LTCF Resources
Long Term Care Facility Reporting
Acute Gastroenteritis Outbreak Definition for Long Term Care Facilities: 3 or more residents/staff form the same unit/wing with 2 or more AGE symptoms* within 72 hours of each other
*Nausea, vomiting, diarrhea, abdominal cramping, fever, chills
To report an AGE outbreak at a LTCF to the Health Department, please:
1. Fill out a Report Form
2. Complete appropriate line lists (please fill ALL fields): Resident Line List; Staff Line List
3. Fax both report forms and line list(s) with subject line reading facility name, AGE reporting to 920-683-4156
4. Continue to submit line lists to Public Health for the duration of the outbreak and when the outbreak is over.
Items to Review and Follow
– Wisconsin DHS Guidelines for Prevention and Control of AGE Outbreaks in LTCFs
– Follow facility/organizational guideline for AGE outbreaks
– Implement appropriate transmission-based precautions
– Increase the frequency of routine cleaning, including bathrooms and frequently touched surfaces
– Post signage indicating that the facility is experiencing an increase in AGE illness
Additional Resources
CDC Contact Precautions Sign
DHS Norovirus Page
Acute Respiratory Illness Outbreak Definition for Long Term Care Facilities (including COVID-19): 3 or more residents/staff form the same unit/wing with 2 or more ARI symptoms* within 72 hours of each other
*Fever >100F or 2 degrees above baseline, cough, nasal congestion, myalgia, sore throat
To report a Respiratory outbreak including COVID-19 at a LTCF to the Health Department, please:
1. Fill out a report form
2. Complete appropriate line lists (please fill ALL fields): Resident Line List; Staff Line List
3. Fax both report forms and line list(s) with subject line reading facility name, ARI reporting to 920-683-4156
4. Continue to submit line lists to Public Health for the duration of the outbreak and when the outbreak is over.
Items to Review and Follow
– Wisconsin DHS Guidelines “Preventing and Controlling Respiratory Illness Outbreaks in Long-Term Care Facilities”
– Follow facility/organizational guidelines for ARI outbreaks
– Implement appropriate transmission-based precautions
– Increase the frequency of routine cleaning, including bathrooms and frequently touched surfaces
– Post signage indicating that the facility is experiencing an increase in ARI
Additional Resources
Interim Guidance for Influenza Outbreak Management in Long-Term Care Facilities
CDC Droplet Precautions Sign
CDC Contact Precautions Sign
CDC Airborne Precautions Sign
DHS COVID-19 Assisted Living Guidance
DHS COVID-19 Nursing Home Guidance
Reportable Multidrug-Resistant Organisms (MDRO) include:
Carbapenem-Resistant Acinetobacter baumannii (CP-CRAB)
Carbapenem-Resistant Pseudomonas aeruginosa (CP-CRPA)
Carbapenem-Resistant Enterobacterales (CP-CRE)
Candida auris (C.auris)
Inter-Facility Infection Control Transfer Form
Transfer Form
Additional Resources
DHS Reportable MDRO Page
Guide for Prevention and Control of Antibiotic Resistant Organisms in Health Care Settings
Recommendations for Prevention and Control of Targeted Multidrug-Resistant Organisms in Wisconsin Nursing Homes
CDC Contact Precautions Sign
CDC Enhanced Barrier Precautions Sign
Infection Prevention Assistance
The Wisconsin Healthcare-Associated Infections (HAI) Prevention Program conducts statewide HAI surveillance and provides technical assistance in a variety of areas for health care and public health partners, including infection prevention and control, the National Healthcare Safety Network (NHSN), multidrug-resistant organism containment, and antimicrobial stewardship.
Northeastern Region Infection Preventionist
Tess Hendricks, BS, MLS, CIC
[email protected]
608-338-9071
Infection Prevention Training
CDC’s Nursing Home Infection Preventionist Training Course
DHS’s Training the Next Generation of Wisconsin Nursing Home Infection Preventionists
Resources
Infection Preventionist Starter Kit
Donning and Doffing PPE
Hand Hygiene and Personal Protective Equipment (PPE) Observations
Handwashing