CMS is putting a general hold on hospital surveys, except for those dealing with immediate jeopardy situations, for at least 30 days, in recognition of growing COVID-19 patient surges in many areas.

Hospitals facing recertification will be automatically extended for that 30 days.

Last March 15, the U.S. Department of Health and Human Services (HHS) waived sanctions against hospitals that did not comply with five provisions of the HIPAA Privacy Rule during the COVID-19 pandemic. Those rules governed:

• The requirement to obtain a patient’s agreement to speak with family members or friends involved in the patient’s care
• The requirement to honor a request to opt out of the facility directory
• The requirement to distribute a notice of privacy practices
• The patient’s right to request privacy restrictions
• The patient’s right to request confidential communications

Treating patients with behavioral health issues such as substance abuse and social challenges such as homelessness pose several difficulties in emergency departments. For example, ED clinicians are under time pressure to treat patients with acute medical conditions and ED staff typically have limited links to community-based organizations.

Expect to deal with many of the same exemptions—such as health concerns or religious reasons—to mandatory COVID-19 shots as you do with a mandatory flu vaccination requirement.

The Equal Employment Opportunity Commission (EEOC) has updated its guidance on how employers can navigate federal anti-discrimination laws while requiring employees to be vaccinated against COVID-19.

On December 16, the EEOC added a section on how COVID-19 vaccines interact with the legal requirements of the Americans with Disabilities Act (ADA), Title VII of the Civil Rights Act of 1964, and the Genetic Information Nondiscrimination Act (GINA) to its publication titled “What You Should Know About COVID-19 and the ADA, the Rehabilitation Act, and Other EEO Laws.”

It might take weeks or months before the U.S. gets the COVID-19 vaccine out to all of those who want it. The CDC and most states are first offering the shots to healthcare workers and other essential personnel.

Whether you are a hospital or off-campus location, you must take several key precautions both with administering the vaccine and ensuring the safety of its storage and handling.

Be extra careful with the vaccine and with the dry ice that will keep it cold—mishandling the dry ice can cause injury and even death, warned Ramya Krishnan, senior project engineer of device evaluations for ECRI, during the patient safety organization’s online Q&A session on December 16, 2020.

Also, think through how you will schedule and move patients through your facility, advised David Watson, vice president of ECRI’s European operations. Watson is based in the United Kingdom, where the first Pfizer-BioNTech vaccines were administered on December 8.

You will need space to take a patient history (including any previous allergic or anaphylactic reactions to food, drugs, or insects), to administer the vaccine, to provide at least 15 minutes of observation for adverse reactions afterward, and an area to care for anyone who does have a reaction—all while maintaining the same social-distancing and infectious-disease precautions you’ve had since the pandemic began, he noted.

Set up clear communication with your hospital staff and remain open to feedback as you receive and administer the COVID-19 vaccines.

Work with supervisors and other leadership to schedule staff vaccinations and, if possible, work around shifts so that workers who do experience symptoms don’t have to cope with them while working.

Scheduling and communication may be two of the most important keys to having a success vaccination program, said Anurag Malani, MD, Medical Director, Infection Prevention & Antimicrobial Stewardship Programs, for St. Joseph Mercy Health System, which includes seven facilities in southeast Michigan. Malani is also an expert for the Society for Healthcare Epidemiology of America.

It’s common knowledge that healthcare water systems can be a source of healthcare-acquired infections (HAI) if not cleaned properly. Just ask any of the facilities that found themselves dealing with a Legionella outbreak among patients.

Or you can ask CMS and other regulators who will be hunting for traces of bacteria, mold, and fungi in your water supply. They will inform you if they find any, and you will not be happy about it.

While we’ve written a lot about the role of plumbing in water infection control, the most common point of contact patients have with water is through showerheads, faucets, and ice machines. Just wiping down the outside of these fixtures isn’t enough to prevent the spread of infection.

Showerheads, faucets, and spigots: Maintaining them and keeping them operating smoothly is key to both savings for your healthcare facility and care quality for your patients.

Plus, if you don’t, CMS, accrediting organizations, and other regulatory agencies will come at you hard.  

To talk about the physical and mechanical maintenance of healthcare water fixtures, we spoke with Charles Bragdon, founder and president of the California-based Water Saver Solutions, which works with healthcare systems to improve water savings, efficiency, and quality. His company also offers fixture-specific information and services at https://fixturecare.com.