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  • CMS Issues COVID-19 Guidance on Infection Control, Protective Equipment

    The ever-growing list of resources from CMS includes guidance related to particular settings including hospice, SNFs, and home health.

    The Centers for Medicare and Medicaid Services has issued several statements recently with regard to infection control, patient care, and provider safety precautions in a variety of settings. To prevent further spread of the virus, "all health care providers must immediately review their procedures to ensure compliance with CMS’ infection control requirements," said CMS Administrator Seema Verma in a press release. Following is a summary CMS guidance.

    Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) in Home Health Agencies
    These guidelines address how to screen home health patients for COVID-19, when staff should avoid home visits, if and when patients with confirmed COVID-19 should be transferred to a hospital, and special consideration for patients requiring therapeutic interventions, among others.

    Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes (REVISED)
    CMS has provided recommendations for limiting transmission of the virus in skilled nursing facilities, including screening and/or restricting visitors. It also offers information on accepting residents from or transferring residents to hospitals.

    Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) by Hospice Agencies
    The document provides guidelines for screening and treating patients, visitors, and hospice staff for COVID-19, as well as infection control and use of personal protective equipment. CMS recommends coordinating these actions with local health departments.

    Emergency Medical Treatment and Labor Act Requirements and Implications Related to Coronavirus Disease 2019 (COVID-19)
    CMS has published guidance to hospitals with emergency departments on patient screening, treatment, and transfer requirements to prevent the spread of infectious disease and illness, including COVID-19. Any hospital that participates in Medicare or Medicaid should follow both CDC guidance for infection control and Emergency Medical Treatment and Labor Act requirements.

    Medicare Advantage Organizations, Part D Sponsors, and Medicare-Medicaid Plans: Information Related to Coronavirus Disease 2019 – COVID-19
    This memo explains special requirements, permissive actions, relaxation of "refill-too-soon" edits in Medicare Part D, and business continuity plans in Medicare Advantage, among other topics.

    Interim Infection Prevention and Control Recommendations for Patients With Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings
    The CDC recommendations include standard precautions, patient placement for those with known or suspected COVID-19, infection control, monitoring and managing personnel who are ill or have been exposed to the virus, and protocol for reporting between and within health care facilities.

    The document updates CMS guidance on personal protective equipment, stating that facemasks, which protect the wearer from splashes and sprays, are an acceptable temporary alternative to respirators, which filter the air, for most medical services until demand for respirators lessens.

    Interim U.S. Guidance for Risk Assessment and Public Health Management of Healthcare Personnel With Potential Exposure in a Healthcare Setting to Patients With Coronavirus Disease (COVID-19)
    The CDC document describes how to assess a provider's level of exposure, risk factors, recommended monitoring, and type of work restrictions.

    Comments

    • I an HHA who has congenital heart disease. The companies I work for has offered no gloves, masks, cleaning supplies or anything to go into multiple elderly and sick patients. I am very scared. Hamdwashing is not enough for an airborne virus. Please help spread more information about the homehealth industry. No one can afford to quit working. We make an average of $11 an hour and we are not offered health care. We do not have the resources to purchase the PPE that we need and we weren't given. Please Help

      Posted by Dena Romanick on 3/13/2020 11:44 AM

    • It seems to me that your guidances all have a glaring hole with regard to COVID-19 and elderly residents of all facilities: There is strong evidence that persons are contagious well before symptoms present, and, regular facemasks do not afford protection from droplets or smaller particles, both through and along the sides of the cheap facemasks being advocated. If such evidence is credible, it seems to me that health workers visiting the elderly in various settings may be important vectors to viral distribution by virtue of healthcare workers moving through many eldercare facilities and other care facilities they may visit. If they are asymptomatic but contagious, it seems to me that CMS recommendations are rather weak-kneed. The operators of all such facilities should have the unambiguous right to lock down too all but essential operational personnel, excluding visiting healthcare workers such as hospice. I suggest further that if there have been community transmissions within the county and immediately adjacent counties, this recommendation becomes even more compelling. I am puzzled why you seem to be so complacent to the obvious.

      Posted by David Mann, M.D. on 3/13/2020 11:51 AM

    • Thank you for the resources! I do find the guidelines for hospital based PTs incomplete. We are not only concerned with our patients who are rule out or confirmed status, we are also concerned about other patients we may come in contact with. On top of that, we are not an immediately life-saving service, but we would be using precious PPE. I hope the APTA and the acute section would consider guidelines for telehealth options where possible, working with the nursing team and the medical staff as the situation changes. We will need these not just for this pandemic but also for any other outbreaks in the future.

      Posted by Margot Flaugher on 3/13/2020 1:30 PM

    • I am a healthcare worker and the hospital I work at says that a simple surgical mask and goggles is required for covid-19. Previously it was a papr or n95, was the isolation standards changed?

      Posted by Micah on 3/14/2020 10:20 PM

    • I’m 72 no underlying conditions I am in Physical Therapy after shoulder surgery(it’s been 9 weeks) lots of people are always there. Is it safe to go with Covid19

      Posted by Susan on 3/15/2020 9:41 AM

    • I am a home healthcare cna. I see several patients and I'm an hourly worker. My agency has given NO ADVICE and has not reached out or even mentioned THIS ONE TIME. Because the symptoms do not show for some I am extremely worried about my clients as well as my type 1 diabetec husband who is at high risk. Several people and aides go in and out of these homes

      Posted by Natalie on 3/15/2020 12:45 PM

    • I am reading all of the links you have provided and still I do not see clear-cut guidance specifically for people in our profession of physical therapy; unless you apply the guidelines associated with the group "non-essential" HCP, which I do not necessarily believe fall into, but we need further instructions as to whether we are considered "essential" or "non-essential" HCP as we read these guidelines and articles so we know how to apply them to ourselves. Thank you for posting these; just, please, be specific to our profession also.

