ADMISSION PROCEDURE SCREENING FOR COVID-19

 

RATIONALE FOR PREADMISSION AND ONGOING SCREENING:

COVID-19 EPIDEMIOLOGY:  THE COVID -19 VIRUS DISPROPORTIONATELY IMPACTS THE ELDERLY WITH MORTALITY INCREASING IN EVERY 10 YEAR COHORT TO APPROXIMATELY 30 % FOR THOSE OVER 80 AND THOSE WITH CHRONIC DISEASE.

  • COVID-19 also spreads easily between people, particularly since younger people often have mild symptoms and be infectious to others without symptoms, especially the individual with chronic disease, trauma or immunocompromised.

  • FOR all individuals, the incubation period is 2-14 days, which elevates the concern that individuals may be admitted from the hospital or community and maybe infected but asymptomatic as they’re in their incubation period.   CDC data in MMWR March 27, 2020 found that 57% of elderly patients without symptoms tested positive for COVID -19 who later went on to develop symptoms seven days later.

  • When individuals test positive, they continues to shed virus at levels that make them infectious to others. 

  • THEREFORE, based on CDC data:  unless a person is tested for COVID-19 and negative before admitting. We should assume that the person has COVID-19 regardless of their having or not having symptoms

REMED ADMISSION GUIDELINES FOR COVID -19 PANDEMIC :

  1. At the time of referral to ReMed, the individual/ family/ funder or referring facility will be informed of the need for symptom monitoring and documentation of the same including:

    1. Twice daily temperatures and other vitals.

    2. Reporting of the following symptoms:

      1. Cough, sore throat, shortness of breath, chest discomfort, Gi symptoms, chest pain or discomfort, runny nose, eye irritation/pink eye.

      2. Individuals with positive respiratory symptoms and fever may also be requested to have a flu test prior to admission.

  2. If the individual/ referral source reports positive symptoms, the referred individual will be quarantined for 14 days prior to a scheduled admission date. Documentation will be provided verifying vs monitoring and current status. 

  3. The admission staff will also inquire about congregate activities and exposure to others who may be exhibiting symptoms. This could include staff and clients in the referring facility. (see admission questionnaire).

  4. All individuals referred to ReMed for initial admission or readmission will undergo Covid testing at least three days prior to scheduled admission date.  If the test is positive, the individual will not be scheduled for admission or readmission until for at least 14 days from emergence of symptoms and three days symptom free without Tylenol. They must undergo another COVID test. The admission will be scheduled when the individual is negative.

  5. The individual will have repeat COVID testing within 48 hours of admission to REMED.  The individual/funder/ family will be informed that serial testing will/may be conducted based on ongoing statistical and risk trends for region and care setting.   These screenings will be covered by funder, family or Medicare/ Medicaid plans. ($100)

  6. Admission to ReMed will be contingent on adequate staffing.  Other factors to consider will be the need for physician/medical support and community access.

  7. Transfer to a ReMed Recovery Program for temporary COVID care may be required if symptom recurrence occurs during length of stay.

  8. All referrals will report on immunization status for Flu and Pneumococcal vaccines and if possible have completed prior to admission. (don’t need verified documentation)