Infectious Disease Outbreak Plan

Statement of Commitment

LifeCare is committed to protecting the health and safety of our staff, our patients, and our therapy team. Our goal is to provide necessary services while simultaneously minimizing risk to our patients and healthcare personnel. To meet this objective, LifeCare will:

• Stay informed about current trends and guidelines by monitoring the CDC website, the Florida Department of Health, and local county websites.

• Provide care safely by complying with recommended infection control practices, universal source control, and healthcare prevention and infection control recommendations.

• Make care decisions based on the individual needs of our patients and staff and prioritize those services for our most at-risk patients.

Executive Summary

PURPOSE

This infectious disease outbreak plan outlines the essential steps our facility will take in response to an outbreak. It is intended to provide a broad overview of infectious disease outbreak planning, with the understanding that disease-specific information and guidance will provide more detail during the actual response. It is based on experience and our Risk Assessment and will supplement our standard operational infection-control standards and procedures.

At all times, federal, state, and local regulatory guidance will take precedence and supersede any written policies developed by our organization. If, for any reason, information conflicts, the most stringent interpretation of a policy or process will prevail. This Plan is based on “lessons learned” and includes the following assumptions.

ASSUMPTIONS

• Infectious disease outbreaks that tax the public health and healthcare systems will occur.

• Vaccine, treatment, and/or reliable tests may or may not be available.

• Resources such as medical supplies and Personal Protective Equipment (PPE) may be limited.

• Guidance on the management of infectious diseases may change frequently and/or be inconsistent.

• Large-scale emergencies may disrupt schools and transportation, making it challenging for staff to report to work or raising concerns about reporting.

• A disease outbreak may require a significant increase in data reporting to public health authorities.

• Risk communication can be challenging, especially when messaging changes.

• Managing mental health concerns will be essential.

• Hospitals and public health authorities may push patients toward the primary care setting.

CONTROL

This Plan is under the control of the Governing Body of LifeCare, which is responsible for activating and deactivating this Plan as ordered by the public authority. If the Governing Body is unavailable, our Succession Plan will be used. Deviations from this Plan to comply with federal, state, or local authority will be made with the approval of the Governing Body.

PLAN REVIEW

When no infectious outbreaks are active, this Plan will be reviewed biannually or as updated guidance is provided. During an Infectious Outbreak, our policies, procedures, and practices will be under constant review, with changes implemented in accordance with guidelines from local health departments, the Florida Department of Health, and the Centers for Disease Control, and updated as needed. Our goal is to consistently comply with best practices and ensure our patients and team are protected.

COMMUNICATION

LifeCare will maintain communication through primary or alternate means at all times. Essential communication is defined as activation/deactivation of this plan, critical resource shortages and hazardous situations. To accomplish this, LifeCare will:

• Monitor local communications through Broward County and City of Tamarac alert system.

• Keep staff informed of facility closure and/or other changes in services.

• Keep patients informed through the use of signage, phone messages and/or our website.

It is understood that this information may need to be changed daily.

TRAINING

This Plan will be included in our Orientation & Annual Training for all team members, with interim updates as needed. During infectious disease outbreaks, we will provide routine updates to our policies and practices as necessary to ensure current information and hazards are communicated effectively. Training will be documented in writing and maintained in the Personnel Records.

Facility Controls

During periods when our facility or region is experiencing an infectious disease outbreak or pandemic, LifeCare will restrict access to the facility and screen all persons, including visitors and patients, before entry. Individuals (patients or staff) who report systems, either directly or symptoms being experienced by a household member, will not be granted entry. Appointments will be rescheduled without penalty. Staff will be encouraged to stay home. Screening for scheduled appointments is to be conducted by phone to minimize patient inconvenience, and again before entry.

Before arriving at the facility, patients with scheduled appointments are to be screened by phone before a scheduled appointment. If the individual or a household member has symptoms or signs of illness, the appointment will be rescheduled.

