ADMISSIONS GUIDELINES DURING COVID-19 PANDEMIC

 

Policy:

It is ReMed’s policy to protect the health and safety of all clients, potential clients, families and staff during the referral, intake, admissions and subsequent treatment processes. ReMed will follow CDC guidelines in formulating necessary protocols and procedures to address the unique issues of serving individuals with brain injury during the COVID-19 pandemic.  

 

Rationale:

The COVID-19 virus disproportionately impacts the elderly and those with chronic disease and medical co-morbidities. Individuals who have sustained brain injuries are, therefore, at higher risk for contracting this virus.

 

Additionally:

  • Research has shown that COVID-19 spreads easily between people, and that many with the virus may be asymptomatic but infectious to others.

  • The incubation period for COVID-19 is 2-14 days, which elevates the concern that individuals may be admitted from the hospital or community and maybe infected but asymptomatic.  

  • Therefore, based on CDC data, unless a person is tested for COVID-19 and negative before admitting, it will be assumed that the person has COVID-19 regardless of their having or not having symptoms

 

1. Referrals

a. ReMed will continue to take referral calls and move clients through the referral to admission process.

b. All non-essential tours have been suspended. Pictures and video meetings will be used to discuss programs and show settings.

2. Intakes

a. Most intakes will be completed via video conference.  The computer application “GoTo Meeting” will be used as it is HIPAA compliant.  All intakes need to be coordinated and scheduled through the Director of Provider Relations.

b. A complete set of medical records will be needed for review since the prospective client will not be able to be seen in person. If the client is currently in a facility, a team meeting with the current team/social worker/case manager, referral source, funder contact, and any other involved parties will be requested to gather the most information possible regarding the individual’s history, trauma event and current status.

c. The Admissions team and Vice President of Clinical Services may determine if a prospective client can be seen at ReMed or in a facility on a case by case basis. 

3. Admission Guidelines for Admission during the COVID-19 pandemic:

a. 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:

i. Twice daily temperatures and other vitals.

ii. Reporting of the following symptoms:

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

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

 

b. 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 vital signs monitoring and current status. 

c. 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.

d. Additional Screening Questions will include:

i. Are you, or anyone in your family, displaying signs or symptoms of a respiratory infection?

ii. In the last 14 days, have you had contact with anyone confirmed with or under investigation for COVID-19?

iii. Have you, or anyone in your family, traveled internationally or to anywhere on the states travel advisory list, in the last 14 days?  Links for PA & NJ are below.  There are no current links for Maryland or Louisiana.

Pennsylvania Listing:

https://www.health.pa.gov/topics/disease/coronavirus/Pages/Travelers.aspx

 

New Jersey Listing:

https://www.health.pa.gov/topics/disease/coronavirus/Pages/Travelers.aspx

 

iv. Do you reside in a community where community spread of COVID-19 is occurring?

v. Have you or anyone in your family been in large, congregated situations in the last 30 days (e.g.: church, gym, hospital, entertainment situation)?

vi. Have you or anyone in your family been in locations with groups larger than 6 in the last 30 days?

e. 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. The individual must undergo another COVID test, and the admission will be scheduled when the test is negative.

f. 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.

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

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

i. All referrals will report on immunization status for Flu and Pneumococcal vaccines and if possible, have completed prior to admission.

updated 9/2020