Residential Care Strike Team FAQs

Connect to care

You can verify if a person is a QMAP at the following website: QMAP Verification

There is not a fee for a facility to use ConnectToCare.

To begin using the Connect to Care Jobs site you must first pre-register with the State so that we can verify your license (ensuring only licensed facilities are using the site). To pre-register, go to this site and select 'looking to hire professionals to fill open positions?'- There are further instructions on the next steps located at Connect to Care Jobs Colorado.

COVID-19 data

All types of COVID-19 outbreak data can be found here: COVID-19 data

For federally certified facilities county-level data can be found on this CMS website: COVID-19 Nursing Home Data

Archived information is located here: COVID-19 Nursing Home Data - Test Positivity Rates

For all other facilities and agencies, county-level data can be found on this CDPHE website: COVID-19 data

Once on this page, select Incidence and Epidemic Curve, then select Two Week Cumulative

Information on county COVID-19 case counts can be found on this CDPHE website: COVID-19 data

Once on this page, select Incidence and Epidemic Curve, then select Two Week Cumulative

The two-week county incidence is the number of new cases of COVID per 100,000 persons in the last 2 weeks. The county positivity is the percent of COVID-19 tests that had positive results.

Statistical information on COVID-19 cases can be viewed on this CDPHE website: COVID-19 data. Presently, this data does not sort by size of facility.

Essential services

Essential health-care services are those which are necessary to address a medical issue or medical concern for an individual resident, regardless of the type of care. Typically, this care or service is accompanied by an order from a medical professional who is directing the specific care/service and, when an order has been issued we have directed facilities that they are compelled to comply with.

Essential service providers of residential care and services are defined in the indoor visitation guidance as employees, consultants, contractors, volunteers, students, caregivers, and others who provide care and services to residents. Facilities should prioritize testing for those individuals who are regularly in the facility (e.g., weekly) and have contact with residents or staff.

Essential workers are those that are necessary for the operation of the facility and the provision of ongoing care and services within the facility and can include, housekeeping, cooks, maintenance staff, and others.

Personal protective equipment

A face shield is a form of eye protection, if they wear a face shield they do not need to also wear goggles.

Masks need to be worn whenever in the building. The risk to transmit the COVID-19 virus does not change when the residents are sleeping.

Everyone within the facility should wear a mask regardless of the type of work they are doing. This not only applies to health care but in all businesses. The exception would be if someone is in an office by themselves with the door closed.

For guidance information on the considerations and recommendations for those who are unable to wear a mask, please refer to this website: CDC Considerations for wearing masks.

Resident socialization

Enforcement

The Residential Strike Team consists of staff from the Department of Public Health and Environment (CDPHE), Human Services (DHS), Health Care Policy and Financing (HCPF), Department of Public Safety and Regulatory Agencies (DORA). The goal of the Residential Care Strike Team is to mitigate the spread of COVID-19 in all high-density environments serving older adults and people with disabilities.

Resources utilized by the Residential Strike Team include information from COVID-19 outbreak and incidence data, EMResource, outcomes in relation to federal/state inspection surveys and engagement with providers and stakeholders.

4/7/21  --Health facility surveyors are currently surveying to the new PHO. Surveyors will consider the time it takes for facilities to implement new visitation policies but may issue citations for facilities that do not offer visitation.

Staffing

The Strike Team, in conjunction with the Staffing Shortage Fusion Center (SSFC), has provided staffing resources in residential care facilities experiencing critical staff shortages as a result of COVID-19 since November 2020. As of March 31, 2021, the SSFC has officially demobilized after successfully staffing 4,850 shifts in 58 different facilities across the state.

The Strike Team will continue to provide staffing assistance and has extended the availability of clinical and non-clinical staffing resources to ensure the health and safety of residents during critical COVID-19-related staffing shortages in residential care facilities.

Extended Staffing Resources:
 

  • The Colorado National Guard
    • 12 national guard members
    • Can provide administrative and non-medical support as well as basic resident care including activities of daily living
    • All guards members are qualified medication administration personnel (QMAPs) and can administer medications in assisted living, group home, and intermediate care facility settings.
       
  • Rapid-Response Nursing Team
    • 6 RNs, 3 LPNs and 3 CNAs
    • Contracted and managed by Healthcare Workforce Logistics (HWL)
    • Can be deployed to facilities within 24-48 hours for short-term clinical staffing support

To request staffing support, complete and submit the updated Staffing Request Form. This is a new form and the previous link no longer accepts requests. If you have not submitted a request in the past 30 days, please complete a new request on the form provided. Please note that the extended staffing resources are available to support short-term staffing shortages as a direct result of COVID-19 and cannot be utilized to address general workforce shortages at this time.


Please direct questions to
residentialcarestriketeam@state.co.us.

Reporting and Notification

Facilities should notify staff, residents and their responsible parties as soon as a positive case of staff or resident infected with COVID-19 is identified. The facility should complete appropriate notifications within 24 hours of identifying the case but under no circumstance should the notification extend beyond 72 hours.

Indoor and outdoor visitation

As outlined in the new Comprehensive Mitigation Guidance (p. 33), the facility should restrict the total number of visitors,  as well as the number of visitors allowed per resident at one time, according to the size of the facility in order to maintain core principles of infection prevention. CDPHE recommends allowing no more than two visitors per resident per room. 

