March 5, 2020 – The Centers for Medicare & Medicaid Services (CMS) has issued three new Quality, Safety and Oversight memos about COVID-19 – two apply to nursing homes and a third to hospitals that are listed below. We strongly encourage you to review.
- QSO 20-14-Nursing Homes (revised 3/13/2020) – https://www.cms.gov/files/document/qso-20-14-nh-revised.pdf
- QSO 20-12-ALL at https://www.cms.gov/files/document/qso-20-12-allpdf.pdf-1
- QSO 20-13-Hospitals (revised 3/13/2020) – https://www.cms.gov/files/document/qso-20-13-hospitalspdf.pdf-2
The first memo (QSO 20-14-NH) provides 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 care providers to review closely the Long Term Care Survey Manual guidance for F-880 tags 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 the new guidance and also continue to keep up to date with CDC guidance on CVID-19 for health professionals and facilities as they continue to update guidance on testing and management of residents with suspected and COVID+ test results.
For additional information, please review the following resources provided by the American Health Care Association (AHCA) and the National Center for Assisted Living, which are being updated as information becomes available or changes.
- AHCA Webinar – March 3, 2020
- Webinar slides – AHCA March 3, 2020 Presentation
- Recognizing an Outbreak
- Managing an Outbreak
- Enhanced Barrier Protections
- CDC Resources
- Implementation of Personal Protective Equipment in Nursing Homes to Prevent Spread of Novel or Targeted Multi-drugresistant Organisms (MDROs)
- Enhanced Barrier Precautions
The Great Plains Quality Innovation Team is committed to providing and sharing updated and timely information as it becomes available. Please visit our Web site for additional information.