Your lips to God’s ear right? Well, that is what was discussed in a study published in the Journal of the American Geriatrics Society on September 15, 2020. To give a little background, in April 2020, Massachusetts Nursing Homes became a hotspot for COVID-19 infections and associated deaths. In response, Governor Charles Baker allocated $130 million in additional funding for 2 months, contingent on compliance with a new set of care criteria including mandatory testing of all residents and staff and a 28-point infection control checklist.
The intervention consisted of these components:
- The checklist: A 28-item Infection Control Competency Checklist.
- Payment incentive: The plan provided for a 50% increase in payments to NH’s for 2 months contingent on passing unannounced state inspection audits by achieving a score of 24 or higher on the checklist while meeting all six core competencies, testing 90% of residents and staff for SARS-CoV-2 RNA nasopharyngeal positivity by a given date, uploading key data each week and providing residents with technology for virtual visits with family and friends.
- On-site and virtual infection control consultation: 123 facilities were targeted for on-site visits by infection control consultants based on their history of deficient infection control practices.
- Weekly webinars: Six weekly webinars for all facilities that focused on the checklist competencies and areas of poor performance on the audits.
- Continuous question and answer (Q&A) communication: Lists of questions were sent to representatives of MassHealth and the DPH after each webinar and answers were provided.
- PPE, Staffing, and Testing Resources: Central command teams provided resources for PPE procurement, the recruitment of temporary staff (resident care assistants, certified nursing assistants and in emergency situations, the National Guard), and SARS-CoV-2 testing.
This project provided several important lessons that may help inform future statewide efforts to improve infection control in NH’s. Stay well, stay safe, and stay tuned!