CDC Information

Personal Care:

1.  All clients will be pre-screened using the following questions before they come within 6 feet of the client :

    1. Have you traveled internationally in the last 14 days to any country currently designated by the CDC as a high-risk location for COVID-19?   
    2. Have you had signs of a respiratory infection in the last 14 days such as a fever, cough and/or sore throat?   
    3. Has anyone you live with had signs of a respiratory infection in the last 14 days such as a fever, cough and/or sore throat?  
    4. Have you had contact with anyone who has been diagnosed with, or screened for COVID19?  
    5. Have you traveled to another state with widespread community transmission of COVID19 in the last 14 days?
 

2. If a client answers “yes” to any of the above questions, the employee must notify their supervisor prior to initiating service of that client.

3. Determination of how to service the client will be made in consultation with the client’s payer, personal representative (as applicable), local or state health department, and current CMS guidance.  

Home Health & Hospice:

  1. Recommendations for screening of patients for possible COVID-19 infection are based on the current knowledge of the characteristics of clinical illness observed in early cases and the geographic distribution of current cases.
  2. Patients should be assessed for exposure associated with risk of COVID-19 infections (e.g., travel to certain areas or close contact with confirmed cases or persons under investigation (PUI)).
  3. Patients should be assessed if they have traveled to another state with widespread transmission of COVID-19.
  4. Clinicians should assess patients based whether the patient has Symptoms AND has the patient traveled to an area with a Travel Advisory within 14 days of symptom onset, OR has the patient had close contact with a person confirmed with COVID-19 or under investigation for COVID-19.
  5. Patients who report having these symptoms and meet the criteria of the clinical features for PUI should be asked to wear a surgical mask as soon as they are identified, and if possible, separated by at least 6 feet from other persons.
  6. Home Health and Hospice employees involved in the care of confirmed COVID-19 should use standard precautions, contact precautions, airborne precautions, and use eye protection (goggles or face shield).
Clinicians should perform hand hygiene before and after all patient contact, contact with potentially infectious material, and before putting on and upon removal of PPE, including gloves.
Perform hand hygiene, then put on clean, non-sterile gloves upon entry into the patient room or care area. Change gloves if they become torn or heavily contaminated. Remove and discard gloves when leaving the patient room or care area, and immediately perform hand hygiene.

Put on a clean isolation gown upon entry into the patient room or care area. Change the gown if it becomes soiled. Remove and discard the gown in a dedicated container for waste or linen before leaving the care area.

Use respiratory protection that is at least as protective as a fit-tested NIOSH-certified disposable N95 filtering mask before entry into the patient care area.
Put on eye protection (e.g., goggles) upon entry into the care area and remove prior to leaving the care area.
Dedicated medical equipment should be used for patient care. All nondedicated, non-disposable medical equipment used for patient care should be cleaned and disinfected according to the manufacturer’s guidelines.

Suspected or Actual Patient/Client Exposure

  1. Any employee made aware of a client exposed (suspected or confirmed) to COVID-19 must immediately notify their supervisor. The supervisor must immediately complete the COVID-19 Incident Report (Attachment A) and send to the Senior Director of Risk Management at eplesco@Private.com.   

2. The Senior Director of Risk Management or designated representative will contact the LOCAL or STATE health department immediately for consultation and guidance and document the conversation.   

3. If a client becomes quarantined or tests positive for COVID-19:  

    1. Private Duty will suspend all personal care services until medical clearance is provided. If suspending personal care services poses a risk to the client (high acuity requiring total care, skilled nursing tasks or nurse delegated tasks) Private Duty will coordinate with the payer and the client’s health care professionals to support the client’s ongoing care needs (i.e.  home health agency, inpatient care facility).   
    2. For Home Health and Hospice operations, face to face services that cannot be suspended due to patient needs (nursing and/or HHA), care will continue to be provided while observing standard infection control principles, including Universal Precautions and proper PPE technique. Staff who are providing face-to-face care to patients who have been quarantined or confirmed positive will not provide care to patients who have not had exposure to the virus.  Home Health/Hospice staff will continue client monitoring and reporting in collaboration with the patient’s primary care physician or hospice medical director, as applicable.   

4. If the branch is notified by a health official, practitioner, family, responsible party, or a payer that a client/patient has been exposed to COVID-19, branch staff are to do the following:  

      1. The person providing notification should be asked for their contact information so a designee of CERC can contact them. To prevent unauthorized disclosure:
        1. No client information should be discussed with the reporting party at that time.   
        2. The person receiving the information is expected to listen and document the information received.
      2. Contact the client to confirm the information, if possible.
        1. When possible and available, implement the client/patient emergency back-up plan  
        2. In instances where there is not an effective back up plan to meet the client/patient’s immediate health/safety needs this is to be shared with the Senior Director of Risk Management so that coordination can occur with the payer, the applicable DOH, and other healthcare providers.   

CERC

  1. CERC will be responsible for:
    1. Reviewing all new cases of confirmed or suspected COVID-19 exposure.   
    2. Appointing a lead to facilitate case-by-case communication plan with payers and other health care providers in the community.  
    3. Providing direction for care coordination in accordance with applicable laws, the most recent guidance from the CDC, any applicable medical opinions or guidance, and recommendations of the local or state health agency   
    4. Developing, evaluating, revising, and communicating official Company and agency policy, guidance, and response effectiveness.   
    5. Driving accountability for the implementation of policy and guidance.
  1. CERC will meet minimally once weekly while COVID-19 remains an ongoing concern according to the CDC.   
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