Department of health and social services issues rules for long-term care facilities

Alaska’s Dept. of Health and Social Services has issued rules for limiting exposure of the COVID-19 coronavirus at long-term care facilities like nursing homes, under authority of Gov. Mike Dunleavy’s public health disaster declaration.

The state’s guidance is critical to containing, mitigating, and slowing the advance of COVID-19, and it aligns with the recommendations announced by the America Health Care Association/National Center for Assisted Living for skilled nursing facilities and assisted living facilities to protect residents, patients, and staff, the Alaska State Hospital and Nursing Home Association, or ASHNHA, said in a March 13 statement issued Friday.

“ASHNHA continues to coordinate close communication between Alaska’s hospitals, nursing homes, the Governor’s office, and the Alaska Department of Health and Social Services to ensure we all have the latest information and resources,” said Jared Kosin, president and CEO of ASHNHA. “We also embedded ASHNHA’s two directors into the State’s emergency operations center to provide support,” he said in a statement.

The guidance directs skilled nursing facilities and nursing homes – including those providing memory care – to incorporate the Centers for Disease Control and Prevention (CDC)’s minimal to moderate mitigation strategies for long-term care facilities with additional measures, as follows:

• Implement a screening process for anyone entering the facility who is not a resident or staff member. Screening should occur before, or immediately upon, entering the facility.

• Change visitor policies to further limit exposures to residents and staff, including:

• Limit visitation to essential individuals (e.g., family members and medical providers).

• Screen all visitors for illness. If visitors have symptoms of respiratory illness/COVID-19 (e.g., fever, cough, shortness of breath) or have had recent travel to an area with known COVID-19 transmission, ask them to use an alternative means to visit with the resident, such as by phone or virtual visits.

• Limit visitor movement in the facility.

• Keep a detailed log of all visitors and health care personnel (HCP) that includes information about which resident and areas of the facility they visit.

• Limit resident activities that involve community outings and group gatherings.

• Support residents’ access to socialization by offering lower-risk opportunities.

In addition:

• Actively monitor absenteeism and respiratory illness among HCP and residents. Follow facility infection control plan for surveillance and tracking of illness within the facility.

• Actively monitor personal protective equipment (PPE) supplies.

• Establish processes to evaluate and test large numbers of patients and HCP with respiratory symptoms (e.g., designated clinic, surge tent).

• Follow CDC Guidance for Risk Assessment and Public Health Management of Healthcare Personnel with Potential Exposure in a Healthcare Setting to Patients with Coronavirus Disease (COVID-19). Work with your Employee Health or Occupational Health Department to evaluate HCP exposure and to determine if work restrictions are needed. If you need additional guidance, contact DHSS Section of Epidemiology at 269-8000.

• Consider staffing contingency plans in anticipation of staffing shortages.

“We thank the Governor, Commissioner, and the Chief Medical Officer for their leadership in Alaska’s COVID-19 preparedness efforts and we support their decision to implement these guidelines for long-term care facilities,” ASHNHA said in its statement.