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COVID-19 April 13, 2020

Posted Apr 13, 20204 min Read

Regulatory & Clinical

New CMS Cohorting Guidance

Today, CMS released detailed guidance on long term care facility transfers.

All nursing homes and assisted living communities should make plans for cohorting residents even before COVID-19 enters the building. Cohorting is imperative to help control the spread of the virus. If possible, nursing homes and assisted living communities should also begin preparing wings, units or floors as “isolation units.” Isolation unit should be a separate, well-ventilated area, ideally with a separate entrance.

ISDH Issues PPE Request Guidance

The Indiana State Department of Health (ISDH) has issued a process and corresponding guidance to provide personal protective equipment (PPE) to local health departments and long-term care facilities.

Long-term care facilities in need of PPE should first contact the facility’s local health department.  If the local health department does not have supplies to meet the request, or the local health department is unreachable, long-term care facilities should complete a ICS 213 RR form and email the form to  ISDH can only fill a request once a facility’s current stock reaches 72 hours or fewer.

The entirety of ISDH’s guidance for requesting PPE can be found here, and the ICS 213 RR form can be found here.


ISDH Assessment and Transfer Forms

The ISDH issued a variety of forms to help guide long-term care facilities’ assessment of residents and/or determination of when to transfer a resident to the hospital.  These forms track with the guidance issued by the ISDH on April 1, 2020, detailing hospital discharge to long-term care facilities, and facilities sending of residents to the emergency department.

The first assessment form may be used by long-term care nurses when assessing a change in the status of a resident at a facility to help guide COVID-related assessments and discussions with the resident’s physician.

The ISDH also provided best practices for long-term care facility administrators and staff to use when determining whether to transfer a resident in a long-term care facility to a hospital.  If it is determined that the resident should be transferred, the following cover sheet may be utilized to send to the hospital.

Finally, the ISDH developed a form to be used by hospital administrators and staff to send a patient to a long-term care facility following hospitalization, as well as a check-list for the long-term care facility administrators and staff to use to help prepare for a resident who is being considered for admission or readmission from the hospital.


New OSHA Resources: Low/Unavailable PPE and Reporting Staff Cases 
AHCA/NCAL released four new resources on guidance from the Occupational Safety and Health Administration (OSHA) and the Centers for Disease Control (CDC) on critically low or unavailable Personal Protective Equipment (PPE). These new resources are applicable to all long term care providers.

  • A form letter providers can fill in when responding to OSHA inquiries due to complaints regarding limited or unavailable PPE.
  • A document on OSHA guidance when PPE is critically low or unavailable including steps providers can follow.
  • An explanation of OSHA and CDC guidance on N95 respirators that are critically low or unavailable. This resource provides five options with guidance on what to do for a limited supply of N95 or other respirators to no N95 or other respirators available.
  • A document with updated guidance from OSHA on employer recording and reporting requirements for COVID-19.