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Update on Long-Term Care Facilities Mitigation Activities

August 7, 2020

Background

The Administration's strategy to protect residents of long-term care facilities (LTCFs) focuses on ensuring resident safety through education, resources and testing; preventing and mitigating outbreaks; and working in partnership with other state agencies, municipal and county health departments and LTCFs. The Commonwealth remains committed to keeping Pennsylvanians, and specifically residents and staff of LTCFs informed throughout the pandemic.

This document highlights many of the specific steps the Department of Health (Department) has taken to execute the strategy to protect residents and staff of LTCFs. This document will be updated regularly to inform stakeholders and the public on activities related to mitigating COVID-19 in LTCFs.

What Personal Protective Equipment (PPE) has the Department Provided to Long-Term Care Facilities to Date?

Throughout the course of the pandemic, the Department has found and will continue to find innovative ways to source and distribute PPE to health care providers and vulnerable communities. Through public/private partnerships and collaboration among state agencies, long-term care facilities have received over 2,500 pushes of PPE to date, which has included over 315,000 gowns, over 350,000 face shields, over 1 million gloves, over 2.8 million N95s masks and nearly 1.2 million surgical masks.

What Resources has the Department Deployed to Long-Term Care Facilities to Date?

The Administration continues to bolster resources available to the Commonwealth to help support long-term care facilities' operational needs. These resources include leveraging the Department's Quality Assurance licensure team and the Infection Control and Outreach team (ICOR), partnering with the Patient Safety Authority (PSA), ECRI Inc., the Educational Support and Clinical Consultation Program (ESCCP), and the Pennsylvania Assessment and Support Team (PAST), which includes the Pennsylvania National Guard, teams from the U.S. Department of Health and Human Services, and direct support from the Pennsylvania Emergency Management Agency. More information on the role of each of these teams can be found here. The Department has also received additional staffing resources from the Centers for Disease Control and Prevention, as well as the Centers for Disease Control and Prevention Foundation.

As of August 6, 2020, the Department has deployed 79 Pennsylvania National Guard Strike Teams to 42 different LTCFs. Response at these facilities included 38 site assessments, 15 PPE trainings, 30 COVID-19 mass testing missions, and 15 facility staffing missions. The Department of Health has responded to 100% of outbreaks, defined as one or more confirmed positive case among staff or residents, in LTCFs, including proactive outreach by the team of field epidemiologists to begin consultation on proper infection control practices. Field epidemiologists have provided advice to facilities and, where needed, the ICOR team has provided additional consultation on infection control and outbreak response. Further, ECRI and PSA have provided infection control and technical assistance to over 130 and 90 different LTCFs, respectively, while working on behalf of the Department.  ESCCP has also provided preparedness assessment and infection prevention and control strategies to over 250 skilled nursing facilities. They have provided clinical guidance, advice on infection control strategies, and clinical needs identification to a broad range of DHS-licensed long-term care facilities. In addition, the US Public Health Service has been deployed to 22 facilities for onsite assessments and training.  

The Department of Human Services (DHS) and Department of Health, in coordination with the Pennsylvania Emergency Management Agency (PEMA) and the Centers for Disease Control and Prevention (CDC), have developed the Regional Response Health Collaboration Program (RRHCP). This program is designed to directly support COVID-19 readiness and response in long-term residential care facilities, including long-term care nursing facilities, personal care homes, and assisted living residences. The RRHCP will provide operational and administrative support to protect residents in long-term care facilities from COVID-19. It will help facilities implement best practices in infection control, implement contact tracing programs in facilities, support clinical care through on-site and telemedicine services, provide remote monitoring and consultation with physicians, and enhance testing capability for both individuals in care and staff at facilities.

What Testing Support has the Department Provided to Long-Term Care Facilities to Date?

The Department is executing a robust universal testing strategy for staff and residents within LTCFs as part of the Administration's statewide comprehensive testing strategy. This statewide testing strategy focuses on ensuring testing is accessible for all Pennsylvanians with symptoms of COVID-19, available by increasing supply and building community capacity, and adaptable to the evolving landscape of the virus and emerging data.

Between May 11 and through May 26, 2020, the Department implemented a pilot universal testing project in 5 LTCFs across the Commonwealth. On June 8, 2020, the Department issued an Order that mandates testing in Skilled Nursing Facilities, which will protect this vulnerable population and frontline workers while increasing facility readiness. This Order requires all Skilled Nursing Facilities accomplish initial baseline testing no later than July 24. The Department is coordinating closely with facilities that are conducting universal testing, by providing testing supplies, access to the Bureau of Laboratories and staffing support through the Pennsylvania National Guard to train and assist with swabbing. Through this partnership, 100% of skilled nursing facilities in Pennsylvania completed universal testing and complied with the Order.

What Information has the Department Provided to Long-Term Care Facilities to Date?

The Department and the Department of Human Services continue to provide regular information and updates to LTCFs throughout the Commonwealth. This information is provided and disseminated in a number of ways, including clinical Health Alert Notices (HANs), guidance and resources, twice-weekly calls with LTCFs, press releases, and press conferences.

On March 18, 2020, the Department issued its first guidance to licensed skilled nursing care facilities. That guidance has been updated and re-issued as available information about the virus continues to evolve. The most recent issuance of this guidance for licensed skilled nursing care facilities was published on May 12, 2020. On June 2, 2020, the Department published Restrictions to Protect Residents in Skilled Nursing Care Facilities Temporarily Remain in Place in Counties in the Green Phase of the Governor's Process to Reopen Pennsylvania. This guidance describes the timeline and measured approach to be used by the Department in creating a plan for safely lifting restrictions currently in place.

As the Department participated in conversations with facilities, families, communities, and other stakeholders, we listened for common challenges and questions, and decided to begin documenting answers to common questions in a variety of Frequently Asked Questions (FAQs). The first set of FAQs for skilled nursing care facilities was issued on April 19, 2020, and addressed information regarding staffing resources. This document specifically describes available options to supplement existing staffing resources and information about suspended and waived licensing regulations. On May 6, 2020, the Department issued another set of FAQs, directed towards families of residents and staff in skilled nursing care facilities, which highlighted precautions, screening, testing, and other pertinent issues.

On May 19, 2020, an FAQ document on Universal Testing was issued to provide further information in support of PA-HAN 508 (later superseded by PA-HAN-509). On June 2, 2020, an FAQ document for COVID-19 Data Reporting Requirements for Skilled Nursing Care Facilities was published to provide clear direction for the Secretary of Health's Order issued May 14, 2020, requiring skilled nursing facilities to report data. On June 8, 2020, an FAQ document was published to ensure clarity with respect to the Secretary of Health's Order issued that same day mandating universal testing in skilled nursing facilities.

Resources for More Information

COVID-19 Data for Pennsylvania: https://www.health.pa.gov/topics/disease/coronavirus/Pages/Cases.aspx

COVID-19 Information for Nursing Homes: https://www.health.pa.gov/topics/disease/coronavirus/Pages/Nursing-Homes.aspx

2020 Health Alerts, Advisories and Updates: https://www.health.pa.gov/topics/prep/PA-HAN/Pages/2020-HAN.aspx

COVID-19 Information for Health Care Facilities: https://www.health.pa.gov/topics/disease/coronavirus/Pages/Health-Care-Facilities.aspx

COVID-19 Information for Health Care Professionals: https://www.health.pa.gov/topics/disease/coronavirus/Pages/Health-Care-Professionals.aspx


Date created: 5/26/2020; Date updated: 6/19/2020