DOH Issues Updated Guidance for ACFs Regarding Infection Prevention and Control
On April 18th, the Department of Health (DOH) issued an updated infection prevention and control advisory to adult care facilities (ACFs). Many aspects of the guidance affirm practices already in place and link to several previously issued advisories. We recommend that you review the advisory carefully to ensure compliance; however, below is an outline of those aspects that are notable, with summaries of linked guidance when possible:
- ACFs must contact the DOH Division of Adult Care Facility and Assisted Living Surveillance regional office program staff before implementing any plans to modify heating, ventilation, or air conditioning systems within the building.
- Assisted Living Residences (ALRs), Enhanced Assisted Living Residences (EALRs), Special Needs Assisted Living Residences (SNALRs), and Assisted Living Programs (ALPs), or any ACF that is caring for one or more residents with SARS-CoV-2 infection, should adhere to applicable recommendations issued by the Centers for Disease Control and Prevention (CDC) in "Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic."
- In collaboration with local health departments, all ACFs should continue to conduct case investigations to identify residents, facility staff, and visitors with close contact or facility staff with higher-risk exposure to a person with COVID-19. Of note is the definition of “close contacts.” The advisory directs ACFs to review the CDC guidance entitled "Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2," notably the chart entitled "Recommended Work Restrictions for HCP Based on Vaccination Status and Type of Exposure," for staff trained in the use of all recommended personal protective equipment (PPE) and standard and transmission-based precautions.
- When evaluating a close contact or higher-risk exposure, consider the time spent with someone with SARS-CoV-2 infection starting two days before the infected person developed symptoms, or the collection date of the test if they remained asymptomatic, until the start of isolation.
The advisory references updated ACF visitation guidance issued last month, as well as more general guidance including:
- A March 2, 2022 directive stating that all ACF personnel, regardless of vaccination status, must wear masks. Additionally, all visitors above the age of two who are able to medically tolerate must also wear a face covering or mask.
- A March 1, 2022 directive regarding isolation and quarantine guidance, which includes a section for ACFs and other populations indicating that they should continue to follow previous guidance for a 10-day quarantine or isolation for residents/clients. While staff in these same facilities can isolate or quarantine for five days according to the guidance in this document, they should furlough (not work) for 10 days following infection or exposure due to the high-risk population served in these facilities. If staffing shortages jeopardize the safe provision of services or resident health and safety, facilities may implement a five-day duration of furlough to the extent necessary.
The guidance stresses the need to provide ongoing education to staff, residents, families, and visitors on infection prevention and control measures and provides resources from the CDC, including considerations for memory care units. The advisory suggests providing signs or posters at the entrance and in strategic places.
The guidance also reminds providers of practices including a visitor screening process and a screening process for residents leaving and returning to the facility as outlined in the March visitation guidance.
Contact: Diane Darbyshire, firstname.lastname@example.org, 518-867-8828