23 9.NF Activities Required for LTC COVID-19 Response In Advance (actions focused on response) • Review/create cohort plans for residents • Review Health Care Associated Infection (HAI) plan • Determine/review who is responsible for specific facility plans • Assign at least one individual with training in IPC to provide on-site management of COVID-19 prevention and response activities • Identify desired applicable waivers • Develop communication plan (external and internal) • Conduct supply/resource evaluation • Review recommended resources listed under List of Referenced Resources • Develop a staffing contingency plan in case a large number of staff must selfquarantine or isolate because of potential exposure, being probable of, or positive for COVID-19. Immediate (0-24 hours) • Activate resident isolation/cohort plan, including establishing a unit, wing, or group of rooms for any positive residents. • Supply PPE to care for residents positive for COVID-19. Read PPE Donning and Doffing Infographic about donning (putting on) and doffing (taking off) PPE. • Provide separate spaces to don (put on) and doff (take off) PPE when possible • When a single area is provided for donning and doffing PPE, these principles should be followed: o Provide for hand hygiene and adequate disposal of used PPE in the donning and doffing area o Only donning or doffing should occur at any given time – do not perform these activities at the same time o Only two people should be in the area at any time - use the buddy system to assure that donning and doffing is done correctly • Screen residents [upon admission or readmission and return to the facility] • Screen staff for signs and symptoms at least at the beginning of their shift • Enact HAI procedures • Clean and disinfect NF o High-touch surfaces include items like doorknobs, light switches, handrails, countertops - clean and disinfect frequently o Workstations include items like computers, chairs, keypads, common-use items - clean and disinfect frequently o Equipment includes items like blood pressure cuffs, hoyer lifts and other shared equipment used for resident care - clean and disinfect after each use Page | 24 o Use EPA-registered disinfectants that have qualified under EPA’s emerging viral pathogens program for use against COVID-19 • Confirm case definitions • Activate resident transport protocols (for transporting residents out) • Establish contact with receiving agencies (hospitals, other facilities) • Identify lead at NF and determine stakeholders involved external to NF • Engage with community partners (public health, health care, organizational leadership, local/state administrators) • Review/establish testing plan • Activate all communication plans • Supply resource evaluations • Maintain resident care • Upon the first positive test result of a NF staff member or resident, work with local health authorities, DSHS, and HHSC to coordinate testing of all NF staff and residents. • Read COVID-19 Reporting Extended (24-72 hours) • Supply PPE for health care workers and staff • Screen residents for signs and symptoms at least once a day • Screen staff for signs and symptoms at least at the beginning of their shift • Continue specialized HAI procedures • Activate resident transport protocols (for transporting residents out/in) • Establish contact with transporting/receiving agencies (hospitals, other facilities) • Engage with external partners • Testing • Consider additional healthcare needs • Maintain resident care Long Term (72 hours plus) • Screen resident [upon admission or readmission and return to the facility] • Screen staff for signs and symptoms at least at the beginning oftheir shift • Continue cleaning and disinfecting procedures • Activate transport (residents in) protocols • Establish contact with transporting/receiving agencies (hospitals, other facilities) • Consider additional healthcare needs and maintain resident care • Report all deaths (COVID-19 and non-COVID-19 related) that occur in a NF, and those that occur within 24 hours after transferring a resident to a hospital from the NF, to HHSC via TULIP 10 working days after the last day of the month in which the death occurred. Page | 25 10. Immediate Response Guidelines IMMEDIATE ACTIONS (0-24 hours) FACILITY ACTIONS REVIEW SPICE ACTIVITIES Prevent further disease spread • Determine number of residents potentially infected • Determine number of staff potentially infected • Invoke isolation precautions/plans • Determine who has been tested • Prevent staff from working in more than one facility when possible • Identify if exposed staff are working in other facilities • Upon the first positive test result of a NF staff member or resident, work with local health authorities, and DSHS to coordinate testing of all NF staff and residents. • Follow reporting instructions outlined in section 12, Reporting COVID-19 Create an isolation [area] for residents with a COVID-19 positive status • Identify a separate, well-ventilated area to use as an isolation area as needed. This NF area should be [a single bedroom,] isolated wing, unit, or floor that provides meaningful separation between COVID-19 positive residents and the space where the NF cares for residents who are COVID-19 negative or untested and asymptomatic. A curtain or a moveable screen does not provide meaningful separation. • The need for an entire unit dedicated to