The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 7, Issue 3.
In this issue:
Please visit QIPMO’s website here for this and other previous newsletters.
The Missouri Hospital Association, Long Term Care Associations and the Department have collaborated to provide guidance on transfers between hospitals and long-term care communities. These documents may be used to help guide decision making during this time.
Please see the documents below for further reference.
Post-Acute Care and Behavioral Health to Hospital Transfer
Hospital to Facility Transfer
Please see the following website regarding recommended guidance for extended use and limited reuse of N95 filtering facepiece respirators in healthcare settings from the CDC.
https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html
The personal protective equipment (PPE) burn rate calculator is a spreadsheet-based model that provides information for healthcare facilities to plan and optimize the use of PPE for response to coronavirus disease 2019 (COVID-19).
Please see the following CDC web page for details: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/burn-calculator.html
OCR Issues Guidance to Help Ensure First Responders and Others Receive Protected Health Information about Individuals Exposed to COVID-19
March 24, 2020
The Office for Civil Rights (OCR) at the U.S Department of Health and Human Services (HHS) issued guidance on how covered entities may disclose protected health information (PHI) about an individual who has been infected with or exposed to COVID-19 to law enforcement, paramedics, other first responders, and public health authorities in compliance with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule.
The guidance explains the circumstances under which a covered entity may disclose PHI such as the name or other identifying information about individuals, without their HIPAA authorization, and provides examples including:
This guidance clarifies the regulatory permissions that covered entities may use to disclose PHI to first responders and others so they can take extra precautions or use personal protective equipment. The guidance also includes a reminder that generally, covered entities must make reasonable efforts to limit the PHI used or disclosed to that which is the “minimum necessary” to accomplish the purpose for the disclosure.
“Our nation needs our first responders like never before and we must do all we can to assure their safety while they assure the safety of others,” said Roger Severino, OCR Director. “This guidance helps ensure first responders will have greater access to real time infection information to help keep them and the public safe,” added Severino.
The guidance may be found at: https://www.hhs.gov/sites/default/files/covid-19-hipaa-and-first-responders-508.pdf
For more information on HIPAA and COVID-19, see OCR’s February 2020 Bulletin: https://www.hhs.gov/sites/default/files/february-2020-hipaa-and-novel-coronavirus.pdf
CMS Memo QSO-20-20-ALL: https://www.cms.gov/files/document/qso-20-20-all.pdf
Infection Control Survey Checklist
CMS is prioritizing surveys by authorizing modification of timetables and deadlines for the performance of certain required activities, delaying revisit surveys, and generally exercising enforcement discretion for three weeks. During this three-week timeframe, beginning March 20, 2020, only the following types of surveys will be prioritized and conducted:
CMS is disseminating the Targeted Infection Control Survey checklist developed by CMS and CDC so facilities can educate themselves on the latest practices and expectations. CMS expects facilities to use this new process, in conjunction with the latest guidance from CDC, to perform a voluntary self-assessment of their ability to prevent the transmission of COVID-19. The checklist is attached.
Though the contents of the memo and checklist are provided by CMS, DHSS is adhering to the same requirements for all facilities. All facilities should complete the infection control self-assessment.
Please see the DHSS Guidance to all hospice agencies and all long-term care facilities.
Please see the Morbidity and Mortality Weekly Report from the CDC for more information.
The resource requesting process for PPE in our state cache was posted to the DHSS website this at this link:
https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/professionals.php.
All resource requests must go through the respective healthcare coalition (maps and contact information are on the website). The healthcare coalition then submits to the Missouri Department of Health and Senior Services for review, approval and processing. All shipments will occur from Jefferson City and be sent via either Federal Express (FedEx) or United Parcel Service (UPS).
Some LTC homes will make the difficult decision to limit and/or restrict entry of family and friends into their care settings. To help family and friends understand restrictions being put into place by many LTC providers, Consumer Voice, a national Ombudsman program resource, has put together a webpage: https://theconsumervoice.org/issues/other-issues-and-resources/covid-19.
JEFFERSON CITY, MO –The Missouri Department of Health and Senior Services (DHSS) activated a statewide public hotline for citizens or providers needing guidance regarding the novel coronavirus, or COVID-19. At 8 a.m. today, the hotline opened and can be reached at 877-435-8411. The hotline is being operated by medical professionals and is available 24 hours a day, 7 days a week.
“Communication is vital to our response to this rapidly-evolving situation,” said Dr. Randall Williams, director of DHSS. “For several weeks, our COVID-19 webpage has been and continues to be a great resource for the public, but having the hotline as an additional resource will likely be invaluable as citizens seek guidance for their concerns.”
