Coronavirus Prevention in LTC Facilities: Information for Long-Term Care Ombudsman Programs

As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is important for Ombudsman programs and other advocates to be informed and take precautions in order to prevent the spread.

According to the Centers for Disease Control and Prevention (CDC), the health risk of COVID-19 for the general public in the United States is low currently.  However, just as with influenza and other viral infections, older adults and some individuals with preexisting medical conditions are at an increased risk for more severe illness.

The information below includes tips for preventing the spread of COVID-19, considerations for facility visits, and links to additional information.

General Tips for Preventing the Spread of COVID-19

• Review these resources before visiting facilities: 
• What You Should Know 
• What You Should Do If You Are Sick 
• What You Need to Know about Handwashing 
• Remind staff and volunteers to contact their supervisor and/or State Ombudsman if they are sick and not to visit any long-term care facilities. Recommend that they contact their healthcare provider if they are sick for medical advice. 
• Advise staff and volunteers that if they travel internationally, or to areas impacted by COVID-19 in the United States, to monitor for symptoms (coughing, sneezing, or fever) and contact their healthcare provider for advice if they have symptoms and/or want to be tested.

Facility Visits

• Wash your hands before, during, and after your facility visit. 
• Wash your hands between visiting residents’ rooms. If handwashing is not readily available, use hand sanitizer. 
• Avoid touching people (don’t shake hands or hug). It is okay to explain that you are limiting physical contact to prevent spreading your own germs. 
• To prevent spreading germs only bring necessary items into the facility (e.g., leave your purse, bag, and other items in your car). 
• Wipe down items you bring into the facility with a disinfectant wipe before and after visiting. 
• Place your business card or other items on a hard surface, instead of handing it to someone to limit hand-to-hand contact. 
• Observe staff and others for hand washing and speak with leadership regarding their hand washing and infection control practices. Share prevention information with facility leadership, such as: 
• CMS - Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes (QSO-20-14-NH)  
• CDC – Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities 
• If a resident is in isolation due to a communicable disease (including COVID-19), postpone visiting the resident until the resident is no longer in isolation. If necessary, communicate with the resident by phone or contact your supervisor and/or State Ombudsman to discuss options for communication. 
• If a facility is in quarantine due to COVID-19 or another communicable disease, do not visit. Contact your supervisor and/or State Ombudsman to inform them of the quarantine. During the quarantine, communication can occur by other means such as phone, email, video conferencing with individual residents, Resident Council leadership, staff, and families.

CMS Actions to Prevent Spread of COVID-19 for Facilities and Surveyors

CMS recently issued guidance for surveyors (QSO-20-12-All) and a call to action to long-term care providers (QSO-20-14-NH) and hospitals to assist in preventing the spread of COVID-19.

Effective immediately, CMS is suspending non-emergency surveys of all healthcare facilities and has directed that states focus surveys to the following activities (in Priority Order):

All immediate jeopardy complaints and allegations of abuse and neglect. Complaints about infection control. Statutorily required recertification surveys. Surveys of facilities/hospitals that have a history of infection control deficiencies at the immediate jeopardy level in the last three years. Surveys of facilities/hospitals that have a history of infection control deficiencies at lower levels than immediate jeopardy.

Review the memo (QSO-20-12-All) for more details regarding the protocols for the survey process in facilities with actual or suspected cases of COVID-19 and visit this CMS page for updates.

Consumer Voice provided a comprehensive review of this CMS guidance here.

Stay Informed

We recommend checking the CDC website for the most timely, comprehensive information about the national response to the outbreak. Links to additional information are below.

For additional information and resources on COVID-19, visit the NORC and Consumer Voice websites.

Read archived issues of NORC Notes. If you have a question, are not able to find a resource, or want to share training materials or program practices, please email ombudcenter@theconsumervoice.org.