Long-Term Care Facilities
The general strategies Maricopa County Department of Public Health (MCDPH) and CDC recommend to prevent the spread of COVID-19 in long-term care facilities (LTCF) are the same strategies these facilities use every day to detect and prevent the spread of other respiratory viruses like influenza.
Overview with details:
- Long-Term Care Facility Guidance (PDF) (as of 03.24.2020)
Prevent the introduction of respiratory germs INTO your facility:
- Post signs at the entrance instructing visitors not to visit if they have symptoms of respiratory infection.
- Ensure sick leave policies allow employees to stay home if they have symptoms of respiratory infection.
- Assess residents for symptoms of respiratory infection upon admission to the facility and implement appropriate infection prevention practices for incoming symptomatic residents.
Prevent the spread of respiratory germs WITHIN your facility:
- Develop a system to regularly monitor all employees for fever and any respiratory symptoms. (For example, employees could be expected to monitor their temperature and any symptoms twice a day or before working a shift.)
- Reinforce that employees should not report to work when ill.
- Identify dedicated employees to care for COVID-19 patients and provide infection control training.
- Guidance on implementing recommended infection prevention practices is available in CDC’s free online course — The Nursing Home Infection Preventionist Training — which includes resources checklists for facilities and employees to use.
- Provide the right supplies to ensure easy and correct use of PPE.
- Post signs on the door or wall outside of the resident room that clearly describe the type of precautions needed and required PPE.
- Make PPE, including facemasks, eye protection, gowns, and gloves, available immediately outside of the resident room.
- Position a trash can near the exit inside any resident room to make it easy for employees to discard PPE.
- Monitor residents for fever or respiratory symptoms.
- Restrict residents with fever or acute respiratory symptoms to their room. If they must leave the room for medically necessary procedures or appointments, have them wear a facemask (if tolerated).
- Implement the correct precautions for residents with respiratory infection.
- For care of residents with an undiagnosed respiratory infection use Standard, Contact, and Droplet Precautions with eye protection unless a suspected diagnosis requires Airborne Precautions (e.g., tuberculosis).
- Encourage good hand and respiratory hygiene, as well as cough etiquette by residents, visitors, and employees.
- Ensure employees clean their hands according to CDC guidelines including before and after contact with residents, after contact with contaminated surfaces or equipment, and after removing personal protective equipment (PPE).
- Put alcohol-based hand rub in every resident room (ideally both inside and outside of the room).
- Make sure tissues are available and any sink is well-stocked with soap and paper towels for hand washing.
Prevent the spread of respiratory germs BETWEEN facilities:
- Notify facilities prior to transferring a resident with an acute respiratory illness, including suspected or confirmed COVID-19, to a higher level of care.
- Report any possible COVID-19 illness in residents and employees to the local health department.
What to Do About Symptoms or Known Exposures
If employees develop any symptoms consistent with COVID-19 (fever or respiratory symptoms) while at work, they must:
- Cease contact with residents.
- Put on a facemask immediately (if not already wearing).
- Notify their supervisor or occupational health services prior to leaving work.
If you are concerned a resident could have COVID-19:
- Please follow MCDPH guidance for testing a resident/patient for COVID-19 at the Arizona State Public Health Laboratory.
- If you think a resident meets testing criteria, please contact Maricopa County Department of Public Health:
- Monday–Friday 8AM–5PM — call (602) 506-6767 and ask for a Surveillance Nurse.
- After 5PM and on weekends — call (602) 747-7111 and ask for the Provider On-Call.
- If a resident does not meet testing criteria, COVID-19 testing can be ordered through commercial laboratories by a healthcare provider.
- You do NOT need to call MCDPH to order a commercial COVID-19 test.
What to do if employees have had a known exposure to COVID-19:
- Allow asymptomatic employees to continue to work after consultation with their occupational health program. Use your monitoring system to ensure exposed employees are monitored daily for the 14 days after the last exposure.
- If the long-term care facility has a sufficient supply, healthcare personnel who were not wearing recommended PPE during the COVID-19 exposure could be asked to wear a facemask while at work for the 14 days after the exposure.
For Further Guidance
Recordings of MCDPH Webinars for Long-Term Care Facilities:
Register here: https://attendee.gotowebinar.com/register/2959105054386271245