Coronavirus: CMS Memo and Best Practices
CMS has issued a memo to all providers on the 2019 Novel Coronavirus Illness (2019-nCoV) and reminders about infection prevention and control measures. In addition, we have gathered additional resources and information related to this emerging virus and how centers can prepare for it.
CMS: Information for Healthcare Facilities Concerning 2019 Novel Coronavirus Illness
(2019-nCoV)
On February 6, 2020, the CMS released a new memo QSO 20-09-ALL with information regarding patients with possible coronavirus illness and healthcare facility expectations. As concerns arise with the emerging 2019 Novel Coronavirus (2019-nCoV) threat, CMS encourages all healthcare facilities to carefully review the information provided by the CDC. Because coronavirus infections can rapidly appear and spread, facilities must take steps to prepare, including reviewing their infection prevention and control policies and practices to prevent the spread of infection. CDC has issued an updated interim Health Alert Network (HAN) Advisory, information about CDC’s response to 2019-nCoV as well as recommendations for healthcare facilities.
Understanding all the various hazards to prepare for emergencies, such as 2019-nCoV, improves patient outcomes and provides protection to residents, family members and staff in healthcare settings. To ensure health and safety, CMS expects healthcare staff to comply with basic infection control practices. For 2019 novel coronavirus, CDC is currently advising adherence to Standard, Contact, and Airborne Precautions, including the use of eye protection. Healthcare staff should adhere to CDC recommendations on standard hand hygiene practices, using alcohol-based hand rub/hand sanitizer (ABHR/ABHS) as the preferred method of hand hygiene in most clinical situations. When hands are visibly soiled, wash with soap and water for at least 20 seconds.
Review Your Center’s Infection Prevention and Control Program
This is an opportune time for centers to review their infection prevention and control program and to evaluate the proper use of hand hygiene, precautions and other key practices in the center. As a reminder in November 2019, CMS released QSO-20-03-NH), which highlights infection prevention and control practices.
Centers should ensure that they have a properly trained infection preventionist who can take the lead on facility risk assessment for this and other infections. Through the Infection Prevention Control Officer (IPCO) training course, individuals will be specially trained to effectively implement and manage an infection prevention and control program in their nursing center or assisted living community. It addresses both clinical and organizational systems, processes and cultural aspects of infection prevention and control which are fundamental to effectively leading and administering a center’s infection prevention and control program.
About the 2019-nCoV
2019-nCoV is a virus (more specifically, a coronavirus) identified as the cause of an outbreak of respiratory illness first detected in Wuhan, China. Additional cases have been identified in a growing number of other international locations, including the United States.
According to CDC, there is limited information known about 2019-nCoV at this time. CDC has developed several checklists to help healthcare personnel prepare to evaluate patients for 2019 novel coronavirus. You can find out the latest on this developing novel virus at https://www.cdc.gov/coronavirus/.
Best Practices
Right now, this virus is not spreading in the community in the United States, and the vast majority of Americans have a low risk of exposure. At some point, 2019-nCoV may start spreading in the United States among people without international travel. Long-term and post-acute care centers should act now to help reduce the potential for spread, which will also help with influenza and other circulating viruses that can impact residents.
Currently there is no vaccine to prevent Coronavirus infection. CDC is currently recommending Standard, Contact, and Airborne Precautions, including the use of eye protection when providing care for patients with confirmed or suspected 2019-nCoV. Review CDC’s interim infection prevention and control guidelines for 2019-nCoV.
- The 2019-nCoV spreads from person-to-person through droplets suspended in the air very similar to how influenza spreads. Centers should review their infection prevention and control policies and procedures for droplet precautions among residents and staff.
- Since family members of residents may have traveled internationally as well as staff or their family members, we recommend that members stay on alert for individuals who have traveled to China and have symptoms (fever, cough, and difficulty breathing or shortness of breath). Facilities should report such individuals to their local or state health department. Individuals who have recently traveled to China, need to know how to self-monitor and what to communicate with their physician or a clinic if they start to develop symptoms. The CDC provides information for returning travelers. If you have additional questions you should stay in touch with your state and/or local health departments.
- Everyday actions can prevent the spread of respiratory viruses, including proper hand hygiene practices and/or the use of alcohol-based hand sanitizers with at least 60 percent alcohol, avoid touching the face, avoid close contact with people who are sick and stay home when you are sick, cover your mouth and nose when you cough or sneeze, and clean and disinfect frequently touched objects and surfaces.
- Centers should consider educating families and visitors on signs and symptoms of respiratory illness and encourage them to visit with loved ones through alternative means when they are ill, such as telephone, Skype, or wearing a mask during visits.
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