February Medical Director Report

Pikes Peak Ethics Committee Meeting

• First Friday of every month at noon.
• Please consider bringing a case to the meeting. It’s a great opportunity to discuss difficult cases with your peers in LTC, share experiences, and learn from each other.
• Email me if you would like to be added to our email list to receive the agenda and reminders about the meeting.
• https://zoom.us/j/97461641616?pwd=YPpJU1ZHMG3bTChSVxAcD9gb39qVaY.1

Falls: Special Focus for Surveyors

• CMS is prompting our Colorado surveyors to pay special attention to falls.
  • The average number of falls is higher in Colorado than the national average.
    • Colorado avg 49%; National avg 44%
• REMEMBER: LPNs are not licensed to assess post-fall or other acute episodes. They are supposed to assess only stable situations.

Regulatory Updates

• Ensure Vaccine documentation: Offer vaccinations, track declination/agreement for vaccine, when vaccinations are given, vaccine clinic dates, etc….***
• Ensure the correct diet orders and textures upon admission. Do NOT give a regular diet to someone who is supposed to have a modified texture! ***

• IFU – Instructions for Use – All medical devices and equipment have IFUs and organizations are expected to follow those instructions for use.
• Ensure we have a facility map outlining where the oxygen is stored, emergency exits, firewalls, etc…
• Enhanced Barrier Precautions and Group A Strep
  • Consider having individualized wound care supplies for each individual patient. Each patient can have their own supply box.
  • Be aware of continued surveillance for Group A Strep.

Vaccination Documentation

• Please make sure that we have offered vaccinations to all of our patients and documented either acceptance or refusal of vaccinations for COVID, Influenza, and Pneumonia.
  • ONE COVID SHOT < 64 y/o
    • Immunocompetent individuals aged 5 to 64 years – Individuals in this age group receive one 2025-2026 formula COVID-19 vaccine dose. This includes individuals who have already received prior vaccine doses.
  • TWO COVID SHOTS > 65 y/o OR IMMUNOCOMPROMISED
    • Immunocompetent individuals aged 65 years or older – Individuals in this age group receive two 2025-2026 formula COVID-19 vaccine doses, with the second given approximately six months (and a minimum of two months) after the first.
    • Individuals aged six months and older with immunocompromising conditions – Individuals with immunocompromising conditions receive at least two 2025-2026 formula COVID-19 vaccine doses, with the second given at least two months after the first. We individualize the decision to give additional doses

COVID/Influenza/RSV

• Influenza cases may have peaked and seem to be trending down.
• RSV cases are trending upward.
• COVID-19, influenza, and RSV resources for residential and long-term care facilities | Colorado Department of Public Health and Environment

Tapering Antidepressants: What Strategy Works Best?

For adults with remitted depression, gradual tapering of antidepressant medication, alongside psychological support, prevents relapse to a similar extent as continuing antidepressants at full therapeutic doses, while abrupt or fast discontinuation should be avoided, a new analysis showed.

Slow tapering with support could prevent one relapse in every five people compared with abrupt stopping or fast tapering, investigators estimated, adding that the findings point to a need for updated evidence-based guidelines that encourage regular treatment review and effective deprescribing when appropriate.

Residential and LTC Facility Call Slides– CDPHE

• Following your manufacturer’s Instructions for Use (IFU)
  • Pam Fricke, CDPHE HAI/AR Program, Infection Preventionist
• Invasive group A Streptococcus in LTCFs
  • Cayla Mayle, HAI Prevention and Response Epidemiologist
• Viral respiratory disease updates
  • Deborah Aragon, FluSurv-NET and Response Unit Manager