May 15, 2020
Return to work for healthcare personnel with suspected or confirmed COVID-19 policy
CDC released new guidance on April 30, 2020. The summary of recent changes includes:
- Changed the name of the ‘non-test-based strategy’ to the ‘symptom-based strategy’ for those with symptoms and the ‘time-based-strategy’ for those without symptoms, and updated these to extend the duration of exclusion from work to at least 10 days since symptoms first appeared. This update was made based on evidence suggesting a longer duration of culturable viral shedding and will be revised as additional evidence becomes available.
- Based on this extension of the symptom-based and time-based strategies, language about the test-based strategy being preferred was removed.
- Removed specifying use of nasopharyngeal swab collection for the Test-Based Strategy and linked to the Interim Guidelines for Collectin, Handling, and Testing Clinical Specimens for 2019 Novel Coronavirus (2019-nCoV), so that the most current specimen collection strategies are recommended.
May 1, 2020
Staffing Decisions – Positive COVID in facility/community
Q: How do I make decisions about potentially exposed staff when there is a positive COVID-19 resident or staff member at our facility/community?
A: CDC has outlined a clear process to determine appropriate work restrictions once there is a positive COVID-19 patient/resident or employee in the facility. It can be found here.
- Determine who had contact with this person during the exposure period (2 days prior to the onset of symptoms through current).
- Determine the type of contact they had as it relates to distance, amount of time, procedures being completed and type of PPE worn.
- Use the grid at the CDC website to determine the risk level for each person (None, Low, Med, High).
- Follow the work restriction based on the risk level.
Using this guidance here are a couple of potential scenarios:
On April 25th a positive test result is confirmed for a resident, Mr. Brown, on long term care wing Alpha. Develop a list of all staff and residents who had contact with Mr. Brown from two days prior to the onset of his symptoms through the current day. All employees were only wearing facemasks: 10 had prolonged contact while providing care or therapy treatments and 4 entered the room to empty garbage, replace linens or deliver a water pitcher. The 10 with prolonged contact are Medium Risk and are excluded from work for 14 days from their latest contact. The 4 without prolonged contact are Low Risk and do not have work restrictions.
A night shift CNA called in sick on April 25th due to cough and fever. She had worked previously on April 24th wearing a face mask. She was confirmed positive on April 26th. 8 employees had close contact with her on April 23rd and April 24th. Since the positive employee and all other employees were wearing facemasks during this contact, the other employees are all LOW risk and do not have any work restrictions.
Please note the importance of sharing information about positive residents and staff in your facility/community with your Consonus Rehab Director and Area Director immediately, so we can help manage the process of determining risk to our employees and implementing appropriate work restrictions in a timely manner.
April 7, 2020
“Our healthcare workers have been nothing short of heroes”.
Phil Fogg, CEO of Marquis Companies and Consonus Healthcare shares a new way you can support Healthcare Heroes who are working on the front lines during the COVID-19 pandemic. Watch the video!
To support #HealthcareHeroes, follow these steps:
1. Download your free #HealthcareHeroes printable here or purchase your own here
2. Find a place to proudly display the You Are Vital poster or sticker
3. Take a picture of yourself with it and post to social media
April 3, 2020
The Coronavirus Disease (COVID-19) confirmed cases are changing rapidly. To stay up-to-date, we’ve created a report showing global cases, with the ability to dial into specific regions. The report was developed using publically available data compiled by Johns Hopkins University (all rights reserved) and is intended for educational and academic research purposes only. Use of the data for medical guidance or commerce is prohibited. View report by clicking the link below.
March 17, 2020
Please watch an important video message from Guy Cowart, President of Consonus Rehab, for a special update on the COVID-19 Pandemic.
March 16, 2020
Policies and Procedures for Consonus Rehab Teams were updated over the weekend in response to the CMS guidance released Friday night.
- Outpatient services are limited to residents in ALF and Independent Living who can be seen in their own rooms or apartments. We will hold or discontinue services to others with three scenarios in mind:
- Outpatients who would like to receive services elsewhere will be Discharged and since the D/C is patient choice a NOMNC is not needed.
- In cases where the Outpatient is essentially done with therapy and appropriate for discharge, the provider will need to provide notice over the phone and a NOMNC mailed.
- Outpatients who would like to remain on hold and return when able will have this decision documented. When the outpatient returns, we will complete a recertification document on their first visit back to restore an appropriate plan of care. No NOMNC needed.
- Communal/Group Activities have been discontinued. Therapists have been instructed to avoid any situations where we place patients in contact with one another closer than 6’. This means we will need to control how many residents are in the gym at any given time, discontinue group treatments, and transport residents individually.
- Only Essential healthcare workers are allowed. Consonus has terminated all Clinical Rotations being completed by Student PT, PTA, OT, OTA, and SLPs. We had already discontinued job shadow/observation experiences. If we have equipment needing annual safety checks or mandatory calibrations, we will work with each customer for permission to obtain this essential service. Our vendor has agreed to cooperate with screening/handwashing protocol, not come in contact with residents, and sanitize all equipment at the conclusion of the service.
