracking.

Click here for a listing of local health departments.

Here is the listing of the Regional Healthcare Coalition Readiness and Response Coordinators:

Region 1     BJ Newbury
Region 2     Casey Clark
Region 3     Amanda Hunter
Region 4     Janarae Conway
Region 5     Kenneth Kik
Region 6     Jessica McElroy
Region 7     Jacquelyn Campbell
Region 8     Gina Porter
Region 9     Lonnie Saylor
Region 10   Peggy Acey

Additionally, CMS has issued guidance on the range of facemasks that can be temporarily used based on recent changes to CDC and FDA facemask and respirator guidance in light of COVID-19 and supply demands. These are steps the White House Task Force is taking to ensure a maximum supply of facemasks and respirators are available that allow healthcare providers to safely treat patients without exposing themselves or others to COVID-19.

 

UPDATED: Is Kentucky Accessing the Strategic National Stockpile for Personal Protective Equipment to prevent shortages?

Yes, Kentucky has received some Personal Protective Equipment yesterday from the Strategic National Stockpile (SNS) [not sure what items were in the SNS push], and is planning on doing a population based distribution to 16 regional SNS Receiving Sites (based on their SNS Plan), and will then work with the local health department (LHD), Regional HPP Coordinators and Local Emergency Managers to reach out to the healthcare providers in each area to see what their needs are. I would anticipate that the breakdown, trans-shipment, and set-up of the process will take several days to a week to get in place. Your facility Emergency Preparedness Coordinator, and probably ED manager, should know how to reach the Regional and/or Health Department preparedness coordinator.

The state has also placed a fairly large 3M N95 mask order, but that is about 7-8 weeks out. They are going to look at doing another SNS request in the meantime to fill the gap.

 

UPDATED: Will I be able to continue to obtain fingerprint checks through the KARES Program?

No, Kentucky is asking that long term care facilities use other vendors for background checks at this time given that the KARES fingerprint locations will NOT be doing fingerprint scans.

Refunds (full or partial to be determined later) will be given when an applicant is resubmitted through KARES.

 

What are the expectations regarding protection of employees?

OSHA has issued Guidance on Preparing the Workplace for COVID-19 which may be access here.

In addition, the CDC has issued Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with 2019 Novel Coronavirus (2019-nCoV) (Updated Mar 7)

 

Where can I find training resources?

The CDC’s guidance on implementing recommended infection prevention practices is available in CDC’s free online course — The Nursing Home Infection Preventionist Training — which includes resources checklists for facilities and employees to use.

 

What about visitor restrictions for independent living?

HUD recently released a Question and Answer document to help housing providers navigate COVID-19. HUD has said they will continue updating the document, which is also available on HUD’s Multifamily webpage.

For the most up-to-date information from CDC please visit the CDC Covid19 website.

For the most up to date information from the Commonwealth of Kentucky please visit the COVID-19 website.

As always, please contact the LeadingAge Kentucky office should you have questions or concerns. Also LeadingAge national has a COVID-19 resource page in which you may find helpful tools to use.

 

For the most up-to-date information from CDC please visit the CDC Covid19 website.

For the most up to date information from the Commonwealth of Kentucky please visit the COVID-19 website.

LeadingAge national has a COVID-19 resource page in which you may find helpful tools to use.

 

Updated CHFS Surveillance COVID-19 Testing for Long-Term Care Facilities FAQs

Updated CHFS Provider Guidance: Surveillance COVID-19 Testing for Long-Term Care Facilities

Updated CHFS List of COVID-19 Testing Labs

 

Kentucky Specific COVID-19 Frequently Asked Questions Page

 

Norton Healthcare Partners with the Kentucky Department for Public Health to Offer COVID-19 Help-Line

 

Please click on the title below to view the COVID-19 Update Alert

 

LeadingAge Kentucky COVID-19 Update (October 22, 2021)

LeadingAge Kentucky COVID-19 Update (October 19, 2021)

LeadingAge Kentucky COVID-19 Update (October 8, 2021)

LeadingAge Kentucky COVID-19 Update (October 5, 2021)

LeadingAge Kentucky COVID-19 Update (October 4, 2021)

LeadingAge Kentucky COVID-19 Update (October 1, 2021)

LeadingAge Kentucky COVID-19 Update (September 29, 2021)

LeadingAge Kentucky COVID-19 Update (September 17, 2021)

LeadingAge Kentucky COVID-19 Update (September 13, 2021)

LeadingAge Kentucky COVID-19 Update (September 10, 2021)

LeadingAge Kentucky COVID-19 Update (September 7, 2021)

LeadingAge Kentucky COVID-19 Update (September 3, 2021)

LeadingAge Kentucky COVID-19 Update (August 31, 2021)

