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Best Practices Against COVID-19 in Long Term Care Facilities

29 Jul

By May 11, 2020 COVID-19 had infected more than 153,000 residents at over 7,700 long-term care facilities. Only 11 percent of total US COVID -19 cases had originated at nursing homes, but over 35 percent of the total number of deaths came from long-term care facilities. As of May 26, 2020, nursing homes and their occupants account for more than 43 percent of all coronavirus fatalities in the United States.[1]

Long term care facilities that had in place, or quickly developed enhanced infection control protocols to combat COVID-19 had greater success in reducing infection rates within their resident population. In completing COVID-19 Focus Surveys our investigations have found there are many pathways for the rapid spread of COVID-19 within a residential facility. For example, long-term care facilities that require residents to use multiple use bathrooms or have two or more residents to a room have a higher incidence of rapid spread of COVID-19 once it has found its way into the facility. 

However, there are several approaches that facilities have developed to prevent initial infection and to control the spread of COVID-19.  Facilities that have a designated area, with private rooms for new or readmitted residents from home or the hospital have shown a decrease in the presence of COVID-19 transmission in the facility.  These facilities have developed a plan that if the resident has not had a COVID-19 test completed prior to discharge from the hospital, the long-term care facility immediately obtains the nasal swab. If the swab is negative the resident remains on the designated unit for 14 days at which time another nasal swab is obtained.  If that second test is negative and the resident had no COVD-19 symptoms for the previous three days, the resident is transferred to the general long-term care unit.

Facilities that have also designated certain wings, units, or hallways into phases of COVID-19 prevention and treatment have shown a decrease rate of transfer or death from the infection.  Residents that have any symptoms of COVID-19 or have a positive COVID-19 test result are transferred to a section of the long-term care unit that has been designated as an isolation unit.  Each resident is placed in a private room with private bathrooms.  The door of the resident’s room remains closed but the facility placed a plastic enclosure over the open doorway so the staff can still monitor the resident.  If that resident had a roommate, the roommate is placed on isolation in their room and observed for fourteen days. 

These facilities have also developed a procedure as to when the resident is able to transfer from the isolation unit.  During our investigations, the facilities that have initiated stricter procedures have maintained their facilities at a lower rate of facility transmission of the virus. The facility obtains a nasal swab COVID test at day seven and day 14.  If both tests are negative and the resident has not had any signs or symptoms of COVID-19 for three days, the resident is transferred to a general long-term care unit.

During an investigation one facility was noted to move dialysis residents to rooms next to an exit, so as not to transport residents down the hallways when they went to dialysis outside of the facility. 

On each of these designated units, the staff is consistent and only works their designated unit.  The staff does not only consist of nursing staff, but also housekeeping and dietary as well.  This practice has also shown to decrease the risk of staff transmitting the coronavirus from one unit to other units.  The Centers for Medicare Services COVID-19 Long-Term Care Facility Guidance dated April 2, 2020 revealed, facilities should use consistent staffing teams to care for COVID-19 positive residents to the best of their ability.  This practice can enhance staff’s familiarity with their assigned residents, helping them detect emerging condition changes and decrease the number of different staff interacting with each resident as well as the number of times those staff interact.[2]

Once placed on the new admit or readmission unit or on isolation, the resident is not allowed to leave their room and only designated staff is allowed in their room.  Facilities have also started obtaining their own laboratory blood draws to prevent additional people in the residents’ rooms.  In room physician visits are kept to a minimum and facilities have started using media technology to complete the physician visits. For example, according to the Minnesota Took Kit, although not feasible in all facilities, consider some of the following approaches:

  1. Dedicate a unit or part of a unit as the care location for residents with COVID-19, including those with or without current symptoms of illness. This unit should be used for COVID-19-positive residents that do not require a higher level of care such as hospitalization. Examples include a block of rooms at the end of a hallway, separate wing, or separate floor.
  2. Anticipate ways to close off units to prevent spread of the virus from ill residents to non-ill residents (e.g., for symptomatic COVID-19, recovered COVID-19 residents, non-COVID-19 suspected residents).
  3. Confine symptomatic residents and exposed roommates to their rooms.
  4. Residents with COVID-19 should be placed in a single-person room with private bathroom, with the door closed for those who are symptomatic. If applicable, implement your cohorting plan to use a dedicated space, with dedicated staff, for COVID-19-positive residents.[3]

These facilities had several residents that were positive for COVID-19 and their tracking investigation could not identify how the residents were exposed to COVID but once they were identified, the facilities initiated these strict guidelines and had no further positive cases of COVID.  Long-term care facilities cannot prevent all incidents of exposure to COVID, but placing these strict guidelines regarding the location and staff involvement of the residents in their facilities have shown, in our investigations, to decrease the rate of transmission in the long-term care facilities.