Before entry by any individual (patient, visitor, or guest), a temperature check will be done. Individuals with a temperature> 100.0°F will not be permitted access.

• Points of entry to the facility will be restricted as follows:

• Visitors may access the facility only through the main front entrance, which will remain locked with buzzer entry only.

• Patients with scheduled appointments will use the direct entrance to the clinic near the west side of the parking area to limit in-building travel.

• Patients and their guests will not wait in the waiting room; instead, patients will be asked to wait in their vehicle at the west side of the parking lot until the scheduled appointment time. The therapist will notify the patient by phone when the area is disinfected and cleared of persons, and then open the door to allow direct access to the therapy area.

For therapy services delivered off-site in a patient's home, therapists will conduct daily self-temperature checks prior to arriving for any scheduled appointment. If the therapist or a household member presents with active signs and symptoms of illness or a fever > 100.0°F, LifeCare and the patient must be notified, and the appointment must be cancelled. At the time of appointment confirmation and before entering a patient's home, the therapist must confirm that the patient and household members have no active signs or symptoms of illness. If symptoms are reported or observed, the therapist is to cancel the appointment and report the cancellation to LifeCare through the EMR system.

Environmental Controls

During an infectious disease outbreak, LifeCare will implement environmental controls and maintain the facility to prepare for and protect against it. This will include:

• Require face masks for all persons who enter the facility.

• Conduct temperature screen prior to access, following the protocol outlined above.

• Limit facility access to patients and essential visitors

• Require a face covering or mask from all staff when in common areas or when co-workers may be encountered.

To effectively implement these controls, LifeCare will maintain (or attempt to maintain in shortage situations) adequate supplies for respiratory hygiene and cough etiquette, including masks, alcohol-based hand sanitizers (ABHS), tissues, and no-touch receptacles for disposal.

Best practice will be encouraged through written/visual reinforcement and training, including signage that is to be posted at the entrance and in restroom facilities.

For off-site therapy services, therapists are expected to don and wear appropriate PPE at all times when providing patient care.

Physical Distancing

Physical distancing is a method of environmental control and will be encouraged at all times and required when feasible. To promote physical distancing in times of an infectious disease outbreak,

PATIENT CARE

• Appointments will be scheduled with only one patient and one therapist onsite at any given time.

• Unless essential for a patient’s emotional health, well-being, or safety, no patient guests will be permitted.

• Patients will wait in the vehicle until the therapist has cleaned/disinfected the therapy area.

• Patients entering the facility will access the clinic from the direct-access door to our treatment area.

• Offsite/in-home care services will be provided for asymptomatic individuals

STAFF CARE 

• Onsite staff will maintain physical distancing guidelines from one another and are encouraged to stagger breaks and lunch periods.

• Staff will be permitted to work remotely whenever feasible.

Enhanced Cleaning

In addition to our standard cleaning and disinfection protocols, enhanced cleaning and disinfection protocols will be used at all times of an infectious disease outbreak. These measures include:

• All treatment areas within the facility are to be thoroughly cleaned and disinfected before and after each patient. Equipment used is to be marked with a sticker for disinfection prior to the next patient’s arrival.

• Restroom facilities are to be cleaned if used by a visitor or patient after use.

• All staff are to maintain personal disinfectant supplies at his or her work station to maintain their personal workspace.

• LifeCare will continue (or resume) our use of EnviroShield for facility disinfecting.

Shortages

Shortages in supplies and staff can impact operations. To address this potential risk, LifeCare will utilize all available resources to minimize the impact to operations:

SUPPLIES

• Maintain an adequate supply of personal protective equipment and supplies to meet current and potential surges.

• Utilize all available resources to secure and re-stock depleted inventory.

• Explore alternative options when supplies cannot be secured, including homemade options.

STAFFING SHORTAGES

• Allow staff to work remotely if feasible.

• Cross-train staff on work functions to minimize impact.

• Recruit and retain new staff as needed and as possible.