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Infection Control Assessment and Response (ICAR) tools are used to systematically assess a healthcare facility’s infection prevention and control (IPC) practices and guide quality improvement activities (e.g., by addressing identified gaps).
This tool is an update to the previous ICAR tool for nursing homes preparing for COVID-19. Notable changes as of November 20, 2020 include:
This updated ICAR tool is a longer but more comprehensive assessment of infection control practices within nursing homes. Due to the addition of example recommendations to aid the facilitator during the process of conducting an ICAR, the facilitator guide version of the tool appears even longer. Facilitators may decide whether to use the tool in its entirety or select among the pool of questions that best fit their jurisdictional needs and priorities as part of quality improvement efforts.
Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating
The Centers for Medicare & Medicaid Services (CMS) is releasing the first episode in a series of short podcasts for frontline nursing home staff “CMS Beyond the Policy”.
This edition is titled “Nursing Home Series for Front Line Clinicians and Staff.” Dr. Shari Ling, Deputy Chief Medical Office for The Centers for Medicare and Medicaid Services and geriatrician is joined by David Wright, Director of the Quality Safety & Oversight Group to discuss training and infection control practices in nursing homes to help combat the spread of coronavirus disease 2019 (COVID-19).
Agency thanks nursing homes whose staff have completed free CMS training, but urges remaining homes to take advantage of this resource
The Centers for Medicare & Medicaid Services (CMS) is publicly recognizing the 1,092 nursing homes at which 50% or more of their staff have completed CMS training designed to help staff combat the spread of coronavirus disease 2019 (COVID-19) in nursing homes. CMS applauds these facilities for taking this critical step to equip their staff with the latest information regarding infection control, vaccine distribution, and other topics.
There are 125,506 individuals from 7,313 nursing homes who have completed the training. This represents approximately 12.5% of the approximately one million nursing home staff in the country. With today’s announcement, CMS is calling on nursing homes to take action, urging them to require their staff to take this free training, as part of the Trump Administration’s continued efforts to keep nursing home residents safe.
“We’ve provided nursing homes with $20 billion in federal funding, millions of pieces of PPE, free testing machines and supplies, and significant technical assistance and on-the-ground support,” said CMS Administrator Seema Verma. “Ultimately, the ownership and management of every nursing must take it on themselves to ensure their staff is fully equipped to keep residents safe. With coronavirus cases increasing across the country and infection control identified as a major issue, we encourage all nursing homes to take advantage of this no-cost opportunity to train their staff.”
The training includes multiple modules, with emphases on topics such as infection control, screening and surveillance, personal protective equipment (PPE) usage, disinfection of the nursing home, cohorting and caring for individuals with dementia during a pandemic. CMS developed this training in consultation with the Centers for Disease Control and Prevention (CDC) and expert stakeholders, and announced the training on August 25, 2020. For anyone interested, the training is free to access on a public CMS website; instructions on how to create an account and take the training are available at qsep.cms.gov/welcome.aspx.
Also see: Guidance for SARS-CoV-2 Point-of-Care Testing
Preparing for COVID-19 in Nursing Homes
Updated Nov. 20, 2020
CMS Alert Addressing Holiday Celebrations
Read the complete guidance here: https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html
Related Documents and Resources
New tool provides innovative solutions for states and facilities to protect our nation’s vulnerable nursing home residents during emergency
CMS has released a new toolkit (updated 11/22/20) developed to aid nursing homes, Governors, states, departments of health, and other agencies who provide oversight and assistance to these facilities, with additional resources to aid in the fight against the coronavirus disease 2019 (COVID-19) pandemic within nursing homes. The toolkit builds upon previous actions taken by the Centers for Medicare & Medicaid Services (CMS), which provide a wide range of tools and guidance to states, healthcare providers and others during the public health emergency. The toolkit is comprised of best practices from a variety of front line health care providers, Governors’ COVID-19 task forces, associations and other organizations, and experts, and is intended to serve as a catalogue of resources dedicated to addressing the specific challenges facing nursing homes as they combat COVID-19.
“The coronavirus presents a unique challenge for nursing homes. CMS is using every tool at our disposal to protect our nation’s most vulnerable citizens and aid the facilities that care for them. This toolkit will support state, local leaders and nursing homes in identifying best practices to protect our vulnerable elderly in nursing homes” said CMS Administrator Seema Verma.
The toolkit provides detailed resources and direction for quality improvement assistance and can help in the creation and implementation of strategies and interventions intended to manage and prevent the spread of COVID-19 within nursing homes. The toolkit outlines best practices for a variety of subjects ranging from infection control to workforce and staffing. It also provides contact information for organizations who stand ready to assist with the unique challenges posed by caring for individuals in long-term care settings. Each state was involved in the creation of this toolkit, resulting in a robust resource that may be leveraged by a variety of entities serving this vulnerable population.
Additionally, CMS has contracted with 12 Quality Innovation Network-Quality Improvement Organizations (QIN-QIOs) to work with providers, community partners, beneficiaries and caregivers on data-driven quality improvement initiatives designed to improve the quality of care for beneficiaries across the United States. The QIN-QIOs are reaching out to nursing homes across the country to provide virtual technical assistance for homes that have an opportunity for improvement based on an analysis of previous citations for infection control deficiencies using publicly available data found on Nursing Home Compare.
The Occupational Safety and Health Administration cites lessons learned from its COVID-19 inspections and citations, as well as noting nursing homes and other companies that have been fined since the COVID-19 pandemic began.
Lessons Learned: Frequently Cited Standards Related to COVID-19 Inspections.(November 6, 2020).
Common COVID-19 Citations: Helping Employers Better Protect Workers and Comply with OSHA Regulations. (November 6, 2020).
Weekly / November 13, 2020 / 69(45);1686–1690
Parag Mahale, MBBS, PhD1,2; Craig Rothfuss, MPA, MPH1,3; Sarah Bly1,3; Megan Kelley1,3; Siiri Bennett, MD1; Sara L. Huston, PhD1,3; Sara Robinson, MPH1 (View author affiliations)
View suggested citation
What is already known about this topic?
Large gatherings pose a high risk for SARS-CoV-2 transmission.
What is added by this report?
A wedding reception with 55 persons in a rural Maine town led to COVID-19 outbreaks in the local community, as well as at a long-term care facility and a correctional facility in other counties. Overall, 177 COVID-19 cases were linked to the event, including seven hospitalizations and seven deaths (four in hospitalized persons). Investigation revealed noncompliance with CDC’s recommended mitigation measures.
What are the implications for public health practice?
To mitigate transmission, persons should avoid large gatherings, practice physical distancing, wear masks, stay home when ill, and self-quarantine after exposure to a person with confirmed SARS-CoV-2 infection.
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