COVID-19 and home health

Here are 4 things home care providers need to do under increasing threat of coronavirus impact

Is your home health agency ready for the COVID-19 challenge? Florida became the latest state to declare a public health emergency this morning as the number of confirmed cases of COVID-19 in the U.S. increases. Washington state as well as several California counties have previously declared public health emergencies. Home health agencies are responding to the spread of the novel coronavirus by making sure their infection control and emergency preparedness programs are up to date, including any necessary revisions of policies, procedures and a mandated all-hazards risk assessment. “CMS expects facilities to include planning for infectious diseases within their emergency preparedness programs,” said J’non Griffin, owner and president of Home Health Solutions, a nationwide home health consulting and outsourcing firm. “This new coronavirus means agencies need to evaluate the potential risk, document their findings as part of their risks and vulnerabilities assessment and have plans in place for addressing the situation.” Last year, the Centers for Medicare and Medicaid Services added “emerging infectious diseases” to the current definition of the all-hazards approach home care providers are required to take in their emergency preparedness programs. Emergency preparedness plans are required under Medicare’s Condition of Participation. Each plan must include a specific risks and vulnerabilities assessment which identifies all potential natural or man-made disasters the agency might encounter, including fire, flood, weather events, hacking and other cybersecurity threats, mass shootings and more. In a February 2019 memorandum to state survey agency directors, CMS specifically included infectious diseases as one of the threats home care providers are required to address. “This means CMS wants COVID-19 and all other infectious diseases, including Ebola, the Zika virus, H1N1, etc., to be treated as any natural or man-made disaster which has the potential to impact the agency,” J’non said. “The agency should evaluate the potential threat, include the evaluation in the agency’s all-hazards risk assessment and have in place a written plan for handling it.”

She recommends home care providers take the following steps to ensure regulatory compliance and prepare for any identified risks to patients, agency healthcare workers and their communities. . WHAT SHOULD AGENCIES DO? 1. Stay informed. The Centers for Disease Control website includes a section specifically addressing the new coronavirus, and it is updated with new information every few days, including information specifically for health care workers. The CDC says home health personnel should refer to guidelines set out here. 2. Update your agency’s Emergency Plan. It’s a good idea to add COVID-19 as a specific line item on your agency’s All Hazards Risks and Vulnerabilities Assessment. Although your agency’s plan for addressing identified COVID-19 risks will probably include material which is pulled directly from your agency’s Infection Control Program, it is a good idea to specifically identify individual infectious diseases rather than having one all-encompassing infectious disease category. 3. Consider drill requirements. Home care providers are required to test their emergency plans annually. If a community-wide drill is not available, agencies are permitted to conduct an individual facility-based functional exercise as often as every other year. In the alternate year, the agency may conduct testing of its choice: a drill, or a tabletop exercise or workshop that includes a group discussion led by a facilitator. Some agencies which meet the criteria to hold a tabletop drill this year are already looking at creating a tabletop exercise based on a COVID-19 outbreak. In addition to helping agencies fulfil emergency plan requirements, these drills may serve as a timely refresher to assist home care personnel in controlling the spread of the coronavirus to vulnerable homebound patients. 4. Review Infection Control

Finally, it’s a good idea to review your agency’s Infection Control Program to make certain your policies and procedures fully address all current prevention and control of emerging infectious diseases such as coronaviruses and influenza. Do your policies and procedures reflect the most up-to-the-minute guidance from the CDC for health care professionals? Are all your staff members current on infection control training? If not, this may be the ideal time to prioritize any additional staff training needed. Click here for a link to current CDC infection control procedures.