      Posted by Lucinda Vizcaino on 3/15/2020 1:29 PM

    • Hi, Hoping you are all doing well in this difficult time. If this communication is better served to others, please let me know to whom with contact information. Thanks so much. The lack of clear advice and guidance by the APTA during this time is disappointing. Vague advice, links to other organizations, standard and old information is just not enough. This is a challenging time for most, but there are certain things that I would expect from the national association to whom so many of us pay and have paid dues. Please make recommendations for appropriate, safe, effective, and cost effective cleaning solutions for tables, handles, goniometers and all other common equipment, supplies, and furniture across rehab settings. Please make clear recommendations for quarantine requirements and type post different levels of possible exposure, confirmed exposure etc. I.e. Employee's boyfriend was exposed, patient's wife was exposed, mailman's colleague was diagnosed and he walked in and delivered the mail.... Please make clear recommendations on required acility closure Please make clear recommendation on cleaning requirements prophylactically and after confirmed case in each setting Please make clear recommendation on best practice to enable a practice to survive for an unknown period of time with a significantly reduced patient volume; let staff go, place people on a per diem basis and change contracts, business interuption insurance,.... what to do? I am counting on the APTA for these and other answers. It is time to give legal advice, it is time to give healthcare advice, it is time to give business advice, it is not time to hide in the shadows and stay neutral and fluffy. Looking forward to a response. Thanks, James

      Posted by Dr. James Nussbaum on 3/15/2020 2:20 PM

    • Please provide guidance for COVID19 and sepsis care.

      Posted by Tish poserina on 3/16/2020 7:04 AM

    • Everyone: APTA is aiming to consolidate coronavirus updates and information on one page whenever possible. It's here: http://www.apta.org/Coronavirus/

      Posted by APTA staff on 3/16/2020 9:15 AM

    • Do you have any concern for outpatient PT clinic? Do we have to keep open at this time?

      Posted by Cherrylene on 3/16/2020 11:59 AM

    • What precautions should I take as a visiting nurse Visiting several homes a day

      Posted by Penny on 3/16/2020 12:41 PM

    • What about caring for patient’s in Inpatient Psychiatric facilities where pt’s are up and about, go to groups, share dining spaces and so on! I don’t see any guidance for these facilities! Please help!!

      Posted by Betsy Boyd on 3/16/2020 9:24 PM

    • I drive for a physical therapy company and I just had a question is that considered essential or non-essential thank you in advance

      Posted by Donald J Paterson on 3/16/2020 10:22 PM

    • Following todays recommendations from the Federal Government. Please advise regarding personal care agency RN’s and supervisory visits. The Government recommends starting telephonic visits effective today (to my understanding) Please advise and update ASAP. Thank you.

      Posted by V Thornton on 3/17/2020 12:28 PM

    • Curious if all outside caregivers will not be able to work because of corona virus . I am trying to be a private caregiver and work in patients homes , and wondering if that is going to stop too for a few weeks or months . Thanks

      Posted by Stacy Rader on 3/17/2020 2:53 PM

    • how about us non-clinical home health employees? we can clearly work from home, and i know several agencies has already done it. but where i am working, the management says that it is not mandated by the federal government we still need to report to this office, where our nurses come and go. a lot of my co-workers are seniors and very vulnerable. i hope u will have a mandate that will have us work from home. thank you!

      Posted by silver bullet on 3/17/2020 7:32 PM

    • Hi. There are a lot of outpatient physical therapists concerned because our clinics are still open and many patients are being seen that are absolutely not medically necessary during a time like this. It is exposing patients, therapists and their families to unnecessary danger and even patients that are recommended to stay home due to being higher risk are still coming in because their appointments aren’t cancelled. Many companies are waiting for guidance and will most likely not close unless they are told. The question that was placed above and that we are all still wondering is - is outpatient physical therapy considered an essential or nonessential service and is it recommended to stay open or closed at this time? And if it’s recommended to stay open what are the guidelines for who should still be seen so that it isn’t vague and everyone is still walking through our doors? Thank you!!

      Posted by Maggie on 3/17/2020 11:25 PM

    • I am feeling extremely anxious as a Physical Therapist Assistant at a small outpatient facility. I am not comfortable working with patients for both mine and their safety even though we take all the precautions we can.

      Posted by Debbie on 3/17/2020 11:29 PM

    • I am a PT at a small outpatient clinic. We have been given no direction, other than “we are considered essential employees, thus it’s business as usual”. We are an outpatient PT clinic owned and operated by a large hospital. It seems as though we are forgotten about, we fall under the same umbrella as doctors and nurses who are essential front line employees. Why isn’t anyone advocating for us?!! Outpatient PT is not life and death! Should I risk getting sick over a patient who has wrist pain because he played in a national baseball tournament (75 baseball teams) in a VERY LARGE city last week? Is that essential??? My employer says yes. Can someone please help us?!

      Posted by Paulette on 3/18/2020 12:05 PM

    • I am wondering if anyone knows of any outpatient clinics that have temporarily closed? We are considering closing, but no clinics in our area are closing.