About Ascellon Corporation: Ascellon Corporation is a small minority-owned company. Our organization employs health care professionals whose expertise and knowledge will be applied to the COVID-19 Focus Survey. Our record of performance includes surveying long term care facilities, renal dialysis, assisted living, hospice, and home health companies for the requirements under the Centers for Medicare and Medicaid Services (CMS) and Veterans Affairs (VA) Long-Term Care and Domiciliary facilities standards.

For more information, contact:

Ascellon Corporation

www.ascellon.com/services


[1] “The Federalist” Copyright 2020, a wholly independent division of Federalist Media

[2] “Centers for Medicare Services” dated April 2, 2020

[3] “Minnesota Department of Health COVID-10 Toolkit” dated 6/5/2020

Best Practices Against COVID-19 in Long Term Care Facilities

29 Jul

As of May 26, 2020, nursing homes and their occupants account for more than 43 percent of all corona virus fatalities in the United States.[1] Long term care facilities that had in place, or quickly developed enhanced infection control protocols to combat COVID-19 had greater success in reducing infection rates within their resident population. Ascellon has published a white paper describing some of the best practices employed by Long Term Care Facilities. Download the whitepaper at: https://www.ascellon.com/services or contact us at info@ascellon.com.


[1] “The Federalist” Copyright 2020, a wholly independent division of Federalist Media

CMMC: What You Need to Know

13 Jul

Ascellon has a published a new white paper to augment our “CMMC: What You Need to Know” seminars. You may download a copy of the white paper at https://www.ascellon.com/cybersecurity or contact us at CMMC@ascellon.com.

The DoD’s Cybersecurity Maturity Model Certification (CMMC) program was released in January 2020. All Department of Defense (DoD) contractors must be certified at the time of award of any new DoD contract, and all DoD Suppliers will need to be certified by 2025.

The Cybersecurity Maturity Model Certification (CMMC) has a tiered-based approach in which contractors must be certified at a maturity level according to the type of Controlled Unclassified Information (CUI) they manage or handle. Once you know the level of CMMC certification you need/seek, the next step is to understand what requirements are mandatory for compliance.

The journey to a CMMC Certified Supplier starts with understanding CMMC V1.2. The certification process can take up to 6 or more months depending on an organization’s state of readiness for the desired Maturity Level.

ASCELLON CORPORATION APPRAISED AT CMMI® Level 3

25 Apr

Ascellon Corporation is proud to announce that it has been appraised at level 3 of the CMMI Institute’s Capability Maturity Model Integration (CMMI®).

An appraisal at maturity level 3 indicates the organization is performing at a “defined” level.  At this level, processes are well characterized and understood, and are described in standards, procedures, tools, and methods.  The organization’s set of standard processes, which is the basis for maturity level 3, is established and improved over time.

We apply our quality processes to our internal processes and how we manage our business.  For these processes, Ascellon is ISO 9001:2015 Registered. We apply our Quality Management System to provide consistent and superior performance on schedule and on budget.

Ascellon specializes in using technology and domain expertise to target problems and achieve breakthroughs. We can answer small, narrowly defined challenges, and we can utilize our capabilities to customize a turnkey program for gathering and analyzing data, identifying and applying best practices, educating and training, managing ongoing operations, monitoring results and supporting ongoing process improvement.

CMMI Institute (www.CMMIinstitute.com) is the global leader in the advancement of best practices in people, process, and technology.  CMMI Institute’s promise is to inspire cultures of continuous improvement that elevate performance and create sustainable competitive advantage.

For more information about Ascellon, please contact Ade Adebisi, President, aadebisi@ascellon.com. 

Ascellon Launches New Website

10 Apr

We are proud to announce the launch of our newly redesigned website, www.ascellon.com. We have redesigned it to make it easy to find information you are looking for by building a responsive layout for all platforms, simplifying the site navigation and providing more information on our services. We have also integrated social media feeds (Linked-In, Facebook, Twitter and YouTube) to make it easy for visitors to stay connected with us.

We encourage you to visit often and explore the site on any platform.  We have updated our resources and white papers.   We will continue to add resources and useful information.

If you have any questions or feedback, please contact our team by filling out the form on our Contact Us page.

We look forward to staying connected.

The most popular pages on our site are:

Careers at Ascellon

Computer and Data Security

Cloud and Hosting Solutions

Project and Program Management Support

Healthcare Facility Survey and Certification

Healthcare Facility Life Safety Code

Workflow Management & Collaboration Systems

Ascellon at 2017 HIMMS Conference (Part 1)

2 Mar

himss2017

Ascellon was represented at the 2017 Annual HIMMS Conference in Orlando in February.  There were many exciting and cutting edge products and innovations to be seen at the conference.  From Ascellon’s perspective, the most exciting things happening at the intersection of information technology (IT) and patient care today are cost reduction, and privacy and security.

