A new study published in the Journal of the American Geriatrics Society examined how three Michigan nursing homes limited the spread of the Coronavirus in their facilities. The study findings demonstrate how a proactive, partnership-based approach to general infection prevention, together with having an effective response plan already in place, could be used by regional and national facilities to better protect their residents when faced with a crisis like COVID-19. See: https://onlinelibrary.wiley.com/doi/10.1111/jgs.16869.
All three of the nursing homes took advantage of their formal pre-COVID connections with the University of Michigan’s (UM) academic medical center. They embedded UM geriatric physicians and nurse practitioners in their facilities and met regularly with UM clinical and administrative team members. The nursing homes also were proactive in connecting with county health departments. Consequently, when COVID-19 cases began occurring in mid-March in Michigan, the connections and plans were in place and allowed the facilities to act quickly.
Key to their response was the COVID-19 viral DNA testing provided by the medical centers’ in-house diagnostic laboratory that supplied testing results within 24 to 48 hours.
Proactive testing recently became a federal requirement, with the frequency dependent upon the level of COVID-19 activity in the surrounding community. See CMS Updates COVID-19 Testing Methodology for Nursing Homes at: https://www.cms.gov/newsroom/press-releases/cms-updates-covid-19-testing-methodology-nursing-homes.
Failure by nursing homes to comply with reporting requirements may result in fines. However, the government has recently been sending nursing homes rapid-testing machines to aid facilities in complying with testing and reporting requirements.
Compliance Perspective
Issue
Facilities must have an effective Infection Prevention and Control Plan (F880) in place to limit the spread of infections—especially highly-contagious viruses like COVID-19—and failure by a nursing home to comply with testing and reporting requirements (F884, F885, and F886) may be considered provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points
- Review policies and procedures regarding the effectiveness of the facility’s Infection Prevention and Control Plan and ensure that the CMS guidelines for COVID-19 testing and reporting have been implemented.
- Train staff regarding the Infection Prevention and Control protocols to follow and the protocols for testing, reporting, and responding related to COVID-19.
- Periodically audit to determine if staff are following protocols for effective infection prevention and control and if response to positive test results is adequate and consistent.
