Chapter Contents


Testing and Contact Tracing
Alignment of Federal and State Guidelines
End-of-Life Issues
Visitation
Congregate Dining Programs
Lessons Learned: Reopening Guidance


Testing and Contact Tracing

In the event of a pandemic that involves a highly contagious infectious disease, resuming “normal” operations for an aging services provider will greatly depend on reliable testing and contact tracing. Scientific study and research will drive this purpose, as will understanding about the disease itself, and how it can be detected, improves and solidifies. Organizations will need to identify reliable sources of  infectious disease information/data and will need to collaborate closely with state and local health agencies to ascertain the appropriate methods for testing and contact tracing.

Many aspects of testing must be considered and provided: testing methodology, testing supplies, labs for test processing, reliability, speed and accuracy of testing results, frequency of testing, stakeholder groups that will be required or requested to participate in testing, and reporting of test results, to mention a few. The question of what entities will bear the burden of immediate and ongoing testing costs must be negotiated. Organizations should expect to work closely with their trade associations and advocacy groups to ensure that their needs and expenses are well represented to regulatory and legislative bodies with decision-making authority.

Contact tracing will also be of key concern to individuals, organizations, and state and local agencies. Aging services providers will need to be prepared to participate in and report on individuals’ contacts with others, should an exposure to a highly contagious, infectious disease occur within their stakeholder groups. State and local health departments will likely request this information, and providers of care and services will need to be prepared to monitor and protect such information accordingly.

Templates:

Alignment of Federal and State Guidelines

Organizations may find that guidelines for resuming their operations will differ between federal and state agencies; multi-state organizations may discover that guidelines are marginally or markedly different between states. Navigating these differences may present a considerable challenge, and organizations should be prepared to allot significant time and resources to distilling these guidelines down to the essential requirements that must be met to ensure compliance with regulatory bodies such as CMS, OSHA, Life Safety codes, and others. Beyond those compliance-driven requirements, organizations will need to navigate guidelines that leave their implementation to the discretion of organizations themselves.

End-of-Life Issues

As organizations plan to resume operations, they may find it necessary to help residents, persons served, staff, and other stakeholders grieve the loss of life precipitated by the pandemic. Funerals, celebrations of life, and other customary memorial events that may be initially postponed due to the pandemic may now be possible as services and supports return to normal.

Organizations will need to be aware and considerate of these changes, and ensure they are prepared to implement whatever transitional supports or requirements are necessary in End-of-Life situations.

Organizations may find that guidelines for resuming their operations will differ between federal and state agencies; multi-state organizations may discover that guidelines are marginally or markedly different between states.

Visitation

If a pandemic involves a highly contagious, infectious disease, admission of visitors and the general public to aging services providers may be completely restricted or permitted only in end-of-life or compassionate care circumstances. When the time comes to resume visitation, organizations should plan to do so in phases that ensure the safety of all involved, and minimize the risk of disease transmission. Policies and protocols must be developed that thoroughly prepare staff, persons served and family members for the visitation experience. Organizations should refer to their state and local health agencies and governing bodies for guidelines on how to permit safe visitation.

Congregate Dining Programs

To reduce the risk of disease transmission, aging services organizations may elect to pause, alter or reconfigure dining services programs in the event of a pandemic. Congregate meal programs may change significantly or be temporarily halted.

Undertaking the resumption of dining services and/or a congregate meal program will require careful planning and coordination. Organizations that plan to do so should seek guidance from state or local health departments, governing bodies, the Food and Drug Administration, the Centers for Disease Control and Prevention, and other agencies as appropriate.

Lessons Learned: Reopening Guidance

In the midst of an emergency as impactful as a pandemic, we must often act first and reflect later. It’s common for leaders to ask themselves retrospective questions, such as:

  • Did I act too quickly or too slowly?
  • What could I have done differently?
  • Did my approach of choice work as well as I anticipated it would?
  • How can I improve my responses if a pandemic recurs?

And then, of course, there are a lengthy series of “What ifs?” that we ponder.

LeadingAge has received numerous Lessons Learned tips from members during the COVID-19 pandemic, which we are sharing at the conclusion of each related Playbook Section. In addition, a compilation of shared Lessons Learned may be referenced in the Playbook Appendix.

When the time comes to resume visitation, organizations should plan to do so in phases that ensure the safety of all involved, and minimize the risk of disease transmission.

LeadingAge Member Ideas and Inspiration stories:

Audio interviews from LeadingAge Daily Calls:

Other resources:

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