A new report from the federal COVID-19 Healthcare Resilience Working Group calls on post-acute and long-term care facilities, including assisted living communities, to adjust operations and standards of care to effectively allocate limited resources during a national public health emergency.

The report, “COVID-19: Considerations, Strategies and Resources for Crisis Standards of Care in Post-Acute and Long-Term Care (PALTC) Facilities,” provides PALTC facilities, including assisted living communities, with general considerations, potential strategies and existing resources that can be used to inform changes to operations and care processes.

PALTC Executive Director Christpher Laxton
Christoper E. Laxton, CAE

“We want to make sure PALTC facilities have everything they need to effectively and efficiently manage during this difficult time and provide the best possible care to residents,” AMDA Executive Director Christopher E. Laxton said. AMDA was one of the organizations providing assistance to the working group, a partnership with the U.S. Department of Health and Human Services, the U.S. Department of Homeland Security and other federal agencies.

Recommendations include preventing and responding to crisis standards of care, response and operations, daily care and life enrichment, medical care and treatment, and transport and transfer, along with preparedness, legal and ethical considerations, advanced care planning and communications.  

Among the recommendations: 

  • Advance care planning discussions should take a patient-centered approach.
  • Communication with residents and their families is critical to crisis management.
  • Standards of care at all levels should adhere to core ethical principles, including fairness, duty to care, duty to steward resources, transparency in decision-making, consistency, proportionality and accountability.
  • Staffing models must account for increased demands and fewer staff members as the level of care changes from conventional to contingency, and as staff themselves fall ill or are otherwise unavailable.
  • Emergency preparedness programs consistent with regulatory requirements and national guidelines should be in place. Those plans may need to be augmented with crisis management protocols that address unique challenges and threats posed by COVID-19.

The report provides sample tools and resources that can be modified to fit local protocols and procedures and are meant to complement existing state and local guidance.