Crisis Standards of Care in Post-Acute and Long-Term Care (LTC) Facilities

Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare

A new report from the federal COVID-19 Healthcare Resilience Working Group, COVID-19: Considerations, Strategies, and Resources for Crisis Standards of Care in Post-Acute and Long-Term Care (LTC) Facilities, says that PALTC facilities need to adjust operations and standards of care in order to preserve and effectively allocate limited facility and system resources.

The Working Group is a partnership with the U.S. Department of Health & Human Services, the U.S. Department of Homeland Security, and other federal agencies—with assistance and content contributions from AMDA – The Society for Post-Acute and Long-Term Care Medicine and others.

The report provides PALTC facilities with general considerations, potential strategies, and existing resources that can be used to inform changes to operations and care processes. Among the report’s suggestions:

  • PALTC facilities should have emergency preparedness programs and plans in place that are consistent with any applicable regulatory requirements and national guidelines; however, those plans may need to be augmented with crisis management protocols that address the unique challenges and threats posed by COVID-19
  • Staffing models need to account for increased demands and potentially diminished staff as the level of care changes from conventional to contingency and as staff may themselves fall ill and/or are otherwise unavailable
  • 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
  • Advance Care Planning discussions that take a patient-centered approach are particularly critical during the pandemic
  • Communication with residents and their families is one of the most important parts of crisis management

“AMDA is pleased to have participated in the creation of this report and to provide access to resources such as our Advance Care Planning toolkit,” said Executive Director Christopher 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.”

I’ve provided the verbiage from the AMDA Press Release on September 28, 2020 in this blog; you can also view that Press Release here.

The 36-page report looks to be a great resource for post-acute and LTC facilities.  I encourage you to download, share, review and utilize the information in this report.  Here’s a view of what the report contains: