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COVID-19 UPDATE 03/06/2020

Posted Mar 6, 202013 min Read

Regulatory & Clinical


Visit this webpage daily for updated news and guidance that IHCA/INCAL has to share with our members about COVID-19. As concerns arise with the emerging coronavirus, officially named COVID-19, we are working with our state partners, including the Indiana State Department of Health to ensure our members receive the necessary guidance to prevent the spread of this disease.

LATEST UPDATE: CMS Issues Three New Quality, Safety and Oversight Memos about COVID-19

The Centers for Medicare & Medicaid Services (CMS) issued three new Quality, Safety and Oversight memos on March 4, 2020 about COVID-19 – two apply to nursing homes and a third to hospitals that are listed below. We strongly encourage you to review.

  1. QSO 20-14-Nursing Homes (NH) at
  2. QSO 20-12-ALL at
  3. QSO-20-13-Hospitals at

The first memo (QSO 20-14-NH) provide NEW and helpful guidance on:

  • Screening visitors and who should be restricted;
  • Screening employees and contractors and who should be asked to stay at home;
  • When patients should be managed in the facility vs sent to the hospital;
  • What to do when transferring residents with suspected COVID-19, and;
  • What criteria to use in accepting patients from the hospital with COVID-19

The second memo (QSO 20-12-ALL) announces that CMS will re-prioritize surveys to conduct focus surveys about infection control for facilities that have had an infection control deficiency in the past to assure that they are in compliance with the new regulations. Specifically:

  • Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years, and;
  • Surveys of facilities/hospitals/dialysis centers that have a history of infection control deficiencies at lower levels than immediate jeopardy.

The Agency also provided a copy of the critical elements pathway in QSO-20-12-ALL that will be used by the surveyors to assess compliance with current regulations. We encourage you to review and use these guidelines in your facility as a self-assessment tool.

We encourage all members to review closely the State Operating Manual’s guidance for F-880 related to infection control and take steps to assure consistent hand washing (or use alcohol hand gels) and contact precautions for residents with respiratory infections.

The third memo (QSO 20-13-Hospitals) outlines guidance to hospitals on screening visitors, employees and when to admit and discharge residents.

We strongly recommend facilities review these new guidance and also continue to keep up to date with CDC guidance on CVID-19 at for health professionals and facilities as they continue to update guidance on testing and management of residents with suspected and COVID+ test results.


While long term care facilities practice quality infection control procedures, the coronavirus (COVID-19) has demanded an increased focus on infection prevention and control. Here are some helpful resources to assist your teams to be fully equipped with information and tools to manage the potential issues surrounding the COVID-19.

INFORMATION ASSETS: Review these helpful resources listed below specifically created for healthcare facilities by Centers For disease Control and Prevention (CDC):

COMMUNICATION PREPAREDNESS TOOLSEarly preparations, speed and accuracy of information is essential to managing an urgent situation. Refer to these resources and put together a communications plan for all stakeholders including employees, clinical staff, residents, families etc.

FACILITY RESOURCE: Download informational flyers highlighting best practices


  • Handwashing: Washing your hands with soap and water for at least 20 seconds or using alcohol-based hand rub kills viruses that may be on your hands.
  • Stay home if you have a fever, cough, sore throat, or difficulty breathing, seek medical attention and call in advance. Watch and share this two- minute video by World Health Organization on how you can protect yourself and others from getting sick.
  • Maintain social distancing: Maintain at least three feet distance between yourself and anyone who is coughing or sneezing.
  • Avoid touching eyes, nose and mouth: Hands touch many surfaces and can pick up viruses. Once contaminated, hands can transfer the virus to your eyes, nose or mouth. From there, the virus can enter your body and can make you sick.
  • Practice respiratory hygiene: Make sure you, and the people around you, follow good respiratory hygiene. Cover your mouth and nose with your bent elbow or tissue when you cough or sneeze. Then dispose off the used tissue immediately.




  • Bold signage: Consider adding more robust language to your entrance signs, such as warning signs in bold letters asking visitors having flu and/or respiratory symptoms to temporarily refrain from visiting the facility even if they don’t have travel history.
  • Encourage all staff to self-isolate at home if they display symptoms of the flu, especially if they have received the flu vaccine.
  • Take precautionary removal of care staff who identify as suspected cases.
  • Prohibit staff from reporting to work if they are sick until cleared to return.
  • Consider restricting admissions or heightened screening.
  • Environmental cleaning: At this time, retrain to and follow these guidelines from CDC about infection control and cleaning.
  • Post visual alerts that remind everyone to wash their hands and cover their coughs.
  • Utilize the Influenza Like Outbreak Toolkit developed by the ISDH as a resource by following this link.
  • Conduct an inventory of PPE and monitor supplies accordingly.  (gowns, gloves, googles, masks, and include alcohol hand-sanitizer 60% or greater in alcohol)
  • Communicate with PPE supplier to establish the current ability to meet your usual ordering demands.



  • If you are experiencing sysmptoms of COVID-19, seek medical attention and report the exact symptoms to your employer.
  • Continue to advise staff to wear their PPE diligently when appropriate.  Currently the CDC is not recommending use of PPE for workers who are not providing direct patient care.
  • Continuing best practice by washing or sanitizing hands after direct physical contact with an individual before going on with the next task.
  • More stringent standards are called for if you have reason to suspect a possible cause, such as droplet precautions for the resident; full PPE for all staff within a six-foot radius; N95 masks; isolation gowns; and face/eye protection.
  • If you suspect a possible coronavirus case, please report it to the local and state department of health.
  • Communicate frequently with all staff to keep them informed on the expectations for prevention steps everyone can take to protect residents, at work and at home.
  • Use the tools – CDC Infographics for sharing information quickly and help staff to take actions
  • Learn and share what the CDC is doing to protect and prepare communities for COVID 19
  • Maximize your front-line defenses – Begin a system for simple screening questions for visitors and staff before they are in contact with residents, for contact with international travelers, and any out of country travel they may take.






(1) AHCA/NCAL Webinar Recording for Long Term Care Providers – March 3, 2020 

This webinar includes the latest update from officials from the Centers for Disease Control and Prevention (CDC) and AHCA/NCAL staff. In the interest of public health, this webinar is open to all long term care providers, including members and non-members of AHCA/NCAL.

(2) CDC Webinar: Coronavirus Disease 2019 (COVID-19) Update—What Clinicians Need to Know to Prepare for COVID-19 in the United States

WHEN: Thursday, March 5 at 2pm EST

WHAT: During this call, clinicians will learn what they can do to prepare for COVID-19 including identifying persons under investigation, applying infection prevention and control measures, assessing risks for exposures, optimizing the use of personal protective equipment supplies, and managing and caring for patients (inpatient and at home).

(3) Indiana State Department of Health Webcast

WHEN: Friday, March 6 at 12 p.m. EST

WHAT: ISDH webcast briefing on 2019 novel coronavirus (COVID-19) to provide an update on Indiana response presented by Dr. Lindsay Weaver, MD, FACEP, ISDH Chief Medical Officer.

LINK: To view ISDH webcasts, please test your access to view streaming videos prior to the event. Please use the following link, and to avoid compatibility issues, Internet Explorer must be used:

Last updated: March 5, 2020