LeadingAge Kentucky COVID-19 Update (August 27, 2021)

LeadingAge Kentucky COVID-19 Update (August 26, 2021)

LeadingAge Kentucky COVID-19 Update (August 25, 2021)

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LeadingAge Kentucky COVID-19 Update (August 20, 2021)

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LeadingAge Kentucky COVID-19 Update (August 18, 2021)

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LeadingAge KentuckyCOVID-19 Update (February 18, 2021)

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LeadingAge Kentucky COVID-19 Update (November 18, 2020)

LeadingAge Kentucky COVID-19 Update (November 16, 2020)

CHFS LTCF Guidance: Visitation, Dining, Group Activities Revisions (November 16, 2020)

LeadingAge Kentucky COVID-19 Update (November 16, 2020)

LeadingAge Kentucky COVID-19 Update (November 13, 2020)

LeadingAge Kentucky COVID-19 Update (November 12, 2020)

LeadingAge Kentucky COVID-19 Update (November 11, 2020)

LeadingAge Kentucky COVID-19 Update (November 10, 2020)

LeadingAge Kentucky COVID-19 Update (November 9, 2020)

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LeadingAge Kentucky COVID-19 Update (May 19, 2020)

Kentucky’s Toolkit for Comprehensive Surveillance Testing In Nursing Facilities and CCRC’s (May 18, 2020)

LeadingAge Kentucky COVID-19 Update (May 15, 2020)

LeadingAge Kentucky COVID-19 Update (May 14, 2020)

LeadingAge Kentucky COVID-19 Update (May 13, 2020)

LeadingAge Kentucky COVID-19 Update (May 12, 2020)

CHFS Connecting LTC Provider with Potential Staff Applicants (May 11, 2020)

LeadingAge Kentucky COVID-19 Update (May 8, 2020)

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LeadingAge Kentucky COVID-19 Update (April 21, 2020)

LeadingAge Kentucky COVID-19 Update (April 20, 2020)

LeadingAge Kentucky COVID-19 Update (April 17, 2020)

LeadingAge Kentucky COVID-19 Update (April 16, 2020)

PPE Reporting and Requesting Process is now on the CHFS website  (April 15, 2020)

LeadingAge Kentucky COVID-19 Update (April 15, 2020)

LeadingAge Kentucky COVID-19 Update (April 14, 2020)

LeadingAge Kentucky COVID-19 Update (April 13, 2020)

LeadingAge Kentucky COVID-19 Update (April 10, 2020)

LeadingAge Kentucky COVID-19 Update (April 9, 2020)

LeadingAge Kentucky COVID-19 Update (April 8, 2020)

LeadingAge Kentucky COVID-19 Update (April 7, 2020)

LeadingAge Kentucky COVID-19 Update (April 6, 2020)

LeadingAge Kentucky COVID-19 Update (April 3, 2020)

LeadingAge Kentucky COVID-19 Update (April 2, 2020)

LeadingAge Kentucky COVID-19 Update (April 1, 2020)

Kentucky Acute to SNF/NF Transfer Guidance (March 31, 2020)

LeadingAge Kentucky COVID-19 Update (March 31, 2020)

LeadingAge Kentucky COVID-19 Update (March 30, 2020)

LeadingAge Kentucky COVID-19 Update (March 27, 2020)

LeadingAge Kentucky COVID-19 Update (March 26, 2020)

LeadingAge Kentucky COVID-19 Update (March 25, 2020)

LeadingAge Kentucky COVID-19 Update (March 24, 2020)

LeadingAge Kentucky COVID-19 Update (March 23, 2020)

LeadingAge Kentucky COVID-19 Update (March 20, 2020)

CMS Call Today March 18, 2020 Waiver & Telehealth Guidance (March 18, 2020)

Personal Protective Equipment From Strategic National Stockpile (March 17, 2020)

UPDATED: COVID-19 & Long Term Care/Assisted Living Visitor Restrictions: What We Know Thus Far (March 17, 2020)

President Declares National Emergency; CMS Announces Emergency Actions (March 16, 2020)

CMS Announces New Visitor Restrictions (March 16, 2020)

COVID-19 and Long Term Care/Assisted Living Visitor Restrictions: What We Know Thus Far (March 13, 2020)

Gov. Beshear Confirms Two More COVID-19 Cases and LTC Visitation Restrictions  (March 11, 2020)

Kentucky Long Term Care and Assisted Living Facilities Asked by Governor to Restrict Visitation  (March 10, 2020)

Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities (LTCF)  (March 9, 2020)

Elder Housing Resources

 

HUD Handbook 4350.3 Revision 1

Chapter 2   Civil Rights and Nondiscrimination Requirements (TEst)

