AHCA: COVID-19 – Update #2

Lisa Volk and Jackie Pappalardi in Clinical & Quality

News reports today indicate that there have been several employees and staff with symptoms of COVID-19 identified in a skilled nursing facility in Washington state. This update #2 outlines some additional steps you should be taking since update #1 sent on Friday, February 28, 2020 to protect your residents, their families, as well as your staff and their families. 

Since COVID-19 is spread from person-to-person through droplets in the air, very similar to how influenza spreads, centers should use the strategies known to reduce the spread of respiratory viruses which includes:

  • Monitor your staff and visitors for following hand washing or use of alcohol hand gels
  • Review your contact isolation procedures and make sure staff follow them consistently
  • Review plans for cohorting residents in the same room or wing who become sick to prevent the spread to other residents and staff, should the outbreak continue to grow
  • Remind staff, contractors, volunteers to stay home if they are sick (see detailed guidance here)
  • Starting now, post notices for visitors who are sick to stop visiting and work with families on alternate ways to visit their family members, like Skype, phone calls and email. Check with the local health department if they are recommending more restrictive criteria for visitations as COVID-19 spreads
  • Stay in close contact with your local and state health department.
    • Make sure your infection preventionist signs up for health department announcements as well as CDC announcements
  • Monitor the CDC COVID-19 website for the latest information on Coronavirus prevention strategies, testing guidance and recommendations for health care workers.

Centers need to review testing guidelines for testing of persons under investigation suspected of COVID-19.

  • Make sure your staff are aware and keep up with CDC and your local health department guidelines (which are changing) as to when to contact them for testing suspected cases.

You should provide information to your staff and their families on what they can do to protect themselves. Per CDC this includes:

  • Following preventive actions known to prevent the spread of viruses including:
    • washing your hands, using alcohol-based hand sanitizers,
    • covering your cough, and
    • staying home when you are sick (which includes any of the following: fever, cough, runny nose, sore throat)
    • The CDC does NOT currently recommend the general public to use facemasks.

We have communicated to CDC and CMS that long term care providers are having trouble accessing types of personal protective equipment such as masks, gowns, etc. due to the worldwide shortage related to decreases in exports from select countries, including China, India, and Taiwan, and increases in demand. 

The CDC has offered strategies for health care providers on how to optimize supplies of N95 respirators in the face of decreasing supply, which can be found here. These strategies include:

  • Minimizing the number of health care professionals who need to use respiratory protection
  • Use alternatives to N95 respirators, such as facemasks where feasible, and prioritize the use of N95 respirators for those with the highest risk of acquiring infection or experiencing complications from infection

You can learn more about the CDC's strategies for optimizing the supply of personal protective equipment here

If a health care provider, including long term care providers, is experiencing challenges meeting personal protective equipment needs, please contact your state and local health departments.  

AHCA/NCAL will continue to provide updates and relay messages and concerns to CDC and CMS. Thank you to all members for keeping our residents and communities safe.


Lisa Volk, RN, B.P.S., LNHA
Director, Clinical & Quality Services
518-462-4800 x15

Jackie Pappalardi, RN, BSN
Executive Director
518-462-4800 x16