      Posted by Jay on 3/18/2020 1:05 PM

    • I work in a hospital and have several concerns. Is there an agency healthcare workers can reach out to?

      Posted by CeCe on 3/18/2020 2:08 PM

    • having worked as a PT in a hospital with isolation patients, we used cotton /poly long sleeve patient gowns worn only once with our other disposable PPE for our isolation patients. For my outpatient clinic which we are limiting access to anyone with symptoms , is the old cotton/poly long sleeve gown PLUS all the disposable head covers, shoe covers, gloves, goggles, masks sufficient with Covid? Dr. Joseph

      Posted by suzanne joseph on 3/18/2020 5:21 PM

    • I need an answer to the question the previous home health aide asked. My office has actually locked its doors, however expects us to work without soap, paper towels hand sanitizers, masks. They do provide gloves. I made a bleach solution that intake to work with me, as well as Lysol for frequently touched surfaces. But I just saw the nurse come in without washing her hands. I have a daughter who has recently gone through chemo..I can not afford to transmit this to her, I want to know if it is legal rot require us to work without Ppe

      Posted by Sara on 3/18/2020 5:47 PM

    • I too am concerned about whether or not outpatient physical therapy is essential or nonessential. I do not feel that treating someone’s IT band for an upcoming marathon is considered essential. Seeing a large volume of patients at one time, I have no idea who has touched what equipment and what needs to be cleaned. And kill time guidelines with our disinfectant is not being followed. We recently scheduled a high number of college students have been sent home because of the pandemic returning from spring break. I don’t know how this is safe for anyone! Please give us some guidance!

      Posted by Racquel Randell on 3/18/2020 6:22 PM

    • I share the same concerns as several others on this thread. I work for a relatively small outpatient physical therapy clinic, privately owned. I personally believe the large majority of our patient population is non essential at a time like this. As it stands now, we are following what I would consider vague guidelines from the CDC. I am disappointed the APTA has not provided more specific guidelines during this time. It seems the clinic owner does not plan to shut down unless he is forced to or if business slows to the point where its not financially sustainable. I do not blame him necessarily, I think a lot of us are looking for some guidance. My personal viewpoint is treating any patient who won’t have long term issues if they are not being seen is medically irresponsible. Please provide us with more detailed guidelines catered to our profession.

      Posted by Katie on 3/18/2020 8:11 PM

    • I am a PT working out of Brooklyn NY for a large Outpatient Facility. In light of the COVID-19 outbreak the company I belong with has come out with minimal guidelines, constantly re-iterating CDC guidelines for washing hands and equipment. Meanwhile we don't have proper disinfectant, nor PPE, and no screening to eliminate possible sick individuals from the office. They've eliminated our ability to order food from outside, and restricted visitors to only parents of minors and caregivers if required. Within an hour we could have 15 patients within the facility and 10 workers. No windows, one way in/out. We work 10 inches to 3 feet away from individuals with no masks for patient or therapist. I've been furious with the way the company has addressed this situation, and I've been seeking some guidance from our beloved APTA for what the outpatient facilities should be doing. We are not a necessity. We are a luxury in most cases. We are not life and death. If someone can come 2x a week and practice an HEP independently, then they can practice it independently for a little longer by themselves. Post op should be priority. OA and other chronic conditions should not. Telehealth is just being placed within the company... however we will still have a full in house caseload... please HELP! They continue to claim they are for patient and employee where I see little effort on their end. We are on the front line, we are the ones working hands on...help us fight this not spread it! Risk vs benefit... the risk of someone transferring this illness to another is way higher then the benefit of them coming 2x per week.

      Posted by Deanna Fiore on 3/18/2020 8:25 PM

    • Can anybody tell me cdc definition of a a non essential health care provider ?

      Posted by joseph parente on 3/18/2020 10:58 PM

    • think it would be a worthwhile effort for the apta to issue guidance on critical diagnoses PTs must treat in a clinic? Or at least an article addressing this matter I think the list will be quite short. Actually non existent. What diagnoses do we Rx whose outcome cannot be accounted for via phone and home exercises Given Covid 19 looks to spread, in part, asymtomatically and given the nature of proximity for our profession, strong thought should be given to continuing in person treatment of any patient. Phone call based care and home programs should be the norm and if we can't get paid... sorry for that. We have as our principle directive, do no harm and assuring benefit of care is >risk Please consider an article, and or ideally a position statement, to address this current vague position of our organization. We can do better Thank you,

      Posted by Brad Jackson on 3/19/2020 12:59 AM

    • Home Health PT here-small hospital based agency, the newer therapists to the agency have not been fit tested for n95, nor given an 95 mask. With this virus ability to spread in those who carry it and are asympomatic….what are we to do? We ask all the usual questions--to a homebound person 'have you travelled out of the country….?' etc, but what if they're infected but no symptoms? I get it, no symptoms, and spread to my other patients? Also, we were told by the hospital that we needed to follow the CDC guidelines-which means no one wears a mask unless they're with a patient who has been exposed, or is thought to have, or confirmed with coronavirus. Otherwise-we need to be a model to the community and not instill fear by wearing a mask. The 'sick' people will be isolated, the not 'sick' people we don't need to wear a mask around. However-without symptoms but possibly infected, and/or, no testing available…how are we to know who is sick and who isn't? And don't get me started on the 'masks don't work so the public doesn't need to wear them' and that 'n95 masks won't work for the public because they haven't been fit tested for them'. I think it was something like 80%+ are size medium in the n95s, and in just using logic, something has got to be better than nothing. I wish the APTA would advocate for us, the PT's, who are wanting to help but are going to be spreading this bug to our dear patients, their families, and our families, and taken out of the game, and not helping more than helping.