Chapter 3  Eligibility for Assistance and Occupancy

Chapter 4   Waiting List and Tenant Selection

Chapter 5  Determining Income and Calculating Rent

Chapter 6   Lease Requirements and Leasing Activities

Chapter 7  Recertification, Unit Transfers, and Gross Rent Changes

Chapter 8   Termination

Chapter 9   Required 50059 and Subsidy Data Reporting

Glossary

Appendix 1  Form HUD-935.2, Affirmative Fair Housing Marketing Plan

Appendix 2  Systematic Alien Verification for Entitlements (SAVE) Program Instructions Manual

Appendix 3  Acceptable Forms of Verification

Appendix 4  HUD Model Leases

Appendix 5  Sample Move-In/Move-Out Inspection Format

Appendix 6  Completing the 50059 Data Requirements

Appendix 7 The 50059 Data Requirements

Appendix 8  50059 Data Entry Rules

Appendix 9  Form HUD-52670, Housing Owner’s Certification and Application for Housing Assistance Payments

Appendix 10 Form HUD-52670-A Part 1, Schedule of Tenant Assistance Payments Due

Appendix 11 Form HUD-52670-A Part 2, Schedule of Section 8 Special Claims

Appendix 13 Form HUD-93104, Monthly Report of Excess Income

Appendix 14 Fact Sheets “ How Rent is Determined”

Kentucky All Hazards Long Term Care Planning & Resource Manual

The Plan provided below has been provided in sections for your convenience.

This Plan can serve as a Template for your facility or as a supplement to your own Emergency Plan. It is understood that many corporate offices/administrative units may have emergency preparedness procedures in place that differ from this Plan and that your plans will be customized according to the standards set by your facility/administrative units.

 

Face Sheet for KY All Hazards LTC Planning and Resource Manual
Face Pages and Instructions for Use
Table of Contents
Section I-Basic Plan Elements
Section II-Vulnerability Assessment and Mitigation
Section III-Emergency Preparedness and Planning
Section IV-Emergency Response Disaster Templates
Section V-Recovery
Section VI-Appendices
CHECKLIST (USDHHS-CMS)
USDHHS Pandemic Checklist

Pandemic Toolkit

 

LeadingAge Kentucky has a new Pandemic Toolkit which has many resources in the appendices which may be of use to you — and also includes a mini-toolkit that we hope will help you plan and/or refine what you may have already developed.

 

Information and Overview – What You Need to Know
Quick Mini – Toolkit Checklist
Basic Information on Influenza Viruses
Avian Influenza A Virus Infections of Humans
Infection Control in Healthcare Facilities Caring for Patients with Known or Suspected Avian Influenza
Transmission of Influenza A Viruses Between Animals and People
National Strategy for Pandemic Influenza – Homeland Secruity
HHS Pandemic Influenza Plan
Kentucky Pandemic Influenza Operations Plan
OSHA Pandemic Influenza Preparedness and Response Guidance for Healthcare Workers and Healthcare Employers
WHO – Best Practices for Communicating with the Public During and Outbreak
Community Strategy for Pandemic Influenza – Mitigation
Sample Evacuation Agreement
USDA Avian Flu Brochure
Altered Standards of Care in Mass Casualty Events
Avian Influenza FAQ’s
Information on Swine Flu from the CDC
Information from the Kentucky Department for Public Health
Kentucky Asks Health Care Providers to Be Alert for Possible Swine Flu Cases
CDC – What’s New on the Swine Flu Site
Key Facts about Swine Influenza (Swine Flu)
Brochure: Swine Influenza in Pigs and People
Swine Flu Talking Points

Survey: PERSONAL PROTECTIVE EQUIPMENT (PPE)

  • Identify amount of PPE by piece quantity OR Box
  • Example: N95s= 10 pc
  • Surgical gowns 50/ box= 10 boxes
  • Burn/ Week= Amount used each week
  • .
  • 1. N95s

  • .
  • 2. HAND SANITIZER

  • .
  • 3. FACE SHIELDS

  • .
  • 4. GOGGLES

  • .
  • 5. POWERED AIR-PURIFYING RESPIRAOTR (PAPR)

  • .
  • 6. NON-STERILE GLOVES

  • .
  • 7. Nasopharyngeal (NP) SWABS with VIRAL CULTURE MEDIA

  • .
  • 8. Oropharyngeal (OP) SWABS with VIRAL CULTURE MEDIA

  • .
  • 9. STERILE URINE CUPS

  • .
  • 10. SERUM SEPARATOR TUBE

  • .
  • 11. BLOOD DRAW EQUIPMENT

  • .
  • 12. NORMAL SALINE

  • .
  • 13. RAPID FLU DIAGNOSTIC SUPPLIES

  • .
  • 14. ISOLATION GOWNS

  • .