So, now it's happened. We have the pandemic called COVID-19. The coronavirus causes illness ranging from the common cold to more severe respiratory infections. COVID-19, the most recently discovered coronavirus disease, was first seen in December 2019 in China.

All of your planning and preparing - as required by CMS - is now being put to the test with corona virus in US.  In the event of emergencies such as these, your agency should have the following emergency preparedness plan to maintain uninterrupted communication between Agency decision makers and caregivers, and uninterrupted home care services to priority flu patients...

1. Patient Care Policies During Emergencies.

WHAT SHOULD BE IN PLACE: Policies and procedures that prioritize how and which patients get care during an emergency: i.e. those with medications and/or procedures - that can be administered only by a skilled, healthcare professional - should be the only consumers receiving care. 

Patients should receive a copy of these emergency-care policies and procedures AT ADMISSION.

WHAT YOU CAN DO IF NOT IN PLACE: Download, customize and print the Patient Teaching for COVID-19 handout. This provides standard home health policies for patient care during an emergency.

2. Maintain a toll-free telephone hotline staffed with live personnel or a recorded line to provide guidance to patients.

WHAT SHOULD BE IN PLACE: Staff and patients need an easy method for obtaining updates on delivery of home health services during a pandemic, flood, fire, hurricane, tornado, blizzard, wind storm, and any other disaster. This hotline should be a recorded message that advises staff on whether they should perform assignments as scheduled, or stay home. The message should alert emergency staff of the number they can call to communicate with Patient Care Management and get assignments of high-priority patients. This toll-free hotline should be maintained 24 hours per day, 7 days per week. Any time a staff member has a question about the status of an assignment because of inclement weather - or any other reason - s/he will call the hotline.

WHAT YOU CAN DO IF NOT IN PLACE: Establish a recorded message that patients can listen to when calling your Agency's telephone number that provides guidance on how the Agency is providing care during the COVID-19 outbreak.

3. Contingency plan established for each and every patient.

WHAT SHOULD BE IN PLACE: The admitting nurse or therapist documents who will provide patient care in the event of an emergency. Admission for home health services MUST be contingent upon the patient having a reliable neighbor, family member, or community member that can make sure the patient is safe in the event of a disaster or emergency.

WHAT YOU CAN DO IF NOT IN PLACE: Determine if the patient is high-priority and requires skilled care for medication or procedure administration and provide those services. Otherwise, resume services after the threat of infection is eliminated.

4. Start discharge planning on the first visit.

WHAT SHOULD BE IN PLACE: Patient teaching for discharge planning should start at the admission visit. Comprehensive Teaching Guides should be provided to the patient/family to prepare for independence in medical care. Accordingly, the patient/family should be prepared for independence and discharge right at the very beginning of care for circumstances such as the occurrence of a natural disaster.

WHAT YOU CAN DO IF NOT IN PLACE: Start incorporating a comprehensive patient teaching system.

5. Maintain and Update High-Priority Patient List Weekly.

WHAT SHOULD BE IN PLACE: Care management should update the High-Priority Patient List on a weekly basis. This list should list all of the Agency’s patients/family members that are unable to manage critical treatments - such as insulin administration or parenteral nutrition therapy. Care management should also be required to notify the patient’s local police and fire station of any patient/family who is dependent on critical treatments. In the event of a  disaster in which emergency caregivers can be mobilized, high-priority patients will be visited by their own emergency caregivers. In the event of a disaster that prevents even emergency caregivers from being mobilized, the Agency will alert the police or fire station to mobilize emergency transportation to move the patient from the home to a hospital.

WHAT YOU CAN DO IF NOT IN PLACE: Provide patient care only to those patients who do not have a contingency plan and require skilled care.

6. Maintain a list of Emergency Caregivers.

WHAT SHOULD BE IN PLACE: Scheduling Coordinator should maintain a list of staff that have elected to be available for emergency assignments in the event of a disaster. Emergency staff are selected based on home location and reliability of their transportation so that they can travel safely to high priority patients that are in close proximity. In the event of an emergency, Care Management should contact all scheduled patients and contingency plans to advise them when to (1) activate the contingency plan, (2) expect an emergency caregiver to be performing the visit, or (3) expect emergency transportation from the local police or fire department to be activated to get the patient to a facility.

Emergency caregivers are provided with Personal Protective Equipment (PPE) for patient and self-protection.

WHAT YOU CAN DO IF NOT IN PLACE: Provide necessary resources (PPE) to employees who can continue to provide patient care. Provide patient care only to those patients who do not have a contingency plan and require skilled care.

7. Maintain a list of patients with equipment that requires electricity.

WHAT SHOULD BE IN PLACE: Documentation should be maintained of the working condition of back-up power supplies such as batteries and/or generators for patient equipment that requires electricity including back-up oxygen, self-inflating resuscitation bags, spare breathing circuits, and ambu-bags.

WHAT YOU CAN DO IF NOT IN PLACE: Start documenting this information.

Home Health CoPs: Emergency Preparedness

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