“CMS has issued a series of updated guidance documents focused on infection control to prevent the spread of the 2019 Novel Coronavirus (COVID-19) in a variety of inpatient and outpatient care settings. The guidance, based on CDC guidelines, will help ensure infection control in the context of patient triage, screening and treatment, the use of alternate testing and treatment sites and telehealth, drive-through screenings, limiting visitations, cleaning and disinfection guidelines, staffing, and more
The guidance is particularly timely for dialysis facilities. The updated guidance has multiple facets, including the option of providing Home Dialysis Training and Support services and establishment of Special Purpose Renal Dialysis Facilities (SPRDFs), which can allow dialysis facilities to isolate vulnerable or infected patients. These temporary changes allow for the establishment of facilities to treat those patients who tested positive for COVID-19 to be treated in separate locations.
For hospitals, psychiatric hospitals and CAHs, the revised guidance provides expanded recommendations on screening and visitation restrictions, discharge to subsequent care locations for patients with COVID-19, recommendations related to staff screening and testing, and return-to-work policies.
Similarly, for hospitals and CAHs, the revised guidance on the Emergency Medical Labor and Treatment Act (EMTALA) includes a detailed discussion of: patient triage, appropriate medical screening and treatment; the use of alternate testing sites; telehealth; and appropriate medical screening examinations performed at alternate screening locations, which are not subject to EMTALA, as long as the national emergency remains in force. This step will allow hospitals and CAHs to screen patients at a location offsite from the hospital’s campus to prevent the spread of COVID-19.
For outpatient clinical settings, such as ASCs, FQHCs, and others, guidance discusses recommendations to mitigate transmission including screening, restricting visitors, cleaning and disinfection, and closures, and addresses issues related to supply scarcity, and Federal Drug Administration (FDA) recommendations. In addition, CMS encourages ASCs and other outpatient settings to partner with others in their community to conserve and share critical resources during this national emergency.
Updated guidance for ICF/IIDs, and PRTFs include practices related to screening of visitors and outside health care service providers, community activities, staffing, and more.”