A March 6 press call held by Dr. David Gifford, chief medical officer of AHCA/NCAL, revealed that one of the larger issues SNFs and healthcare facilities at large may have is a shortage of gowns, masks, and other personal protective equipment (PPE), much of which usually ships from China.
“It’s one of the issues that keeps me up at night,” said Gifford on the call. Some suppliers of PPE, he noted, are running low, while others have started limiting the size of orders. He said that facilities, when needed, should look to their neighboring healthcare providers to share such supplies. He said this will help to avoid a situation in which a facility in need runs of supplies, and consequently must transfer residents to a facility better equipped. Gifford also shared that federal agencies are looking into increasing production of such supplies in the U.S. Right now, he said, there is no estimate for how long existing stocks of supplies will last.
Gifford noted that state agencies generally keep a stock pile of supplies some LTC facilities have turned to Amazon and Costco for supplies.
Testing is of course, another issue. “We are trying to make the plea to the health departments and hospitals where they have testing that LTC be included in the priority list that’s being generated,” Gifford said. Priorities in locations with community spread might differ from those who need surveillance. He added that while test availability have been short, there has been a recent dramatic increase in the number of tests and labs making tests.
Gifford also discussed new CMS guidance that will help SNFs navigate visitation policies. Because LTC facilities have so many elderly high-risk residents, the worry is that a young visitor who is asymptomatic but has been exposed, or has a mild case of COVID-19, could bring trouble. And while Gifford has not yet heard of facilities barring all visitors entirely, as a precaution, he said it wouldn’t surprise him if facilities choose to do so in areas where there has been community spread.
He also notes that residents with mild cases does not necessarily need to be transferred to a hospital, which in the case of residents with dementia or other medical issues, might create other health concerns.
Gifford also said that in the event of emergency, it’s up to states to decide whether to allow clinical staff licensed in one state to work in another.