To date, 46 patients in Missouri have been tested for the virus that causes COVID-19; one of those has tested positive.
“It is important to know what to do if you have concerns about an illness during this outbreak,” said Williams. “For those who may be at risk for COVID-19, we encourage them to utilize this hotline or call their health care provider or local public health agency to inform them of their travel history and symptoms. They’ll be instructed on how to receive care without exposing others to the possible illness.”
Simple preventive actions that help prevent the spread of all types of respiratory viruses include:
For more information, visit www.health.mo.gov/coronavirus or the CDC’s COVID-19 website.
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Past Missouri COVID-19 news releases:
About the Missouri Department of Health and Senior Services: The department seeks to be the leader in protecting health and keeping people safe. More information about DHSS can be found at http://health.mo.gov or find us on Facebook and Twitter @HealthyLivingMo
Guidance for use of Certain Industrial Respirators by Health Care Personnel
Please see the memo for further details.
For additional information, please visit the Department’s website at health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/. This site also contains a link specific to long-term care communities.
Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in nursing homes (REVISED)
Please see the memo for further details.
For additional information, please visit the Department’s website at https://health.mo.gov/living/healthcondiseases/communicable/novel-coronavirus/.
Release of Additional Toolkits to Ensure Safety and Quality in Nursing Homes
The Centers for Medicare & Medicaid Services (CMS) is announcing the release of two toolkits that align with the CMS strategic initiative to Ensure Safety and Quality in Nursing Homes.
Please see the full memo download at www.cms.gov/httpswwwcmsgovmedicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and/release-additional-toolkits-ensure-safety-and-quality-nursing-homes.
Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness (2019-nCoV)
Please see the full memo download at www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/information-healthcare-facilities-concerning-2019-novel-coronavirus-illness-2019-ncov.
Questions about this memorandum should be addressed to QSOG_EmergencyPrep@cms.hhs.gov.
Questions about the 2019-nCoV guidance/screening criteria should be addressed to the State Epidemiologist or other responsible state or local public health officials in your state.
The Quality Improvement Program for Missouri (QIPMO) has published MDS Tips and Clinical Pearls – Volume 7, Issue 2.
In this issue:
Please visit QIPMO’s website here for this and other previous newsletters.
March 3, 2020: Dementia Care: CMS Toolkits Call
Speakers: Cathleen Lawrence, CMS; Michele Laughman, CMS; Sheila Hanns, CMS; and Dara Graham, CMS
Target Audience: Consumer and advocacy groups; nursing home providers; surveyor community; prescribers; professional associations; and other interested stakeholders
National Partnership to Improve Dementia Care and Quality Assurance Performance Improvement
During this call, learn about new CMS toolkits for nursing homes:
Additionally, CMS provides updates on the progress of the National Partnership to Improve Dementia Care in Nursing Homes. A question and answer session follows the presentations.
As you are likely aware, the response to the 2019 Novel Coronavirus (2019-nCoV) outbreak is rapidly evolving. On January 18, 2020, the Missouri Department of Health and Senior Services (DHSS) disseminated a Centers for Disease Control and Prevention (CDC) Health Update on this outbreak. The CDC Health Update includes recommendations for health care providers pertaining to 2019-nCoV (https://health.mo.gov/emergencies/ert/alertsadvisories/pdf/cdc-update1-17-20.pdf). The specific topics covered include patient evaluation, reporting, specimen collection, testing, and recommendations for infection control.
For the most up-to-date information regarding the outbreak of 2019-nCoV, please continue to check the CDC website (https://www.cdc.gov/coronavirus/2019-ncov/index.html). Please be aware that guidance for health care and public health professionals is subject to change, and that updated guidance will be disseminated through the CDC website and the Missouri Health Alert Network (HAN). All HAN documents are archived and available on the DHSS website at: https://health.mo.gov/emergencies/ert/alertsadvisories/index.php.
February 4-5, 2020: Infection Preventionist Boot Camp
Location: Harrah’s Casino & Hotel, North Kansas City
You have been named the Infection Preventionist for your facility. You have completed your certification for the IP but still aren’t sure where to start or how to go about doing the job with confidence. We are here to give you the confidence you need! Bring your laptop and your infection control policy and procedures and leave with assurance that you and your facility are where they need to be with IPCP and all its requirements.
We will review the CMS 23-hour training as the core to IPCP development and review your IPCP and its accompanying policy and procedures to improve your confidence. We’ll build your personal library of resource material, develop your tracking logs and QAPI communication tools and finally we will create a schedule of routine tasks for you to adhere to for purposes of maintaining compliances.