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Nursing HomesAssisted Living/Board & Care Home and Community Based Services

Coronavirus Prevention in LTC Facilities: Information for Long-Term Care Ombudsman Programs

Updated September 22, 2020

As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve, it is important for Ombudsman programs and other advocates to be informed and take precautions in order to prevent the spread.

For more information, visit:

ACL COVID-19 page    CMS COVID-19 page    
 
Consumer Voice COVID-19 page    CDC COVID-19 page


The information on this page includes tips for preventing the spread of COVID-19, alternative ways to stay in touch with residents, and links to additional information. Jump to:


ACL Resources

ACL: Long-Term Care Ombudsman Programs Reporting Requirements for CARES Act Funding - May 4, 2020

ACL: State Allocations and Program Allocations for CARES Act Funding (ACL website)

ACL: Long-Term Care Ombudsman Program-Fiscal and Programmatic FAQs: The Coronavirus Aid, Relief, and Economic Security Act (CARES ACT)

ACL: Long-Term Care Ombudsman Program Frequently Asked Questions – COVID-19

ACL: Long-Term Care Ombudsman Program and COVID-19 Overview - March 10, 2020

Emergency Preparedness and Response:  Model Policies and Procedures for State LTCO Programs - November 23, 2015


CMS Resources

NEW! CMS Memo (QSO-20-39-NH) on Nursing Home Visitation - September 17, 2020

CMS Coronavirus COVID-19 Stakeholder Calls
This page holds all Partner Relations Group Podcasts, transcripts, and audio recordings. CMS makes Open Door Forums and other presentations available as an audio podcasts. The Podcasts are available, free of charge.

NEW! CMS Memo (QSO-20-35-ALL) on Survey Activities and Enforcement - August 17, 2020

NEW! CMS COVID-19 Nursing Home Data - July 18, 2020

NEW! CMS Resources to Protect Nursing Home Residents Against COVID-19 - July 22, 2020

REVISED! CMS Guidance (QSO-20-28-NH) on Nursing Home Five Star Quality Rating System updates, Nursing Home Staff Counts, Frequently Asked Questions, and Access to Ombudsman – July 9, 2020

CMS Press Release: Nursing Home Residents’ Right to Retain Federal Economic Incentive Payments – June 11, 2020

CMS Memo (QSO 20-32-NH) Release of COVID-19 Nursing Home Data – June 4, 2020

CMS Press Release: Nursing Home COVID-19 Data and Inspections Results Available on Nursing Home Compare – June 1, 2020

CMS Memo (QSO-20-31-All) to State Survey Agency Directors Focused Infection Control Surveys and CARES Act Supplemental Funding – June 1, 2020

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CMS Letter to Governors – May 31, 2020

CMS Nursing Home COVID-19 Data Chart and Website – May 24, 2020

 Press Release: HHS Announces Nearly $4.9 Billion Distribution to Nursing Facilities Impacted by COVID-19 - May 22, 2020 

CMS Guidance (QSO-20-30-NH) on Nursing Home Reopening Recommendations for State and Local Officials (press release and FAQs) - May 18, 2020

CMS Press Release on Trump Administration Changes to Support U.S. Healthcare System During COVID-19 Pandemic - April 30, 2020

CMS Guidance (QSO-20-28-NH) on Nursing Home Compare Updates, Nursing Home Staff Counts, and FAQs - April 24, 2020

Civil Money Penalty (CMP) Application for Communicative Technology Requests - April 24, 2020
Recognizing that visitor restrictions may be difficult for residents and families during COVID-19, CMS has developed this application template and application approval letter for requests for the use of Civil Money Penalty (CMP) Reinvestment funds to provide residents with adaptive communicative technologies. Applicants shall submit this CMP Reinvestment Application to the applicable state agency (SA). The SA shall make a determination on the potential of the project to benefit nursing home residents and improve their quality of care or quality of life. The applicant will be notified by the SA about a funding decision, and applicants may contact the applicable SA with questions about their CMP Reinvestment Application. For additional information review the CMP Application for Communicative Technology Requests Frequently Asked Questions (FAQs) for State Medicaid Agencies

CMS Memorandum (QSO-20-25-NH) on COVID-19 Long-Term Care Facility Transfer Scenarios - April 13, 2020

