The COVID-19 pandemic has arrived and as providers, we need to make some tough decisions regarding what is considered “essential” and how that decision may impact our residents. Determining whether a skilled physical therapist, occupational therapist or speech-language pathologist should enter your community to provide services can be difficult. Do you assess the level of need/potential decline the resident may experience or do you adhere to the guidance to restrict visitors and consider skilled therapists “non-essential”?

First, it is important to consider the intent of the federal and state guidance as it applies to meeting the needs of each resident individually.  This should be done on a case by case basis and remember to consider the increased susceptibly of the population in your center to infection.

While there are no hard and set rules or even “best practices” available to us, here are a few things to consider:

• Review the care plan interventions and set goals; discuss with the resident/family to determine if it meets the needs of the resident or if it could be revised. Remember, the care plan is a living document and should be updated when situations change such as a “hold on therapy”.
• If you determine that skilled therapists are “essential” to your community and COVID-19 begins to spread, consider assigning therapists and assistants to provide services needed to meet the basic needs of the residents.  This decision should also include input from the Administrator and the Medical Director.
• If the center is allowing skilled therapists to provide services to residents, all group and concurrent services should be discontinued. Services should be individual and provided in resident rooms while maintaining social distancing.
• Cleaning/disinfecting/sanitizing therapy equipment between each use is mandatory and a high priority for preventing the spread of infection. Be sure to document each time equipment is cleaned.
• If COVID-19 is identified in a community, therapists should not be permitted to travel between communities providing services. Ideally, dedicated therapy staff should be assigned to each community.
• Therapy staff will observe the same precautions as other “essential staff” i.e., an assessment upon arrival at the beginning of their shift that includes temperature checks. Other precautions that should be mandatory include masking, social distancing, frequent hand washing, and quarantining if symptoms develop.

Yes, these are unprecedented times and although the days run together and there seems to be little “brightness” in our days, this too will end, life will take on a new “norm” and our residents and staff will thrive! Stay safe, stay well, and stay tuned!