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COVID-19 Resources

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Workforce

DCH Establishes Temporary Nurse Aide Bridge Program for Full Certification
DCH has established a bridge program whereby individuals currently working as Temporary Nurse Aides (TNAs) can become fully certified and continue working in the center beyond the public health emergency. Click here to review information regarding the bridge program and certification requirements. CMS previously waived some portions of 42 CFR 483.35(d), allowing nurse aides to work for more than four months at a nursing home without completion of the training and certification process. CMS has not released guidance on whether additional time will be granted once the public health emergency period is ended. TNAs interested in sitting for the competency test are encouraged to work on completing the required coursework and clinical rotations as soon as they are able to do so. Likewise, nursing centers should proceed to support completion of the certification requirements for any TNAs that they want to hire for permanent employment.
 
Discounts are available for TNAs to complete the CNAonline Training Program. Click here for additional information and pricing.

COVID-19 Temporary Nurse Aide Training Program Effective March 20, 2020 - Updated April 14
We know workforce challenges continue to be an ongoing issue for providers during this time of crisis. As such, GHCA has been working with DCH and Alliant Quality on Georgia’s approval of the Temporary Nurse Aide Training Program. Under the authority of the March 20, 2020 Executive Order issued by Governor Kemp, and the Section 1135 blanket waiver issued by the Centers for Medicare and Medicaid Services (CMS) on March 30, 2020, HFRD is authorizing a temporary nurse aide training program, as follows:

  • Nursing homes are not required to have a current CNA Training Program in order to participate in the temporary program.
  • The temporary nurse aide training program may be administered by the nursing home utilizing the 8-hour online training course and associated skills competency checklist developed by the American Health Care Association in association with Academic Platforms, LLC (branded as CNAOnline.com).
  • All nursing homes that intend to utilize the temporary nurse aide training program must complete the Temporary Nurse Aide Facility Application and send it to Alliant Health Solutions.
  • Nursing homes also must maintain documentation at the facility of all nurse aides that complete the temporary training program including, at a minimum: evidence of successful completion of the online exam following the 8-hour training; and documentation of at least 2 hours of supervised training and completion of a skills checklist by a member of the nursing staff at the facility.
  • • Nursing homes may employ current nursing students who are enrolled in an LPN or RN program in Georgia as temporary nurse aides. If a nursing student has completed Nursing 101 and Nursing 102, there is no requirement to complete the 8-hour training or take the online exam. These students can be onboarded at the facility with 2 hours of supervised training and completion of a skills checklist. Nursing students hired as temporary nurse aides do not have a larger scope of duties than other temporary nurse aides. Temporary nurse aides may only perform tasks that are consistent with typical CNA job responsibilities.
  • Once the state of emergency has been lifted, the Department will allow a period of time for temporary nurse aides to complete any additional training necessary for them to pass the required Georgia Certified Nurse Aide Competency Test administered by Pearson VUE and to enroll in the Georgia Nurse Aide Registry.

Click here for the Department’s memo related to this authorization.

Additionally, Georgia’s Nursing Board has developed a process  to obtain a temporary permit for nurse graduates who have applied for license by exam to work as a Graduate Nurse in a role consistent with their scope of practice. This is a wonderful opportunity to strengthen relationships with local nursing programs and to fortify your workforce. Our hope is that centers would hire individuals through the various pathways created as a result of the public health emergency and demonstrate exceptional customer service and support as they assimilate with your teams. This will increase the likelihood these new associates will remain employed in your center long after the declared public health emergency has lifted. Embrace this opportunity and demonstrate why our health care teams are super heroes!

Please see below process for employing nursing students, allied health students and nurse graduates: 

  1. Nursing Students
    1. Pre-requisite: Fundamentals in Nursing
    2. Upon hire, student will be required to complete a competency skills check-off (linked above) and perform with 2 hours supervision
  2. Allied Health Student (or other students) and external applicants interested in Temporary Nurse Aide employment opportunity
    1. Upon hire, student will be required to complete the 8-Hour AHCA Temporary Nurse Aide online training program and exam
    2. Upon successful completion of exam, will be designated as a Temporary Nurse Aide with appropriate job responsibilities
    3. Once public health emergency has passed, DCH and other stakeholders will define process to allow TNA to complete other requirements for Certified Nurse Assistant testing and certification
  3. Nurse Graduates
    1. Graduate of accredited nursing program
    2. Apply for a temporary permit
    3. SNF, ALs and other providers may employ appropriately permitted Graduate Nurses to perform duties commensurate with their scope of practice.