      Posted by Kate on 3/19/2020 4:26 AM

    • To all your questions regarding APTA bring vague. APTA: crickets....

      Posted by Apta on 3/19/2020 5:21 AM

    • I own a small out patient clinic in a small town in Vermont and made the difficult decision to close as of yesterday. And, YES, I am the only one that has closed to date, but I felt it was my civic duty to to try to flatten the curve. I am NOT saving lives. Luckily, I had already put many patients on home programs earlier in the week. Our state has been very proactive and cancelled all elective surgeries starting last week,so the amount of "essential " PT should be limited other than CVA, heart or acute trauma. I believe that people have the viirus long before the " screening" guidelines, so if you follow that, I believe people are being treated with active virus and exposing all those around. For every different patient that you see, you increase YOUR risk , as well as all the others you are exposed to. I have one other employee who works at a near by hospital as well , and they have closed all their out patient clinics and are leaving only the main hospital open for essential , which includes post surgery, CVA, heart. Agreed that we have had very little strict guidelines but there is NO way to practice safe social distancing in our profession, despite our best efforts to disinfect, sanitize, etc. Telehelath is a great opportunity for us and CMS is lifting restrictions daily. This will hopefully help keep those small businesses stay afloat for this undetermined amount of time.

      Posted by Heidi on 3/19/2020 8:30 AM

    • Where can one find the answers to the post above. I too am a small Outpatient PT - I only treat one patient at a time and people have been grateful that I am still open. Yes we have had multiple cancellation - we take all precautions in sanitizing all surfaces and equipment as well as door handles, water coolers, etc. Until issued mandatory "Closure" directions from my association for which I pay a lot of money -I would like to get some answer.

      Posted by Miri Ingwer -> =IQaBH on 3/19/2020 8:38 AM

    • Can you please make a clear statement regarding Outpatient Physical Therapy as essential or non-essential. Thank you.

      Posted by Jack on 3/19/2020 11:50 AM

    • Profiteering amongst denial and putting us as therapists at risk seems to be rampant everywhere. My small clinic is doing the same. I work in both HH and OP settings as a PTA for a rural health center and nobody is advocating for my health or the health of my patients. We are not being told/ordered to wear droplet precautions. All we are hearing is reactionary, nothing proactive to stop spread. It's shameful and negligent and I almost want to quit.

      Posted by Andrea on 3/19/2020 1:52 PM

    • Please issue a definitive statement on whether our pair own clinics should remain open. I am fearful for my family’s safety working hands on with patients. We don’t have masks and proper PPE. One of our patients mom flew home from abroad and didn’t even quarantine herself, which would put everyone at risk, even our immunocompromised patients. PLEASE give some guidance......

      Posted by Rebecca on 3/19/2020 4:26 PM

    • Where do we find the answer regarding if out patient is essential or non-essential?

      Posted by Holly Eshbach on 3/19/2020 5:56 PM

    • Regarding hospice care during the Covid-19 pandemic. Should hospice non clinical staff working in office admin setting be working from home? We currently have hospices where some staff has been granted to work from home but others are still required to work at the office. I feel office staff can and should work remotely as they can do the same work from home setting. Please clarify. Thank you

      Posted by Wayne on 3/19/2020 6:17 PM

    • What is wrong with our profession? First an 8% cut in 2021, then 15% cut for PTA care in 2022 on top of that, and now the EXTREME of putting our lives and the public's lives in danger?? Is anyone advocating for us? I am so upset and seriously considering leaving the profession. I am embarrassed to be part of a profession that is DOING HARM!! PLEASE SHUT DOWN OUTPATIENT PHYSICAL THERAPY FACILITIES! Owners and corporations are putting their finances first, but without our health finances do NOT matter! We are BEGGING you APTA for your help to save lives and prevent the spread of this deadly virus. LOOK AT ITALY WHO DID NOT TAKE THE NECESSARY PRECAUTIONS, NEED I SAY MORE??

      Posted by Alex on 3/19/2020 7:35 PM

    • Same here i work for a chiropractor and he does not know if we are suppose to close or not. are we considered essential healthcare to be open now in such an emergency? shouldn't we also be closed for the safety of us, our families and our patients.

      Posted by stephanie on 3/19/2020 9:44 PM

    • I too want to know where to find the answer regarding if out patient is essential or non-essential? Should we continue to treat patients for outpatient PT, OT, ST?

      Posted by DeDe Bowles on 3/19/2020 11:09 PM

    • I work at a hospital as a nurses aide we are non professional are we going to stop working and just keep nurses and professional workers?

      Posted by Lisa lake on 3/20/2020 5:58 AM

    • EVERYONE: APTA IS OBVIOUSLY NOT GOING TO DO ANYTHING, PLEASE BOMBARD GOVERNMENT OFFICIALS WITH EMAILS. IF LOCAL LEGISLATION IS DECLARING A STATE OF EMERGENCY AND SHUTTING DOWN STORES, RESTAURANTS, GYMS, BARBERSHOPS, NAIL SALONS, SCHOOLS, AND DAYCARE...URGE/BEG THEM TO CLOSE NON-URGENT MEDICAL OFFICES SPECIFICALLY PT!