For outdoor visitation, the number of visitors should be determined by using the outdoor social distancing calculator, which will provide the allowable number based on the square footage of the area designated for outdoor visits. Any codes, regulations, or ordinances requiring a smaller number of people must be followed. Require visitors to schedule an appointment for the visit to ensure the facility can safely accommodate the number of people and have enough staff to monitor compliance with required infection prevention activities. This guidance can be found in the Comprehensive Mitigation Guidance under "General Visitation Guidance" and "Outdoor Visitation" (p. 32). The recommendation for allowing no more than two visitors per resident per room is found under "Indoor Visitation" (p. 33).

For smaller facilities, such as those in residential home-like structures and/or those with limited room ventilation systems, indoor visitation must be limited to one visitor for one resident at a time with no congregating of individuals in the area being used for indoor visitation. See "Indoor Visitation" in the Comprehensive Mitigation Guidance  (p. 34).

Yes. According to the Comprehensive Mitigation Guidance  (p. 33), staff members must escort the visitor to the designated visitation area after screening.

  • Designated meeting areas should be monitored to ensure they remain separated from the facility population and from facility staff. 
  • If the resident is fully vaccinated, they can choose to have in-room visits (p. 33). In-room visits do not require staff supervision if all criteria are met for in-room visitation. 
  • The comprehensive mitigation guidance (p. 32) states visitors are required to schedule an appointment for the visit to ensure the facility can safely accommodate the number of people and have enough staff to monitor compliance with required infection prevention activities.

Compassionate care visitation

In addition to terminal end-of-life situations, Compassionate Care visitation may be allowed to provide personal medical and emotional care for residents who have experienced a sharp decline in their overall health and well being due to COVID-19 isolation. 

Situations such as these can include any or all of the following:

  • a decline in overall status due to worsening mental health 

  • memory or cognitive conditions 

  • progressively worsening conditions of grief and/or depression, confusion, anxiety 

  • physical decline due to COVID-19 isolation restrictions. 

In some cases weight loss, weakness and decline in physical function accompany these circumstances. Compassionate care visits must be allowed at all times, even during an outbreak.

State ombudsman and adult protective staff (APS)

Adult Protective Services (APS) workers and Long-Term-Care (LTC) Ombudsman have legal rights to enter the facility. As with anyone entering the facility from the outside, APS workers and LTC Ombudsman should undergo the facility’s screening process and conform to appropriate infection control measures prior to their entry and during their presence at the facility.

In addition to in-person visits, APS workers and LTC Ombudsman may conduct interviews by telephone or other electronic means when deemed appropriate by their respective organizations. Facilities must provide accommodation and access to these means of communication.

Essential indoor visitation related to healthcare services in facilities

Public Health Order 20-20 requires facilities to restrict indoor visitation of non-essential individuals. External healthcare providers are considered essential visitors and should be allowed to conduct individual visits with residents to provide medical assessments and essential services for the well-being of the resident. External healthcare provider services include, for example:

  • Medical services which includes individual resident visits for wound care, podiatry, dental, mental health services and dietary services.  

  • External hospice or home care and services which have been ordered by a physician.

EMResource

EMResource is a web-based tool used to assist the state with situational awareness and identification of a facility’s and providers' capacity and resource needs. The state monitors the data that providers enter EMResource several times each week to create critical needs reports to assist the state’s response to a crisis or state of emergency such as a pandemic.  Furthermore, this data can be used to help guide assistance to providers and agencies at the state, regional, and local level

Yes, per Public Health Order 20-20, regular reporting to the Colorado Department of Public Health and Environment (CDPHE) is now required for residential care settings.  The public health order can be found here: Public Health Order 20-20

Colorado residential care facilities should update EMResource daily by 10:00am MT and/or following any significant changes in Personal Protective Equipment (PPE) or other anticipated shortages in staff or space availability.

This information you provide in EMResource supports local, regional, and state level situational awareness and can assist the state in identifying trigger points for critical supply levels for staff, supplies, or space.

NO.  Once a facility identifies a needed resource(s) (PPE, staff, medical materials, etc), the facility must contact their Local Public Health Agency Emergency Operations Center (EOC) or Emergency Support Function 8 (ESF 8) Representative to discuss and review the resource request.  The list of LPHA contacts can be found here.

EMResource is provided by CDPHE to Colorado health and residential care facilities at no cost to the facility.

Once a long term care facility administrator or manager gains access to EMResource, this training document and video illustrate how to log in to EMResource and answer daily questions.

Once you have established your EMResource account and provided foundational information regarding your facility, updates to previously provided information can be made in approximately 10 minutes.

For questions regarding access to EMResource or technical assistance, please email CDPHE_EMResource@state.co.us 

There can be flexibility in the time of day that you report. If your answers to questions in EMResource tend not to change every day, you can indicate "no change" in the data in EMResource. In the question section, if you do not check the box next to the question, EMResource treats that as "no change." So, if there are no changes in all nine of your facilities, you can report that consistently by not checking the boxes.

As we receive questions from the community and providers we will post the questions and answers here. Some questions will be reworded for clarity and make take longer to answer. Questions have been organized by topic.

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