If you have questions, please contact GHCA VP Quality Advancement & Regulatory Affairs Pam Clayton at pclayton@ghca.info or 678-902-9224

Click here for a template information document for center to use to recruit Temporary Nurse Aides or Graduate Nurses.

Updated Guidance for DPH Staffing Resource Requests
While DPH has indicated that centers should first utilize your local staffing agencies, resources, volunteers, and partnerships with schools, providers can also submit requests for staffing supports through your local EMA. The Department has indicated that staffing resources are limited, and request fulfillment cannot be guaranteed.

If you are in need of critical staffing, please include in your resource request the following information:

  1. Title the resource request “Staffing support”
  2. Type of facility (hospital, skilled nursing, assisted living)
  3. Name of contact person at the facility who understands the request with a verified telephone number and e-mail
  4. Date staffing is requested and length of time the assistance is needed.
  5. Total number of positive COVID cases of patients/residents
  6. Total number of staff that are confirmed COVID positive
  7. Total number of staff leave callouts due to COVID concerns
  8. Describe the type of assistance needed including any specific requests.

Your local EMA will submit your request into WebEOC. Once the resource request is submitted, it will be assigned to ESF8 and someone will contact you to discuss the request for clarity and planning.

Data Collection Changes Implemented July 6

Effective July 6, 2020, all personal care homes of 25 beds or more, assisted living communities and nursing homes should report COVID-19 data directly into the Georgia COVID-19 Long-Term Care Facility Database. Surveyors will not be calling or emailing to collect the data. Facilities should report the data each weekday using the instructions here.

  • The COVID-19 Data Collection Form should be submitted online Monday through Friday by 2:00 PM even if there are no changes from the previous day.
  • The database includes personal care homes of 25 beds or more, assisted living communities and nursing homes. 
  • Instructions on how to access the database and complete the online form can be found here.
  • Surveyors will be reaching out to facility contacts the week of July 6th to assist in this transition. 

Electronic Reporting to CDC’s National Healthcare Safety Network (NHSN)

Testing

CMS' New COVID-19 Testing Requirements Effective September 2, Reporting Point of Care Antigen Test Results to DPH
On August 25, CMS issued the interim ​final rule with requirements for routine COVID-19 testing in nursing centers based on county positivity rates. This rule has been published in the Federal Register and became effective September 2, 2020.  Rates of county positivity are posted here. 
 
Under the new requirements, reporting of point of care antigen COVID-19 test results to the Georgia Department of Public Health (DPH) is required (see Question 16 in this FAQ Document for more details). DPH is developing a web-based reporting mechanism for this purpose. Until this mechanism is finalized, nursing centers are asked to report point of care COVID-19 test results using the Department’s spreadsheet template and accompanying instructions.
 
Reporting via this spreadsheet is an INTERIM process to provide a means of reporting until the web-based mechanism is ready to field. As an interim solution, it does not include all the variables required by HHS but is intended to collect the critical information needed for case and outbreak investigation by district and state public health. Once the web-based mechanism is fielded, this spreadsheet will no longer be accepted by DPH. Centers will not be asked to backfill missing variables once the web-based system is in place.
 
Once you begin using point of care antigen tests, please upload this spreadsheet within 24 hours after testing to a secure folder within DPH’s surveillance system (SendSS). Instructions for the uploading of the spreadsheets are included in the instructions document. Each spreadsheet should only contain the most recent test results; please do NOT include previously reported test results.
 
Please send questions about technical aspects of reporting to contactpublichealth@dph.ga.gov, and all other questions to hai@dph.ga.gov
 
AHCA Resource Related to New Testing Requirements
AHCA has developed several resources to help members understand and meet these new requirements: 
 
AHCA Summary of Testing and Reporting Requirements  
​This resource summarizes the QSO memos and the guidance established by CMS for testing and reporting. 
 
CMS Testing Requirements: Steps to Get Started​  
This resource is geared toward providers who are not routinely testing and need to quickly implement a testing program. 
 
Rapid Point-of-Care Antigen Devices: What SNF's Need to Know 
This resource offers steps providers need to take when they receive their rapid point-of-care antigen devices from HHS. 

Abbott BinaxNOW™  Assisted Living Webinar Presentation

CLIA Information
This booklet describes recommended practices for physicians, nurses, medical assistants, pharmacists, and others who perform patient testing under a CLIA Certificate of Waiver. 

 Visitation Guidance

  • CMS Guidance  
  • DPH Guidance 
    • The DPH guidance has been updated to allow for a 14 day period since last confirmed COVID-19 case prior to progressing beyond Phase 1 rather than 28 days.The Administrative Order also specifies the websites that centers can access to get the information that is required for moving through the phases. CMS has confirmed again that the Agency does not object if centers use a source other than its own for information on positivity rates. The only requirement is that centers be consistent in the source they use, and it must be official and dated. It is critical that centers document your efforts as you move through the phases of visitation.