Foremost on everyone’s mind is the risk posed to patients by unauthorized access to medical records and identifying data.  Beyond the usual identity theft issues, there could be life-threatening consequences if unauthorized or malicious activities are introduced into a medical device that is in active use, or even the interception of an electronic prescription.  Several vendors exhibited new and exciting products to counter such threats.  Ascellon has developed channel partnerships that will allow us to recommend the best solutions for our customers based on the relationships we have developed with industry leaders in this field.

In the next post, we will discuss how cutting edge IT systems are helping providers and payers to control cost without jeopardizing quality of care.

Ascellon Partners with Junior Achievement to Mentor Youth on Financial Literacy

27 Feb

ja-financial

Under the leadership of Ascellon Corporation CEO, Sheila Scott, employees from the company facilitated a workshop with students at the Junior Achievement Finance Park, Prince George’s County, Maryland on February 13, 2017.  At the workshop, students from William Wirt Middle School learned about the importance of creating a budget, saving, and investing in a hands-on and fun environment.  Junior Achievement Finance Park is part of Junior Achievement of Greater Washington, an international non-profit founded in 1919 dedicated to preparing youth to become future leaders in a global economy.

The workshop involved using a software simulation program in which students learned how to navigate real-life financial situations. They were taken through exercises based on a given monthly income, create a budget, pay bills and other expenses, and deal with financial emergencies.  Ascellon’s volunteers guided students through the simulations and advised students on how best to budget their monthly incomes, save, and spend.

Ascellon is proud to be of service in our community.  Volunteering to support the mission of Junior Achievement of Greater Washington is one of the ways we hope to make a difference and prepare our students for a competitive economy. For more information about Junior Achievement of Greater Washington, please visit  http://www.myja.org/.

For information about Ascellon in the community and volunteer activities, please email: info@ascellon.com.

Ascellon President Joins Foundation School Board

28 Nov

the-foundation-school

Ascellon Corporation is pleased to announce that Company President, Ade Adebisi has joined the Board of Directors of the Foundation Schools of Prince George’s and Montgomery Counties.

The Foundation Schools’ mission is to provide a highly-specialized educational and therapeutic program for students with emotional disabilities, as well as those with social, emotional and learning challenges.

Through 40-years of history, thousands of students have benefited from academic and therapeutic services the schools have provided in the Washington Metropolitan area.

“I am proud to join the board of such important institutions,” Adebisi said. “The Foundation Schools’ core values in service to its students mirror our own, both in our corporate personality, and in our commitment to corporate citizenship. I look forward to helping generate support for the schools, the students and the families they serve.”

Ascellon Corporation Re-Registered as an ISO 9001:2008 Company

24 Oct

iso-9001-2008-logo

After weeks of updates to our cloud-based, Quality Management System (QMS), various Internal Audits and Team Working Sessions, Ascellon Corporation has officially received its re-registration as an ISO 9001:2008 Company. Ascellon has maintained, without interruption, ISO 9001 registration since 2007.  The current renewal of our registration is valid through September of 2018.  The re-certification illustrates Ascellon’s commitment to quality, consistency, and continuous improvement throughout the organization.

ISO 9001:2008 has recently allowed Ascellon to achieve 100% On-Time Delivery (95% Goal), and a 97.1% Customer Satisfaction Rating (90% Goal). The specific requirements for ISO 9001:2008 are highlighted below:

  • Ability to consistently provide product that meets customer and applicable statutory and regulatory requirements.
  • Aims to enhance customer satisfaction through the effective application of the system, including processes for continual improvement of the system and the assurance of conformity to customer and applicable statutory and regulatory requirements.

 

Beyond the EHR – Big Data Analytics in Healthcare

2 Jun

Background3

As the adoption of electronic health records (EHRs) reach critical mass, the healthcare industry is increasingly looking for ways to optimize on this now digital data. As we look beyond the implementation of the EHR, we have to ask ourselves, what’s next?  Digital health data, and the ability to mine that data, holds the promise of improved efficiency, lower costs, fewer errors, better health outcomes and greater accessibility.  Access to actionable and easy to understand personal health data could also be helpful in creating a more consumer focused health system.

While it is likely that most health entities have begun to collect some form of electronic health data, the challenge now is to figure out how to use big data to achieve the promise.  Healthcare entities should be planning their big data future. Entities should define their strategic objectives, and go about the work of developing a roadmap. Start with the end in mind. The big consideration is insourcing vs. outsourcing. Insourcing can be a high cost, high-risk proposition but it is an option that may pay out in the long run if done properly. Outsourcing offers a lower entry cost and lower risk option in that it allows you to push off the costs of implementation, development and maintenance. Regardless of which path an entity takes, a well-planned process will yield results by giving payers, providers, and patients access to the right data, at the right time for the right outcome.