      Posted by Alex on 3/20/2020 9:42 AM

    • I work in the home health sector traveling from patient home to patient home. I use PPEs and wash hands frequently, but I am still considered for the health of my elderly patients. Most of the SNF and ALF have closed their doors to outside providers such as home health. But the company is still pushing therapist to make home visits of patients that agree to treatment at this time. If their is a mandatory quarantine, the company is saying I am exempt as a health care worker. I will not leave my home if a quarantine is issued. I don’t want to be a part of spreading this virus. I feel like PTs should be exempt since we are not front line, life saving health care professionals.

      Posted by Adriana on 3/20/2020 10:27 AM

    • I am scheduled for spinal fusion surgery April 6 2020 .I was told Medicare will not pay for my surgery unless I complete my out patient Physical Therapy . To date my Surgery has not been canceled .However it is unclear whether my physical therapy is essential or non essential Please let us know via news network .

      Posted by Ronna Hand on 3/20/2020 12:33 PM

    • Please define essential vs. non essential in regards to the physical therapy profession.

      Posted by Jack on 3/20/2020 12:48 PM

    • As a PTA at an outpatient clinic, I do not feel safe. We are cleaning after every patient, but that doesn’t stop it spreading through the air. How is outpatient PT deemed essential care? When is the APTA going to speak up for us? This is unsafe for workers and patients!

      Posted by Stacy on 3/20/2020 2:03 PM

    • Are Case Managers considered essential workers with a need to be in the hospital?

      Posted by Marie Tompkins on 3/20/2020 3:32 PM

    • Please Provide some clarity if outpatient physical therapy should be staying open or closed. As of right now there has been very little guidelines of this and we are in very close contact with people. I feel this is very poor decision making on the APTA as we should be healthcare leaders in this situation and following directions from our government. Please make a statement. The state of New York is suppose to be shut down and outpatient physical therapy continues to be open due to lack of authority in our field.

      Posted by Amanda on 3/20/2020 4:35 PM

    • How is it that outpatient PT is essential? Why are we still open??? My patients are coming in because the “gym is closed” or “Covid is a hoax”. We are unnecessarily being put in harms way and corporate and private PT owners are doing nothing nor is APTA or our government/ state boards. How do flatten the curve when people are allowed to come to outpatient PT because they are bored being “stuck in the house “. Now we see how we’re we rank, it’s all about the money and not about doing the right thing! We need to stand up as a profession and stop this, now we know. Outpatient PT is not essential at this moment in time when we’re in the middle of a pandemic. If a patient has an urgent surgery or a serious injury it should be addressed as a special need in a one on one designated environment.

      Posted by Joe on 3/20/2020 5:23 PM

    • Agreed! APTA needs to answer these questions! Are outpatient PT's considered essential or non-essential clinicians?

      Posted by Cristina Macke -> BKW\CL on 3/20/2020 5:35 PM

    • PTs are getting left in the dark about this. Please APTA show some leadership and responsibility by delivering some more guidelines and resources. We need it, our patients deserve it, and we’re looking to you for help at this time. Step it up APTA!

      Posted by D on 3/20/2020 6:07 PM

    • Please issue a statement regarding outpatient therapy clinics. I do not feel safe treating my elderly patients at this time. How is outpatient therapy considered essential during this crisis?

      Posted by Laura on 3/20/2020 9:36 PM

    • This is scary situation for all . I don’t think its necessary to go in home unless they don’t have family they can help and the help is essential or they need a skilled services like catheter change ,IV ,WOUND VAC, wound care . I think nurses should use nurse judgment and limit visit that can be limited especially for pt just receiving education which can be done over the phone and shouldn’t be a option in this troubling time . I have a little baby and elderly people in my home. I’m sure we all have someone that we matter to and we need to stay safe as health care worker . It’s sad we don’t have PPE and these pt do have people in and out there home . Praying for all .

      Posted by Kevin on 3/21/2020 12:16 AM

    • In response to all of the above concerns I referenced the letter written by APTA president Dunn (which apparently was updated on 3/20/20)..but that's unclear, as is much of the information and direction provided specifically by the APTA. My takeaway from the page and the letter is that "WE" are to follow CDC guidelines and do what "WE" feel is best for our patient populations. President Dunn leaves that decision to individual therapists (providers) to follow our practice act "do no harm" blah, blah, blah. Most of us work for companies large and small and strive to provide the best care possible. What many of you may or may not know is that large health care organizations ($$$$) have members that are on the boards of at least state, if not the national board of the APTA. In the clinic, it is the Physical Therapists License that is at risk "when the rules are broken" not on the company that covertly requires you to do all those things you know are questionable, yet we do because we need a job. Not all companies are guilty of this, but ALL companies need to pay Bill's. Is outpatient PT essential? Of course not, for at least 90% of the patients we see. President Dunn leaves the decision up to the individual Therapist to "do the right thing." How is this possible when your company is driven by their financial need to stay open and we as Therapists need to show up for work in order to secure a job when this pandemic is over. We know without question that outpatient centers need to close..its what our practice act dictates..The APTA has cancelled all group meetings, yet nearly every clinic experiences groups of 10 or more everyday..forget about social distancing or maintaining a completely sterile environment in a PT clinic, especially without PPE. IT`S NOT POSSIBLE. I'm always willing to admit when I'm wrong, so please do correct me if I am misdirected in my comments. In the meantime continue to speak up, contact our politicians--as mentioned above--continue to seek clarification for the health and safety of our patients, ourselves and our families. Also remember that President Dunn needs a job, as well, when this pandemic has resolved. So please be kind to the APTA, they are there for us.

