***IHCA is aware that the CDC has also issued updated guidance for infection control and long term care on September 10, 2021. IDH has indicated that facilities can follow either IDH or CDC guidance and not be cited for following CDC guidance that differs from current IDH guidance. We expect IDH to update their guidance to conform with CDC guidance the week of September 20.***
The Indiana Department of Health posted an updated COVID-19 LTC Infection Control Guidance document that restates existing guidance that LTC facilities have already been following. It is critical that facilities read this guidance and compare it to current facility policies. This new guidance has also been incorporated into the COVID-19 LTC Toolkit (a link for which can be found on the IHCA’s main COVID-19 page).
The highlights of the updated COVID-19 LTC Infection Control Guidance are as follows:
- All persons that enter the facility must be screened.
- Continue to limit confirmed or presumed COVID-19 positive resident contact to essential direct care providers and designated essential family care givers.
- All direct and indirect care staff, vaccinated and unvaccinated, must wear a medical procedure mask for the duration of their shift when indoors.
- Fully vaccinated HCPs and residents may choose to not wear a mask outdoors if in small groups (if in medium or large crowds, mask is required and adhere to social distancing).
- N95 respirator masks are required in Red and Yellow Zones.
- Ensure a plan is in place to transition away from approved KN95 to N95 masks
- Cloth masks for visitors are acceptable.
- Residents should mask (cloth is acceptable) when they leave their room and when receiving care within 6 feet of the HCP.
- Eye protection (and required face mask) must be used when delivering care within 6 feet of a resident.
- Fully vaccinated HCPs can choose not to wear eye protection, regardless of county positivity, unless the resident is in TBP (Red and Yellow Zones).
- Eye protection is based on vaccination status, community transmission and status of outbreak testing.
- All residents, visitors, and staff should maintain social distancing in all cases as much as possible. This reduces changes of meeting close contact definition of being within 6 feet for more than 15 minutes over a 24 hour period.
Cohorting of Residents
- Continuation of effective cohorting in separate areas that are clearly marked with signage to also ensure that appropriate PPE is worn upon entering the area.
- Ensure a plan is in place to rapidly implement a yellow or red zone for a positive or presumed positive COVID-19 resident.
- Facilities with a dedicated COVID-19 memory unit, residents may continue to socialize as long as there are no COVID-19 negative residents or residents with unknown COVID_19 status in the unit.
- Maintain institutional signage to remind folks of guiding principles and safety continuously
Isolation and Removal Recommendations
- Track and monitor resident with COVID-19 to ensure they remain on TBP until at least 10 days and up to 20 days (residents with severe to critical illness or are severely immunocompromised) after symptom onset and 24 hours after resolution of fever, without use of antipyretic medication, improvement in symptoms (e.g., cough, shortness of breath), whichever is longer.