Revised Guidance for Nursing Homes (press release) - April 2, 2020

COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers - March 30, 2020

CMS Waivers for Long-Term Care Facilities: CMS Flexibilities to Fight COVID-19 - March 28, 2020

Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit - March 28, 2020

Revised Guidance for Surveyors (QSO-20-20-All) - March 23, 2020

Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes (QSO-20-14-NH REVISED) (press release) - March 13, 2020

Press Release: CMS Announces Actions to Address Spread of Coronavirus - March 4, 2020

Suspension of Survey Activities - March 4, 2020

Guidance for Infection Control and Prevention Concerning Coronavirus Disease (COVID-19): FAQs and Considerations for Patient Triage, Placement and Hospital Discharge - March 4, 2020

Coronavirus – Updates for State Surveyors and Accrediting Organizations 

 

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CDC Resources

CDC: Return to Work for Healthcare Personnel with Confirmed or Suspected COVID-19 - April 13, 2020

CDC: Recommendation Regarding the Use of Cloth Face Coverings, Especially in Areas of Significant Community-Based Transmission - April 3, 2020

CDC: Coronavirus Disease 2019 (COVID-19) Preparedness Checklist for Nursing Homes and other Long-Term Care Settings

CDC: Frequently Asked Questions on COVID-19 Testing at Laboratories

CDC: Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities

CDC: Clinical Outreach and Community Activity (COCA) Calls – Coronavirus Disease 2019 


NORC Resources

 
 

 
 

  

 

 

 

 

 

 

 

NEW! NORS FAQs on Documenting Activities During COVID-19 (View the FAQs as a PDF)

Long-Term Care Ombudsman Program Postcard
This postcard is available in three versions and can be used by long-term care Ombudsman programs or long-term care facilities to share information about the Ombudsman program. Programs can personalize the postcards and/or print and share them with residents and family members. Version 1 - 8.2 x 5.8 PostcardVersion 2 - Printable Half Sheet, Version 3 - Printable Half Sheet with space for program contact information 

NOTE: The postcards are available for free printing and shipping for Ombudsman programs. It is printed on 8.2 x 5.8 card stock postcard paper. If your program is interested in receiving free copies of this postcard, email ombudcenter@theconsumervoice.org. Supply is limited.

NORC Infection Control Issue Page


NORC Webinars

Ombudsman Program Communication and Advocacy During COVID-19 Webinar (June 23, 2020)

View the PowerPoint slides as a PDF or PPT

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Materials

In-person visitation restrictions intended to reduce the spread of Coronavirus Disease 2019 (COVID-19) required Ombudsman programs to adapt quickly to ensure residents have access to program services. In-person visits with residents are a core part of Ombudsman program outreach and advocacy and there is no substitute for that connection and experience. However, during this crisis programs must use other means to connect with residents to provide information and respond to complaints. During this webinar presenters shared state and local examples of how to they are communicating with residents to make sure their experiences are heard and concerns are addressed.

Speakers: Carolyn Tenaglia, Northeast Region Ombudsman, Pennsylvania LTCOP; Kim Shetler, Northcentral Region Ombudsman, Pennsylvania LTCOP; Kim Palmore, Managing Local Ombudsman Texas LTCOP, Ark-Tex Council of Governments/Area Agency on Aging; Vicki Elting, Assistant State LTC Ombudsman, Washington State LTC Ombudsman Program; Beverley Laubert, Ohio State Long-Term Care Ombudsman; and Kathleen Heren, Rhode Island State Long-Term Care Ombudsman.

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Four-Part Webinar Series - COVID-19 and Ombudsman Programs: Understanding How Trauma Impacts You, Residents, and Your Advocacy

In partnership with the Colorado Long-Term Care Ombudsman program, Consumer Voice and NORC are offering a four-part webinar series regarding the impact of trauma due to the COVID-19 pandemic on long-term care residents and Ombudsman programs.The webinar series will highlight important themes related to trauma-informed care, person-centered care, compassion fatigue, and vicarious trauma. The series will include case studies, self-reflection activities and exercises, and materials for attendees. 