      Posted by A Physical Therapist on 3/21/2020 2:20 AM

    • It is unethical for CMS to fail to mandate nurses in ALL outpatient clinics to wear N95 masks (mandatory admin to mandate this) based upon what we know about COVID19 having the highest transmission rates of all known viruses and living in the air for 3 hours. This FAILURE on the part of your oversight that we rely on for our protection and the protection of our families and other patients and communities is unforgivable. Pathetic. Seriously. Completely undermines your entire purpose and is an insult to the intelligence of healthcare providers. An utter slap in the face.

      Posted by Lynn Stark on 3/21/2020 3:39 AM

    • URGENT: Email your governor....and mayors of your city and neighboring cities EVERYDAY with your concerns. We all need to do this, they are the ones that can mandate closure, not the APTA. Ask them to mandate closure of outpatient physical therapy clinics or better yet order a shelter-in-place!

      Posted by Anton on 3/21/2020 10:28 AM

    • Agree with so many of you. Extremely disappointed in APTA's spineless response. Thank you to the Governor of Kentucky for closing all outpatient rehab clinics there. Let's get our governors to follow, please.

      Posted by LB on 3/21/2020 10:34 AM

    • I am a non-clinical personal care assistant for a homecare agency. We travel to multiple homes of seniors and veterans daily. Since our agency has never provided masks or hand sanitizer, I think that all services for level 1 clients should stop in our highly affected county in NH and in all of MA. Level one clients already have other family members in their home, especially now with so many working from home. Level 1 clients fall in the homemaker category for services; ie, housekeeping, socializing. The bottom line; We are exposing seniors by not social distancing. Many clients have cancelled services and many of our older caregivers are refusing shifts for their safety and many caregivers have to stay home because schools are closed. Stop the spread. Protect the seniors.

      Posted by Linda on 3/21/2020 10:37 AM

    • How is outpatient physical therapy essential? Working for a large corporation we are not using any PPEs. We are not able to use social distancing. We are touching: stretching, STM our patients for extended periods of time. This virus is contagious before there are symptoms. We can be spreading it to our patients and our family who are home under social isolation. Please APTA keep us safe and consider us non essential healthcare workers.

      Posted by A concerned PT on 3/21/2020 3:19 PM

    • I’m a in home health care giver. I recently started taking my client to her treatments at the hospital. I was told I was not aloud to wear a mask inside of the hospital (wound care) I would be labeled as sick and kicked out of the hospital. This is ridiculous. I need to protect myself my client and my family. Please tell me I can protect us.

      Posted by Cynthia on 3/21/2020 7:03 PM

    • I Work For A Hospice Unit JOURNEYCARE , This Employer Removed A Mogority Of Our Mask, Wanting Us To Use Universal Precautions For All Patients, This Employer I Know For A Fect Will Not Let Us Know If A Patient Was Escubated Off Life Support, This Employer 1st Removed All Mask, Until Staff Threatened To Leave There Shift, T That Time 6 Mask (For Each Employee Working, Was Handed Out, ) JOURNEYCARE Could Care Less About There Employees, This Was A Slept In The Face For Us The RN And CNA, Taking Care Of The Very Sick, And Dying. ITS TIME FOR NEW EMPLOYERS.

      Posted by SHELBY LIDDELL on 3/21/2020 11:19 PM

    • Clarification regarding essential services is needed! I am a home health and hospice social worker and I have had no direction from my company in regards to a standard practice regarding social service visits. I am being directed to make home visits if pt. and families are agreeable. My temp is taken, face mask worn and I am expected to make visits. PT& OT are also making routine visits, this seems irresponsible. I understand compassionate care for hospice patients but again what it seems less exposure is better now.

      Posted by Social worker on 3/21/2020 11:22 PM

    • We need guidance on home health visits to protect us! We are not a necessary service right now - no one will die without us! We are putting ourselves and patients at risk by making several visits a day - especially without gowns! I have an autoimmune disease but I need my job! Please protect us!

      Posted by ScaredHHPT on 3/21/2020 11:59 PM

    • As a cna in in a senior rehab center Shouldn't all the cnas be wearing face mask even if we don't have the n95s so I don't give it to people and they can't give it to me . Just to for preventive measures????

      Posted by cindy lee Hendricks on 3/22/2020 12:26 AM

    • Yes, PT is definitely essential and we are not downplaying our profession. Many are just saying that OPPT is not essential during this pandemic. What is essential during this time is everyone's LIVES and health! Pre-screening is not enough protection since people can have the virus without symptoms (it takes 2-14 days for symptoms to develop after exposure) or be carriers. From the CDC: https://www.cdc.gov/coronavirus/2019-ncov/prepare/transmission.html The virus is thought to spread mainly from person-to-person. -Between people who are in close contact with one another (within about 6 feet). -Through respiratory droplets produced when an infected person coughs or sneezes.These droplets can land in the mouths or noses of people who are nearby or possibly be inhaled into the lungs. From the NIH: https://www.nih.gov/news-events/news-releases/new-coronavirus-stable-hours-surfaces The virus that causes coronavirus disease 2019 (COVID-19) is stable for several hours to days in aerosols and on surfaces, according to a new study from National Institutes of Health, CDC, UCLA and Princeton University scientists in The New England Journal of Medicine. The scientists found that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detectable in aerosols for up to three hours, up to four hours on copper, up to 24 hours on cardboard and up to two to three days on plastic and stainless steel. The results provide key information about the stability of SARS-CoV-2, which causes COVID-19 disease, and suggests that people may acquire the virus through the air and after touching contaminated objects. Again, write to your governor and local politicians, they are the ones that can mandate closure, not the APTA. On the other hand, OPPT owners don't have to wait for a mandate or for others to close to make the decision to close themselves. We decided to close our doors without a mandate. And for employees who do not feel safe, you have every right as an employee to say that you don't feel safe and can refuse to go in, as some of our employees have done. Yes, we are all afraid about our finances if we don't work, but what good are our finances if we don't have our health. I read someone's post on another site and they stated, "Do not change your behavior to avoid being exposed – act like you already are exposed, and change your behavior to avoid exposing others." I think that was a great statement. Take care everyone!

