There’s nothing quite like a National Public Health Emergency to shake things up and force an altered perspective. Most providers are doing well to keep up with near-daily changes relative to managing the pandemic in its current form and, in a whirlwind of Infection Prevention, waivers, vaccination clinics and organizational challenges– it’s hard to guess what the future will look like for our facilities. In the process of “getting back to normal,” consider taking steps to rethink processes and apply positive changes in response to lessons learned.  Consider these areas in your action plan:

Emergency Preparedness

The PHE has clearly been an impactful real-life event, but also an effective exercise in the effectiveness of a facility’s Emergency Preparedness Plan. Aside from the nation-wide PPE shortages, some facilities quickly realized they were ill-prepared for an infectious disease outbreak in the areas of staffing, communication plans, facility layout for isolation/quarantine rooms, vendor contracts, and additional supply needs to name a few. As barriers are overcome during the current PHE, updates and revisions to the plan should be made to better prepare for future emergencies.

Individualized and Advanced Care Planning

As always, care planning should be person-centered and reflect individual preferences. New and increased use of technology for communication, activities, and telehealth is one area that is likely to continue to grow even after the PHE and should continue to be a part of the care planning process where appropriate and preferred. Another care planning concern that can’t be understated is the potential psychosocial effects of isolation, fear, and in some cases trauma, that were and/or continue to be experienced by some residents due to COVID-19. The aggressive nature in which COVID-19 affected the elderly population also underscored the importance of Advanced Care Planning. Each individual deserves an advanced care plan based on comprehensive assessment and shared decision-making. Early discussions about prevention, rehabilitation, and timely palliative care are imperative to meeting the needs and wishes of the individual.

Promoting Safe Socialization

Quarantine, isolation, and limited physical interaction, the interventions required to protect the vulnerable population, inevitably led to increased seclusion due to potentially unsafe gatherings. This made group activities, communal dining, and prolonged interactions dangerous, discouraged, and restricted. As we collectively turn a corner in the fight against COVID-19 through vaccinations, re-evaluating activities, excursions, and social events are a hot topic of discussion in the days to come. Visitation requirements and restrictions continue to evolve as well, and may still require advanced planning, communication, and specific accommodations for quite some time. Take advantage of any activity that can be safely performed while following current restrictions, and continue to think creatively to provide opportunities for socialization through activities using virtual platforms and in-house television systems.

Restoring Physical Ability

Due to the safety restrictions mentioned above, some residents have likely been more inclined to develop limitations in self-care and mobility. This may be further coupled with staffing challenges including shortages and reassignments that would, directly and indirectly, impact therapy provision and restorative nursing services. Implementing or reinvigorating a Restorative Nursing Program would be in everyone’s best interests as an arrow in the quiver to begin restoring function to those recovering from or otherwise affected by COVID-19.

Rebuilding Census

The National Investment Center for Seniors Housing and Care (NIC) reports that skilled nursing occupancy has fallen by nearly 11% since the pandemic began. While there is likely more than one reason a facility may be experiencing diminished occupancy, now’s the time to evaluate capabilities and strategize to improve admission rates. For starters, become reacquainted with hospital discharge planners; communicate your ability to receive residents and highlight clinical capabilities.  Additionally, remember to address the community. Update the facility website and/or social media outlets – tout your infection control and prevention program and applaud vaccination rates, and remind consumers of respite programs, value added services provided, and technological advancements. Above all, reconnect, build trust, and focus on quality care and positive outcomes.


Join Proactive’s expert presenters for a weekly 6-part series, Restorative Nursing Excellence: Revitalizing Programs & Restoring Function After COVID-19, that offers a fresh perspective on restorative with insights into considerations related to COVID-19 recovery. This virtual series will cover restorative nursing staff orientation/competencies, program development essentials, care plans, promoting optimal care delivery and outcomes, compliant documentation, accurate reimbursement, and quality assurance best practices. Learn more


Blog by Eleisha Wilkes, RN, RAC-CTA, RAC-CT, DNS-CT, Proactive Medical Review

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