Read Dr. Sheri Gibson's bio

The presenter, Dr. Sheri Gibson, received her Ph.D. in Clinical Psychology with an emphasis in Geropsychology from the University of Colorado, Colorado Springs (UCCS). She is an instructor and clinical supervisor for the Psychology Department at UCCS and a faculty affiliate with the UCCS Gerontology Center.  Dr. Gibson serves on the editorial board for the Journal of Elder Abuse & Neglect, is a member of the Research Committee for the National Adult Protective Services Association (NAPSA), and a member of the Pikes Peak Elder Abuse Coalition. She has been recognized for her trainings on person-centered and trauma informed care approaches with older adults among professional programs such as Adult Protective Services, Area Agencies on Aging, long term care facilities, and community outreach Veteran services.

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Part I: April 29, 2020

View the slides as a PDF or PowerPoint with presenter notes.

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This webinar addressed person-centered, trauma-informed care. Highlights included:

  • What "person-centered care" and "trauma-informed" care means. 
  • Why person-centered care and trauma-informed care is critical in a crisis. 
  • The impact that re-traumatizing events can have on a trauma survivor, including residents, facility staff, and Ombudsman program representatives. 
  • How to recognize and respond to the effects of all types of trauma. 
  • The bio-psycho-social components of trauma-informed care to support survivors in rebuilding a sense of control and empowerment.
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Part II: May 20, 2020

View the slides as a PDF or PowerPoint with presenter notes.

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Materials

This webinar addressed compassion fatigue and vicarious trauma to help attendees:

  • Understand the differences between sympathy, empathy, and compassion. 
  • Understand the unique symptoms associated with and contributing factors leading to burnout, compassion fatigue, and vicarious trauma. 
  • Recognize symptoms of compassion fatigue at the individual and organizational level and being able to identify negative outcomes if left untreated. 
  • Increase competency in implementing resilience strategies – at the individual level as well as the organizational level – to enhance self-awareness and prevent onset or worsening of symptoms.
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Part III: June 17, 2020

View the slides as a PDF or PowerPoint with presenter notes.

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Materials

This webinar addressed anxiety related to COVID-19, coping mechanisms, and tools for you and to help others. Dr. Gibson discussed coping strategies in response to COVID-19 related anxiety to assist Ombudsman programs and the residents you serve. She also highlighted two tools, a COVID-19 anxiety scale, and a coping tool that provides simple, practical steps to recognize and address anxiety.

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Part IV: July 29, 2020

View the slides as a PDF or PowerPoint with presenter notes.

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Additional Materials and Information Discussed During the Webinar:

This webinar addressed understanding and coping with grief during COVID-19.

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Consumer Voice Resources

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NEW! Family Advocacy for Nursing Home Residents During COVID-19

NEW! Family Council Advocacy During COVID-19

NEW! Consumer Voice Tool: State COVID-19 Nursing Home Policies

Consumer Voice Summary: CMS Information Related to COVID-19 Released June 1, 2020 - June 4, 2020

Consumer Voice Webinar Series - COVID-19: Advocating for Nursing Home Residents 

Consumer Voice COVID-19 Frequently Asked Questions Webpage

Consumer Voice Summary of Supplemental Information for Transfer/Discharge Issued by CMS - April 13, 2020

Consumer Voice Summary of Revised Guidance for Nursing Homes - April 2, 2020

Consumer Voice April 2020 Issue of The Resident Advocate Newsletter on COVID-19 - April 2020

Consumer Voice Summary of CMS Waivers for Long-Term Care Facilities - March 28, 2020


General Tips for Prevention, Communication, and Self-Care

Review these resources to help stop the spread:

Remind staff and volunteers to contact their supervisor and/or State Ombudsman if they are sick. Recommend that they contact their healthcare provider if they are sick for medical advice.

Advise staff and volunteers to monitor for symptoms and contact their healthcare provider for advice if they have symptoms and/or want to be tested.

Communicating with Residents, Families, Long-Term Care Facility Staff, and Others

Review the FAQs and memo from ACL for additional information for Ombudsman programs.