      Posted by Jane on 3/22/2020 12:04 PM

    • I work in a small desert town and am a PTaide.I was threatened with my job on friday that if I didn't come in I would be fired. I have been there for over three years, rented from my boss for over 8 years, I am 63,smoke and am scared to get this. 90% of our patients are over 60,most in their 70's to 90's. I don't want to be there, can she legally fire me during this crisis? thank you,Kym in California

      Posted by Kym Shull on 3/22/2020 12:10 PM

    • I am a PT working in a SNF setting. We have not had a confirmed case yet but I am feeling in this pandemic situation and the spread is so easy, this makes sense to discontinue PT services to prevent the spread from patient to patient. We can’t insure spreading it to the next patient. The benefit of isolation far outweighs us seeing the patient for care. We are risking our patients.

      Posted by Don Fredericksen on 3/22/2020 12:29 PM

    • I visit an outpatient physical therapy office 2-3x a week.. Truth be told every single person visiting was a car accident victim or the like..WALKS in and out to their CAR..and is in no way in a life or death situation. Meanwhile, 10 people are being assembly line treated with 6 staff members in a small closed in situation..whos gonna pick up the ball and say enough is enough?..these greedy lawyers and doctors are gonna kill everybody by not shutting down the shop until the coast is clear..so in these cases the state needs to step in!!

      Posted by Danni on 3/22/2020 5:16 PM

    • Physical Therapy is essential for quality of life. However, it IS NOT essential for life or death.

      Posted by Rhonda Whitt on 3/22/2020 9:54 PM

    • Reading everyone who wrote in have the same concerns as I. APTA is suppose to provide the guidance and standards to follow in times like these. I understand that Covid19 is unchartered waters, but you need to step up to the podium and air on the side of extreme caution. Outpatient PT clinics are in my mind nonessential. Essential is hospital based PT services and some home health. Plane and simple. Stand your ground and make the decision before the spread of Covid19 continues,

      Posted by Sean on 3/22/2020 11:28 PM

    • My question is, why are you waiting for the APTA to decide for you? Or your employer? Use your clinical judgment. If you feel unsafe, use your PTO. Someone needs to be the leader in this.,Maybe others will follow suit. I can understand if you are living paycheck to paycheck and have a family. But Trump just passed a 12 week paid leave IF your employer has < 500 employees. Look into that. I am in my 50’s and have seen it all. I took a stand on other issues in the 90’s and have no regrets. If you are living with your folks, you can afford a couple of weeks away from work.

      Posted by Rita Schnell on 3/23/2020 4:08 AM

    • In regard to outpatient PT, It seems irresponsible to have therapists and support staff needlessly exposed to a virus that can spread very easily. We are not able to stay 6 feet away, we do not have masks, many may not have gloves or a limited supply, and we are in contact with a multitude of people a day, not knowing who they were in contact with and if they were exposed. Furthermore, many return to home to families with spouses, children, and possibly older adults they take care of. Of course, we want to serve and love our patients, but the loving thing to do may be keeping safe distance to avoid further spread and harm to others.

      Posted by Kyle on 3/23/2020 11:51 AM

    • I work in Home Health Care and there really isn't any guidelines set for us. We may be considered life sustaining but not all of us go out in the field yet we are still required to come into work each day. We are putting our families at risk by coming to work and Governor Wolf is doing nothing to assist us. Help the people on the front lines not just the people out of work that can collect unemployment. I'd prefer not to contact this virus because I must come to work.

      Posted by Tiffany on 3/23/2020 1:38 PM

    • PLZ adise outpatient clinics to close especially in those states with GOV executive orders to stay in place are you idiots Thank you this is why the should be closed NOW https://www.nbcchicago.com/top-videos-home/chicago-doctors-blunt-speech-about-covid-19-hits-home-across-the-country/2241880/

      Posted by tj jonson on 3/23/2020 3:28 PM

    • close outpatient clinics now how MANY HAVE TO DIE OHIO MICHIGAN ILLINOIS MERCY HEALTH IS BIGGEST VIOLATOR OF HUMAN SAFETY WHY HERE IT IS https://www.nbcchicago.com/top-videos-home/chicago-doctors-blunt-speech-about-covid-19-hits-home-across-the-country/2241880/

      Posted by tj jonson on 3/23/2020 3:36 PM

    • I too am a home health aide for a small company who have not provided anything for protection. I go into private homes with clients all over 80. The office workers have shut the doors to the public. This is horribly irresponsible behavior to me. The company told us you don't go to work you don't get paid. What can we do for the safety of our elderly clients and ourselves? I am a minimum wage worker.