Consonus appreciates our customers who are keeping the lines of communication open with timely reporting to Rehab Directors and Area Directors any residents who are exhibiting respiratory symptoms or being tested and the results of testing in a timely manner. We want to ensure we have the knowledge necessary to keep our employees, your employees and all our residents/patients safe.
March 11, 2020
Q: Is Consonus still providing treatments to Outpatients?
A: If our customer facility/community is still allowing outpatient treatments to either the public or community (independent, ALF) patients, we will provide these treatments to patients who participate in a screening process and are able to answer NO to all the questions outlined by CDC/CMS. If a customer has asked us to stop providing outpatient treatments, we will adhere to that request.
Q: Is Consonus able to provide PPE for their employees?
A: Masks are very difficult to obtain, especially in our case where we do not have existing contract with a medical supply company. We are working to obtain an emergency supply, but right now we are depending on our customers to provide all PPE to therapists like they usually do.
Q: Are Consonus Therapists hosting “visitors” to the rehab departments such as vendors, job shadows, and students?
A: We will follow facility protocols regarding “visitors” and be in close communication regarding anyone we invite into the building. If a customer is restricting visitors to those only “essential for patient well-being” we would only consider vendors who are providing necessary safety/calibration checks on equipment or delivering medically necessary equipment. The vendor will have to undergo screening and will avoid resident contact. Job Shadow experiences will be discontinued for now. Students who are completing professional clinical rotations with a contracted partner university/school will continue their internship. They will undergo daily screenings as per all Consonus employees. Again, we will work with customers on any restrictions.
Area Director and Clinical Director visits will also only be occurring within customer restrictions.
Q: Do we need to communicate with Consonus if we have residents who have been exposed, are suspected, are being tested or have been confirmed to have COVID-19?
A: Yes, absolutely. Please keep your Rehab Director and Area Director fully informed with the details we need to keep our employees safe. Consonus recommends a medical hold for therapy patients who are exhibiting respiratory infection symptoms requiring isolation.
March 10, 2020
Consonus Rehab is continuing to implement screening protocols per CMS and CDC guidance for employees, rehab generated visitors and outpatients. We are cooperating with customers who have implemented stricter protocols. Please communicate with your Rehab Director and Area Director immediately if you have residents being tested for COVID-19 so we can assess our risk and implement precautions. Thank you!
March 9, 2020
Consonus Rehab has implemented mandatory screening protocols for all outpatients, rehab department visitors and employees. These screenings will be done unless the facility has already initiated its own protocol. Screenings involve answering the following three questions:
1. Have you traveled within the last 14 days to any Travel Advisory countries?
(3.9.2020: China, Iran, South Korea, Italy – subject to change)
2. Do you currently have any symptoms of Respiratory infection/illness?
(Fever over 100 degrees, new/worse cough, sore throat)
3. Have you had direct contact, within 6 feet, of someone confirmed or undergoing testing for COVID-19?
Outpatients and visitors who answer “Yes” to any of these questions will be rescheduled at a later date when they can answer “No”. Employees who answer “Yes” will be subject to further screening such as a temperature check and consultation with the facility infection control preventionist prior to working.
March 5, 2020
Please remember to consider gait belt use in your infection control policies. Best practice is to issue each resident their own gait belt upon admit and keep it with them their entire stay for all caregivers and therapists to use with that particular resident. Vinyl gait belts that can be disinfected between patients are another option, but many find they are slippery and uncomfortable. Vinyl gait belts are difficult to find right now, but additional cloth ones are available. Please have a discussing with your Rehab Director about the approach you wish to take in your facility/community.
March 4, 2020
Consonus Rehab is continuing to update and educate your therapy teams. Today they received resources on Standard Precautions and a Consonus Rehab Team Coronavirus Plan that outlines specific responses as it relates to Environmental Issues, Staff/Patient Infection Control Practices, and Staff Quarantine Procedures. Your Consonus Rehab Director will be able to share this plan with you. As you manage your facility response, the last thing you should have to be concerned with is your Rehab Team. Consonus is educating them on factual information from local health departments and the CDC in order to support you.
March 3, 2020
Consonus Rehab is actively preparing and educating our therapy teams regarding the Coronavirus and COVID-19. We are releasing frequent updates in the form of Questions and Answers based on guidance from the CDC. The first update included information such as the following:
- Therapists returning now from travel to China need to follow the quarantine as guided by the CDC. Therapists returning from other countries who did not have direct exposure to someone who is sick and are not sick themselves may return to work. https://wwwnc.cdc.gov/travel
- Therapists who choose to go abroad to Level 2 or Level 3 travel advisory countries now will likely be in quarantine for 14 days upon return.
- Signs and Symptoms in staff that warrant staying home from work.
Appropriate infection control standards including hand washing, equipment cleaning, standard precautions, and avoiding bringing sick patients to the gym.