  • Ombudsman programs are to serve as a resource and refer individuals to appropriate public health entities, not attempt to answer specific questions about COVID-19.
  • Share information from the CDC with facilities and others by phone, email, mail, social media, and program websites.
  • During the quarantine, communication can occur by other means such as phone, email, video conferencing with individual residents, Resident Council leadership, staff, and families.
  • Obtain resident census lists, contact information for resident representatives, and contact information for Resident and Family Council leadership. If possible, identify 2-3 residents in each facility and establish regular calls/emails/videocalls to check in.
    • Ask if residents have access to a computer, tablet or a smart phone, and if they are interested in video chats or conferences. Confirm with your host agency if video chats and conferences can be an option to communicate with residents, families, and others.
    • Ask residents if they have email addresses and if they would like to receive email updates or correspond through email.
    • Ask residents if they prefer that you contact a representative for ongoing communication.
  • Post Ombudsman program contact information on front door. Make brochures available outside by the front door, if practical.
    • Send business cards and program brochures to long-term care facilities to share with residents, family members, and others. NORC created a free postcard template in three downloadable options, including one with space to customize with program contact information. 
  • Encourage facility staff to distribute your email address as an alternate way to communicate with residents and family members or legal representatives. You may experience higher call volume due to COVID-19 and email may allow a shorter response time.
  • Provide information regarding visitation restrictions from the recent CMS guidance and how to contact your program on your program’s website, via email, e-newsletters, and social media. 

Examples of Communication with Residents and Family Members

  • Postcards from the Ohio Ombudsman program
  • 30 and 15 second videos produced by the East Alabama Regional Planning & Development Commission on wearing a mask, the local Ombudsmen participated in the video.
  • Missouri Long-Term Care Ombudsman Program Video
  • Utah Resident Newsletter
  • The Kern County Ombudsman program in California produced a 30-second and 60-second PSA Volunteer Long-Term Care Ombudsman video that is airing on three local TV stations. The videos are also available as audio files (30-seconds, 60-seconds) so they can be aired on local radio stations.
  • Ohio Statewide Ombudsman Volunteer Snapshot - This infographic is created each month by Ohio's state-level volunteer coordinator to highlight Ombudsmen work during this time.
  • Iowa Ideas for Socializing While Maintaining a Six-Foot Distance
  • Iowa Creative Ideas and Best Practices for Staying Connected During COVID-19
  • Alabama Quarantine Activity Booklet - The Ombudsman program representatives at Central Alabama Aging Consortium put together this booklet to help combat the loneliness, isolation, and boredom during the COVID-19 pandemic.
  • Kentucky Nursing Home Ombudsman Agency Commitment Video to Kentuckians Living in Long-Term Care
  • Iowa Resident Check-In Questions
  • Georgia Resident Interviews
  • Illinois Ombudsman Program Guidance on Window Visits
  • The South Program of the Georgia Long-Term Care Ombudsman Program has started a newsletter sent to all nursing home residents.  The newsletter includes Ombudsman contact information and news that affects them. In addition, they included several puzzle types using themes that tie into the news. 
  • The Oklahoma Office of the State Long-Term Care Ombudsman worked with Dr. David Herendeen, Director of Opera and Musical Theater at Oklahoma City University, to share the power of music and theater with long-term care residents. Dr. Harendeen and his students have created a YouTube channel to share music with long-term care residents and anyone else who wishes to listen. 
  • The Connecticut and Texas Long-Term Care Ombudsman Programs shared these Care-A-Van infographics on their Facebook pages as an idea for families and facilities to celebrate Mother's Day when long-term care facility visits aren't possible. 
  • The Texas Ombudsman program is hosting weekly Facebook Live Q&A events for residents and family members to ask the Ombudsman program questions.
  • Texas Ombudsman program representatives, Vanessa Conway and Kim Palmore, visited a nursing facility and gave window hugs to residents. They made signs with positive messages and went to each window that was open. The residents waved, blew kisses, and gave air hugs. View Picture 1, Picture 2, and Picture 3.
  • The Pennsylvania Ombudsman program representatives started a new Facebook page titled Virtual Visits of Cheer and Support. On the page people are creating and posting videos to say hi and support nursing home and personal care home residents.
  • Children can participate in the Maine Notes for Seniors initiative by writing notes, uploading a drawing, or sending a short video to residents in nursing homes and assisted living facilities. 
  • Michigan Attorney General, Dana Nessel, made a video on visiting at the window of a nursing home. 
  • The Pennsylvania Ombudsman program launched a statewide Virtual Family Council based on Zoom that will meet weekly for as long as necessary. Program representatives will facilitate the meeting and 10 representatives are contributing to the structure, content, and outreach. The meetings will educate, support, and gather information from the families. The program has created materials and a corresponding Facebook page that includes a button to allow for families to request the link for the call. This information was also sent to local legislators for their offices, the Department of Health, and the Department of Human Services.
  • AARP Texas hosted Texas State Long-Term Care Ombudsman, Patty Ducayet, on Facebook Live for a conversation about nursing homes, assisted living facilities, and care for loved ones during the pandemic.

