COVID-19 Tools for LTCF

Below are the documents you need to report to the state. Please return the contact form, so the DHHS team has your information if there’s ever a need to reach out to you, and your template with all the results, positives and negatives within 24 hours of testing to dhhs.epi@nebraska.gov   Note: you only need to fill in the contact sheet once.  Please contact Nebraska ICAP or dhhs.epi@nebraska.gov to obtain the password for the template.

Dr Fein at DHHS (Rebecca.Fein@nebraska.gov) is the reporting authority for assisted living facilities. ICAP usually gets AL data from this reporting system.

If any additional reporting is required, Dr. Fein will know and the attached forms will get you started. However, it is best to check with Dr. Fein on if it is necessary for you.

Implementation Guide – for CSV or Excel files reportings

NEDHHS Pre-Onboarding form Version-2.1

Reporting Template for Labs

Where to Set up COVID – 19 Vaccination for Residents in the Building: Considerations for Long – Term Care Facilities

CDC Post Vaccine Considerations for Healthcare Personnel

CDC Post Vaccine Considerations for Residents

CDC COVID-19 Vaccination

Pregnancy COVID-19 Vaccine Decision Aid

STOP Sign for Visitors : “Help Protect Our Residents”

Visitor Screening for LTCF 3.16.2020

Visitor screening Log for COVID-19 LTCF 3.16.2020

AMDA Resident Screening Form

CDC’s Additional COVID-19 Guidance for Caregivers of People Living with Dementia in Community Settings

CMS Prioritization of Survey Activities Ref: QSO-20-20-All

CMS COVID-19 Long-Term Care Facility Guidance 4.2.20

OSHA Respiratory Protection Guidance

02.10.22 Zones and PPE

08.26.21 Cohorting Plan for LTCF

03.24.21 LTC Respiratory Protection Plan Template

Eye Protection Risk Assessment updated 03.24.22

COVID-19 Outing Risk Assessment Template

ICAP Suggested Plan for Managing New Admissions, Readmissions and Return from Community Outings

COVID-19 in Post Acute and Long Term Care (PALTC) settings – from AMDA

04.16.20 PPE use when a LTCF has a COVID 19 infection – ICAP guidance

03.20.20 Preventing the Spread of COVID-19 in Retirement Communities and Independent Living Facilities (Interim Guidance)

03.20.20 Guidance for Retirement Communities and Independent Living: Plan, prepare, and respond to coronavirus disease 2019

03.13.20 Coronavirus Disease 2019 (COVID-19) Preparedness Checklist for Nursing Homes and other Long-Term Care Settings

Actions needed to be taken upon identification of a Covid-19 case 2.10.22

CDC Nursing Home Testing Algorithm – Considerations for Interpretation of Antigen Tests in LTCF

What to expect during COVID testing, in many languages

7.9.20 DHHS Packaging and Shipping Instructions for LTC COVID-19 Tests

7.9.20 Testing Instructions Long-term Care Facilities Abbreviated Registration – Test Nebraska

CDC Interim Guidance for Rapid Antigen Testing for SARS-CoV-2

08.26.20 Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to COVID-19 Focused Survey Tool

BD Veritor Plus:

08.27.20 Product Sheet: BD-Veritor-Plus-SARS-CoV-2_Package Insert

BD Veritor Training Module with Quiz & Printable Certificate (user ID needed)

09.03.20 ICAP Adapted BD Veritor COVID POC Testing Log

Quidel Sophia FIA:

08.27.20 Product Sheet: Sofia_SARS_Antigen_FIA_Pkg_Insert_EUA

09.03.20 ICAP Adapted Quidel Sofia COVID POC Testing Log

Abbott Binax NOW:

09.18.20 Abbott BinaxNOW Webinar for AL v CONSOLIDATED

05.18.20 CMS Nursing Home Reopening Recommendations for State and Local Officials

CMS Frequently Asked Questions (FAQs) on Nursing Home Visitation

State Fire Marshall Temporary Isolation Barrier Requirement form

American Society for HealthCare Engineering (ASHE) COVID-19 FAQ

American Society for HealthCare Engineering (ASHE) Negative Pressure Patient Room Options

American Society of Heating, Refrigerating and Air-Conditioning Engineers Healthcare Guide to the COVID-19

CDC Guidelines for Environmental Infection Control in Healthcare Facilities – Air

09.04.20 MN Department of Health, Heating Ventilation and Air Conditioning (HVAC) and Fan Considerations for LTC during COVID-19