      Posted by Jacquie on 3/23/2020 4:08 PM

    • I work in healthcare where we take care of 126 elderly people noone at the job wears any kind of PPE. We are not allowed to wear masks and have to count gloves. Today i had a temp of 101.8 shortness of breath and a cough. I called 8 places in CT also contacting the CDC and I was not allowed to get tested because i was not 60 years old. I explained to them im around people over 60 everyday with no mask that i need to know so i can make them aware, and they didnt care. I have a baby who also has a temp and a cough. This is a shame healthcare workers taking care of the elderly need to be in gowns mask sheilds and gloves, and should be tested when they have symptoms. We need to do better here America, cdc this is not enough. If im 60 im most likely calling 911 to go to the hospital with bad symptoms never mind sitting hours in line to get tested. Shouldnt matter the age ANY Healthcare worker should be tested. We need to be able to test younger people especially ones that work with elderly. Help this issue please help!!!

      Posted by Tracy on 3/23/2020 8:40 PM

    • H!! One of my PT colleagues found out one of their home care patient (geriatrics) was diagnosed with Covid19. They are told to stay home and quarantine. Now we are given their case load/patients (not the one with Covid). Should we see their patients? Could the patients be possibly affected by our colleague and potentially spread it to other PTs?? Should their patients be told they could be affected?? what is the protocol for this situation?? Thanks for any help!!

      Posted by VVal on 3/27/2020 12:07 PM

    • Anyone who thinks that physical therapy is not essential has never been in chronic pain. I wish that PT were "nonessential" in my life.

      Posted by Rachelle Shurtliff on 3/28/2020 8:05 PM

    • Hi I am concerned because we have sick unit for strictly covid patients but why are the nurses from non-covid designated area being floated there. Can anyone help me find evidence based practice to help me proof this is not safe for our patient. I work on a surgical unit were some surgery still are happening in some cases. Does anyone again. Why isn’t all nurse on board like our CEO or office staff that are RN helping on floors we should all be helping out we are getting burnt out. We need more help!!!!!

      Posted by Amy on 3/30/2020 4:21 PM

    • Are the office staff at a nursing home required to come in or should they be considered no essential and work from home? I am being told healthcare employees are essential yet I am not nursing? PLEASE ADVISE

      Posted by Mary O on 3/31/2020 8:27 AM

    • Please shut down all outpatient PT clinics , we work for a large company and they want us to still double our patients 2 a hour .. patients were sent emails from our company NOT to cancel their appts and that we are staying open and taking precautions. We have 3 PT and one is a cancer therapist who only sees cancer patients .. we have no gowns and NO masks and no one wears gloves while in the gym , we do disinfect after as Much as we can. I’m now the only one working the front desk and answering the phones and doing the scheduling and live with my 77 year old mother .. look at all the comments about this issue on this and please give us all a answer !! I feel like we r risking our lives , they aren’t doing anymore elective surgeries at the time and I don’t feel like they all need therapy at this time. I want to quit but hate leaving my PTs that are working so hard behind.. our company is just worried about the $$$ while the big guys and managers are all working from home !

      Posted by Stephanie on 3/31/2020 10:44 PM

    • will the state of ohio medcade and medicare going to stop these home health aides going in homes untill this virus is gone

      Posted by Donald J. Blair on 4/1/2020 9:54 AM

    • Why won't the APTA advocate for us? The ADA is advocating for dentists. The ADA president even did a YouTube video from his home telling his fellow dentists that he hears them and is advocating for them. I wish the APTA would do the same. PLEASE HELP OUTPATIENT PTs AND ANY OTHER PTs WHO DO NOT FEEL SAFE TREATING PATIENTS! Contact the CDC for guidance on our behalf, PLEASE! Telling us to use our professional judgement is not enough! PLEASE HEAR US! The ADA contacted the CDC and is advocating for their dentists: “We urge you to publish immediate guidance on how to protect patients and dental workers during emergency and urgent care episodes during the COVID-19 outbreak,” the letter concluded. “Such guidance would also go a long way to help prevent unnecessary referrals to local hospital emergency departments during this time of crisis.” https://www.ada.org/en/publications/ada-news/2020-archive/march/ada-urges-cdc-for-guidance-on-protecting-dental-patients-staff-from-covid-19-during-emergencies

      Posted by Anton on 4/2/2020 3:45 AM

    • Seriously,, APTA wake up. CDC wake up,, CMS wake up. Without proper guidelines and lack of strong action you are putting healthcare workers and senior citizens/patients at risk. What ever can wait / like HH PT, outpatient physical therapy, hand therapy needs to wait. This is a Pandemic we are dealing with that will put millions of life at risk because you couldn’t define difference in essential and non- essential healthcare personnel and you couldn’t put stricter control on social distancing in long term care communities. Take action now.

      Posted by John P on 4/2/2020 10:15 PM

    • I am looking for referrals to a website where I can buy cleaning supplies, masks, gloves, or anything else I might need to keep my client safe. My client cannot afford to buy all the PPE I may need to keep myself and my client safe. I can provide a CNA license number if necessary. The health of my client is more important than money spent.

      Posted by Jennifer L on 4/6/2020 2:44 PM

    • I'm a PCA & HHA employed by a home care agency for seniors. Office workers are working from home & yet we are mandated to report for all our shifts. Obviously our clients aren't life sustaining or they would be hospitalized or in a nursing home. We've been told if we aren't sick with Covid or signs of it, we Must report to work or be terminated. I'm over 60, have an underlying immune problem and am the main income at home. Of course the company I work for offers no sick pay or vacation pay. I've been with this company 10 years. Is this legal the way they are putting us in harm's way? My current client sometimes has up to 12 different workers coming & going!

      Posted by Anna T. on 4/7/2020 8:52 AM

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