Examples of Communication with Long-Term Care Facility Staff

Review this NORC tip sheet for additional examples and considerations for communication with residents, families, long-term care facility staff, and others and find additional examples and ideas for staying connected with residents living in long-term care facilities on the Consumer Voice website.

Taking Care of You

SAMHSA’s Disaster Distress Helpline Toll-Free: 1-800-985-5990 (English and español)
SMS: Text TalkWithUs to 66746 SMS (español): “Hablanos” al 66746 TTY: 1-800-846-8517
Website: (English) (Spanish)

SAMHSA’s National Helpline Toll-Free: 1-800-662-HELP (24/7/365 Treatment Referral Information Service in English and español) 
Website:  (English)

National Suicide Prevention Lifeline Toll-Free (English): 1-800-273-TALK (8255)
Toll-Free (español): 1-888-628-9454 TTY: 1-800-799-4TTY (4889)
Website: (English) (Spanish)

COVID Coach Mobile App

Tips from a Mental Health Practitioner

What to Do in These Stressful Times: A Blog by Susan Wehry, MD

Free Online Class from Yale: The Science of Well-Being

The American Red Cross is Offering Mental Health First Aid for COVID-19 Online Course


Additional Resources and Information

 

NEW! KFF: State Data and Policy Actions to Address Coronavirus - July 27, 2020

NEW! HHS and FEMA: Free Face Coverings for the Aging and Disability Networks - June 18, 2020

NEW! Alzheimer's Association COVID-19 Resources - June 2, 2020

FEMA: COVID-19 Pandemic Operational Guidance for the 2020 Hurricane Season - May 2020

Dementia and COVID-19: How to Help People Living with Cognitive Changes - May 21, 2020

NCLER Practice Tip on Stimulus Payments and Representative Payees: What You Need to Know - May 28, 2020

NCLER Tip Sheet: Advance Care Planning and COVID-19 - May 20, 2020

Institute on Aging Fact Sheet: COVID-19 Related Scams (English, Spanish, Chinese, Russian) - May 15, 2020

NCLER Fact Sheet: Nursing Home Residents, Medicaid, and Stimulus Checks: What You Need to Know - May 7, 2020

American Bar Association: Frequently Asked Questions by Guardians about the COVID-19 Pandemic - Updated June 16, 2020

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Kaiser Family Foundation: State Reporting of Cases and Deaths Due to COVID-19 in Long-Term Care Facilities - April 23, 2020

Letter to Faith Community Leaders to Increase Efforts to Connect with and Support Older Survivors of Abuse - April 23, 2020

American Council on Aging: Do COVID-19 Stimulus Checks Impact Eligibility for Persons on Medicaid? In Nursing Homes? Or Spouses? - April 16, 2020

Notification of Enforcement Discretion for Telehealth Remote Communications during the COVID-19 Nationwide Public Health Emergency (memo) - March 17, 2020

Alzheimer’s Association: Emergency Preparedness: Caring for persons living with dementia in a long-term or community-based care setting (press release) - March 30, 2020

Alzheimer's Association Webpage: COVID-19 Tips for Dementia Caregivers in Long-Term or Community-Based Settings 

NCOA: Tools for Reaching a Remote Audience - April 3, 2020

Coronavirus Aid, Relief and Economic Security (CARES) Act Signed into Law
The President signed the Coronavirus Aid, Relief and Economic Security Act, or CARES Act, into law. The Act provides a total of $2.2 trillion, with $955 million directed to Administration for Community Living (ACL) programs, which includes $20 million for the Ombudsman Program under Title VII of the Older Americans Act (OAA). ACL staff are developing FAQs and other technical assistance materials which will be available on the ACL COVID-19 page. Read more on the CARES Act on the ACL website.

Justice in Aging: Nursing Facilities and Assisted Living During the COVID-19 Emergency Webinar Recording (PowerPoint Slides)

AMDA: COVID-19 in PALTC settings

Long-Term Care Community Coalition: Protecting Vulnerable Residents from Coronavirus

 

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