DCH Updates Rules and Regulations for Disaster Preparedness Plans to include COVID-19 Requirements

DCH has updated Rules and Regulations for Disaster Preparedness Plans, Chapter 111-8-16, to include special requirements for long term care communities related to the COVID-19 pandemic. Click here for the public notice of the proposed rule change and here for a synopsis of the revised rules.  A virtual public hearing is scheduled for September 16, 2020 at 11:00 a.m. at https://dchevents.webex.com/dchevents/onstage/g.php?MTID=e57882a150f60319a2ac391b3ced0b735. You may also comment in writing on or before Spetember 18, 2020 via email to PublicComment@dch.ga.gov.


Guidance for Healthcare Facilities


CMS
CDC
DPH

OSHA

​Environmental Protection Agency
GHCA

AHCA

NRC Health

Alliant Quality

Requesting Civil Money Penalty (CMP) Reinvestment Funds for Communicative Technologies - UPDATED APPLICATION TEMPLATE

Recognizing that visitor restrictions may be difficult for residents and families, CMS has developed an application template for requests for the use of Civil Money Penalty (CMP) Reinvestment funds to provide residents with adaptive communicative technologies and accessories (iPads, tablets, headphones etc.).
 
Click Here for the CMPRP Application Template - Updated 4.29.20

Click Here for Special Instructions for Submitting CMPRP Application Template for Georgia Nursing Centers
 
Applications must be submitted electronically to cmpgrant.hfrd@dch.ga.gov and must be submitted on the application template linked above. NOTE: This template can only be used for communicative technology and accessories for nursing homes.


COVID-19 Specimen Collection Demonstration Videos

AMDA Resource Pages

Optimizing N95 Strategies

Lab Pages

HCBS Resources

Communication Resources

Childcare for Health Care Profesionals

  • YMCA of Metro Atlanta Childcare Program for Hospital Staff & Medical Professionals
  •  Georgia Department of Early Care and Learning Child Care Resources - The Georgia Department of Early Care and Learning has provided a resource for the public to search for child care that is still open while schools are closed amid COVID-19. You may search available child care programs online at www.qualityrated.org, or you can do so by calling 1-877-ALL GA Kids (1-877-255-4254). Employers seeking child care options for a group of 25 employees or more can call 470-426-2610 for direct support.


Telehealth Resources



General Infection Prevention Resources


Infection Prevention Control Recommendations for Patients with Candida Auris
The Centers for Disease Control and Prevention (CDC) is alerting U.S. healthcare facilities to be on the lookout for Candida Auris due to concerns of an increased incidence of Candida Auris. Candida Auris is a type of yeast that may cause severe illness in residents and patients in a variety of health care settings, including long-term care. The yeast can enter the bloodstream and spread throughout the body causing serious invasive infections. Unfortunately, this strain of yeast does not respond to common antifungal drugs, making infections more difficult to treat. People at highest risk of infection with this type of yeast are people who have been hospitalized or live in a healthcare facility a long time, have central venous catheters, or other lines or tubes entering their body, or have previously been receiving antibiotics or antifungal medications. Common symptoms include fever and chills that don’t improve after antibiotic treatment for suspected bacterial infection. Only laboratory testing can diagnose Candida Auris infection. Georgia’s Department of Public Health recommends the following:

  • Place patients infected or colonized with C. auris in a single room on standard and contact precautions.
  • Assess and enhance gown and glove use. This should include ensuring staff have completed PPE donning and doffing training with return demonstration. Audit compliance with PPE selection, use, donning, and doffing for all disciplines and all shifts. Set a facility goal for compliance.  Graph results monthly to easily detect trend and provide feedback to all stakeholders regularly. During auditing, perform real time coaching when non-adherence is observed. Once facility goal is achieved and sustained for a minimum of 3 months, consider de-escalation of auditing frequency (e.g., from monthly to quarterly). Escalation and de-escalation of auditing can be determined by performance.
  • Reinforce hand hygiene. This should include ensuring staff have completed hand hygiene training with return demonstration. Perform auditing and feedback as described for PPE. Hand hygiene auditing should be performed for both opportunity and technique. 
  • Coordinate with environmental services to ensure the patient care environment is cleaned with a disinfectant that is effective against C. auris (i.e., those effective against Clostridioides difficile). Learn more.
  • Work with the environmental services team to monitor the cleaning and disinfection process. 

Further details regarding CDC’s recommendations for infection prevention for C. auris can be found here. Below are additional resources that may assist with your infection control program review and staff education: