Clarification Regarding Admissions

DHS Logo Original 07/11/2018

Division of Quality Assurance: Notifications & Updates

Attn: Nursing Homes and Assisted Living Facilities

Clarification Regarding Admissions

The Department of Health Services (DHS), Division of Quality Assurance, has been notified that some Wisconsin long term care facilities are not admitting hospital patients who were treated for COVID-19 for a variety of reasons. As a result, Wisconsin residents have been admitted to out-of-state facilities making it difficult for residents to stay in contact with their family and friends. Please see the following clarifications.

Concern: Admitting a resident who tested positive for COVID-19 will trigger a focused infection control survey (FICS) (for nursing homes only).
Clarification: This is incorrect. A focused infection control survey is triggered when there is one new in-house resident COVID-19 positive case and the facility was previously COVID-19 free, or there are three or more new in-house resident COVID-19 cases from the previous week.

Concern: The long term care facility needs two negative COVID-19 tests from the resident before they can be admitted.
Clarification: This is not a recommendation from the CDC or DHS. The individual is able to be admitted to the long term care facility once they are clinically ready for transfer. The resident can be transferred to a regular unit in the long term care facility if they no longer require transmission based precautions (TBP). Additionally, an individual may be transferred while still on TBP if the facility has a segregated area, dedicated equipment, dedicated staff, PPE, and specific protocols for TBP, cleaning, and aerosol generating procedures. See additional guidance regarding new admissions and CDC guidance. While a temporary restriction on new admissions during an active outbreak is generally advised, facilities should contact their local public health departments to discuss any extenuating circumstances. For example, all area facilities are in outbreak status or a facility offers specialized care, such as ventilator care, needed by a resident and may allow for admissions to accommodate the resident locally.

Concern: We may not have adequate staff to care for COVID-19 positive residents.
Clarification: Facilities are encouraged to develop a contingency plan that will ensure minimum staffing is maintained and resident needs are met. Consider contracting with staffing agencies, local hospitals, and clinics. The continued presence of COVID has impacted numerous Wisconsin businesses which have laid off employees. Wisconsin's long term care facilities should seek to hire these displaced employees as a possible staffing source. Long term care facilities could be the new career for many of these employees. Facilities can also cross-train staff so that they are able to work in multiple roles, adjust staff schedules, and address barriers and social factors that might prevent well staff from working (e.g. transportation). The CDC provides additional information to help mitigate staff shortages. If options listed above are exhausted, explore assistance from the Wisconsin Emergency Assistance Volunteer Registry (WEAVR). WEAVR is a web-based online registration system for Wisconsin's health professional volunteers willing to serve in an emergency.

Concern: We do not want to risk introducing the coronavirus into our facility.
Clarification: We all have a shared goal of ensuring the health and safety of residents in these communities during these difficult times. We also want to prevent residents from going out-of-state for care when we have beds available in Wisconsin. While keeping Wisconsin long term care facilities free of COVID-19 is our highest priority, COVID-19 infected residents may be safely cared for in these facilities as long as they possess the necessary space, staff, supplies, and procedures.

Long term care facilities are encouraged to regularly review DHS and CDC guidance at COVID-19 Nursing Homes and COVID-19 Assisted Living.