SLIDE 20 If you had no exposure, we are not sure why are you wanting to isolate the staff. If someone is exposed and they are asymptomatic after they get exposed, they are required to have a 14 day
- quarantine. The best thing to do for that healthcare worker is to stay home and self-quarantine,
separate from rest of their family. However, Individuals who have been exposed but are asymptomatic can work as long as they are monitored with daily checking of temperatures and symptoms prior to their work. But if they tend to develop symptoms over time, it is required that they isolate at home and stop coming to work. Up until last week, for any outbreak in LTC where healthcare workers were exposed, there would be an investigation as to the level of that exposure and recommendations may be based on that level of exposure whether a healthcare worker should quarantine away from the facility for 14 days. We would try and triage based on whether that was low, medium, or high risk exposure. In terms of the above question, there is a lot of movement right now, most healthcare workers are finding ways to separate themselves from their families so that they are not bringing potentially the exposures they may have at work home. So, if your facility is going to do that, it could protect individual’s family and it also protects the residents and staff from that person going out to the world, getting exposed and bringing it back. As long as it is done in a careful way, it might provide a way to decrease exposure coming into and going out of the facility.
- 5. Has the governor changed his stance on SNF admitting positive patients?
The particular recommendation form the Governor or statement in the LTC guidance was that if there is a test pending on a patient who is an inpatient in an acute care facility, that the result of their test needs to be obtained before someone should be moved either into for the first time or back into a Skilled Nursing Facility. The recommendations are that a facility should admit the patients that they would normally admit even if they are coming from an acute care hospital that may have had COVID-19 patients. If the person has been in a hospital for a reason other than there has nothing to do with COVID, they had a stroke or some other issue there have been no other COVID symptoms during their admission, that a negative testing is not required and a negative test achieved prior to them going in. Again, if they have test done for any reason, the result needs to be back. But, if there is not a reason to test someone based on clinical history, there should not be a reason to test them to accept them back in. That is also why the recommendation is being made that facilities develop a sort of step-down or transition area for when people come back from the hospital or are newly admitted from the community. So that if indeed there is a chance that there was any exposure, for the first 14 days they be in a separate area from other patients to prevent any transmission. Insisting on a test being done when it is not indicated clinically isn’t really beneficial. Having a transition setting in you LTC facility would be beneficial.
- 6. Moving the patients out from the nursing home if they are positive. Criteria?
There is not so much criteria as there are factors that come into that decision. There is some capacity at certain facilities to take patients from LTC. If the facility is not capable of managing those patients or if there is particular imminent concern that keeping folks really places a risk on
- ther individuals and so it will come into place in terms of what is the skill level of staff available,
number of staff available, size of the staff tested positive, is there a capacity to create a
