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Tools and Resources

Admission Transfer Discharge Rights

Admission Transfer Discharge Rights

Discharge Summary

Discharge Needs Assessment

Infection Control

PPE Guidance: Gowns

PPE Guidance: Gloves

DOHMH Infection Control Resource for Long-Term Care 

Sample Antibiogram

SBAR_UTI

Facility Assessment

Facility Assessment – IG

GNY Sample Facility Assessment

Facility_Assessment_2017_08_18_Final QIO CMS

Regulatory Guidance

Generator Testing

Winter Weather Preparedness

Fire Watch Procedures

Temporary Fire Watch Plan

Fire Watch Log

CMS Requirements of Participation for Long Term Care Dental Services

GW-Sample SNF Investigations Log

(NYSDOH) POC guide

PDPM

PRESENTATION #1 GNYHCFA OVERVIEW HEALTH CARE LANDSCAPE MEDICARE 101 SNF DOCUMENTATION

PRESENTATION #2 GNYHCFA UNDERSTANDING PDPM; COMPONENTS & MDS CODING FOR PDPM

PRESENTATION #3 GNYHCFA ICD-10-CM AND UB-04 CODING FOR PDPM

PRESENTATION #4 GNYHCFA PUTTING IT ALL TOGETHER PDPM CASE STUDY

PRESENTATION #5 GNYHCA MANAGING THE MEDICARE RESIDENT

HANDOUT #1 SNF DOCUMENTATION GUIDELINES

HANDOUT #2 DAILY SKILLED NURSE’S NOTE FORM

HANDOUT #3 AANAC PDPM TOOLS

Handout #4 TCG PDPM Medicare Diagnosis Worksheet

HANDOUT #5 SAMPLE PHYSICIAN DIAGNOSIS QUERY TEMPLATES

TCG PROPOSED PDPM Rate DRAFT Nassau and Suffolk

TCG PROPOSED PDPM Rate DRAFT NY Boroughs

Phase II

4.13.22 SAMPLE Comprehensive Care Plan Policy

Discharge Planning Policy & Procedure

QAPI Policy and Procedure

Facility Assessment – IG

Phase III

Policies and Procedures

8.5.22 Sample PP Monkeypox

6.22.22 Sample Comprehensive PP-Covid-19-Rev-6 22 22

6.22.22 Sample PP – Covid 19 Vaccine for Staff Rev 6 22 22

6.22.22 Sample-PP-Covid-19-Vaccine-for-Residents-Rev-6 22-2022

6.8.22 Sample-PP-Testing-Covid rev 6 8 22

5.1.22 Sample PP – Discontinuation of TBPs Rev 5-1-2022

4.27.22 Sample PP – Side Rail Usage

4.26.22 Sample PP Legionella Policy incl audits

4.24.22 Sample PP – Return to Work Rev 4-24-2022

4.22.22 Sample PP – Legionella

4.26.22 Sample PP – Out on Pass Rev 4-26-2022

3.10.22 Sample PP – Tuberculosis

3.7.22 Sample PP – Thickening Liquids

3.7.22 Sample PP – Medication Adminstration Guidance for Thickened Liquids

3.8.22 Sample PP – Aspiration precaution PP

3.7.22 Sample PP – Abuse Prevention

2-24-20223.2.22 Sample PP – Linen Management

2.17.22 Sample PP – Foley Catheter Insertion Removal and Maintenance Rev

2.10.22 Sample PP – Notification Communication COVID-19

1.14.22 Sample PP – Visitation 1-14-2022

1.14.22 i-Health Swab instructions

1.13.22 Visitor Fact Sheet

1.5.22 NYS Work Restriction for HCP Algorithm

12.28.21 Sample -NFPA_99_Risk_Assessment

11.3.21 Sample – Contact Tracing – Staff

11.3.21 Sample Contact Tracing – Residents

  • Covid19_immunization_screening_and_consent_form_10.23.21
  • Information for Healthcare Providers_COVID-19 Screening Checklist_10-23-21
  • Guidance for COVID Vaccine Providers 10.23.21

QAPI

  • QAPI Policy and Procedure
  • QAPI MADE EASY sample
  • QAPIPlanHow-To-Guide
  • LS3-QAPIPlanHow-To-Guide (1)
  • SAMPLE QAPI STATEMENT AND ACTION PLAN
  • 9.15.21 Religious Exemption Form – Rev 9 15 21

GNY – Medical Exemption Form Rev

7.21.21 Sample PP – Candida Auris

7.12.21 Sample PP – Communal Dining 7-12-2021

7.14.21 Sample PP- Group Activities 7-12-2021

7.14.21 Sample PP – Cleaning and Disinfecting Environmental Surfaces

6.10.21 Sample PP – Personal and Compassionate Caregiving Visitation in NHs

  • 6.10.21 Personal and Compassionate Cargiving Visitation Fact Sheet
  • 6.10.21 Personal and Compassionate Caregivers Elective Form

Bed System Measurement Device Test Results Worksheet

Vaccine Fact Sheets

  • Fact Sheet – Covid-19 JJ Vaccine
  • Fact Sheet – Covid-19 Pfizer Vaccine
  • Fact Sheet – Covid-19 Moderna Vaccine

6.3.21 Sample Covid-19 Vaccine Tool

6.3.21- Lesson Plan – Covid Vaccine

5.30.21 SAMPLE PP – Eye Protection Use During Covid 19 Rev 5-20-2021

NYSDOH – Predrawn Vaccine Policy 5-3-2021

4.22.21 Sample PP – Out on Pass

4.22.21 – Sample Risk Assessment – Covid Exposure OOP

4.22.21 Sample PP – Resident Risk Assessment for Covid Exposure

4.22.21 Sample Risk Assessment – Covid Exposure Admissions

  • 4.20.21 Sample Risk Assessment – Residents Going out to Community

4.19.21 Sample Covid Vaccine Declination Form HCP

4.19.21 Sample Covid Vaccine Declination Form – Residents

P and P – Using Rehab Gym During Covid Pandemic

Summary – DOH Visitation Guidelines 3 25 2021

  • NYSDOH Updated NH Visitation Guidance 3 25 21

2.18.21 SAMPLE PP Influenza Vaccine – Residents

2.18.21 SAMPLE PP Influenza Vaccine – Staff

2.18.21 SAMPLE PP Tuberculosis

Sample PP – Resident with Dementia

  • Dementia Care Compentency

PP Elevator Entrapment

PP COVID-19 Revised 1-27-2021

21-02 Attachment – Encouraging Staff to Vaccinate

PP Resident Screening

PP Regulated Medical Waste – biohazard

PP Staff Screening Tool

PP Bedhold

PP Vendors during Pandemic

PP Surveillance of Infection

PP Developing Cohorts During Pandemic

  • CDC Guidance Resident Cohorting

PP Telehealth During Pandemic

PP PPE

PP Subsistence Policy

PP Infection Control Program

Risk Communication Policy

DOH SURVEY Q&A

Emergency Communication Policy

Communication with Family and Residents

Communication with NYS DOH and NYC DOHMH

NYSDOH Review PPE Notification

NYSDOH Advisory – Tropical Storm Isaias Guidance

Federal Point of Care Testing Equipment

  • Federal Point of Care Testing Equipment
  • Frequently Asked Questions. COVID-19 Testing at Skilled Nursing Facilities

CEMP & PEP

  • CEMP_and_PEP_Template_revised 8-20-2020
  • PEP_Tool_Kit_Annex_K_final 8-20-2020
  • Accessing PEP plan files on HCS

PP SAMPLE Contact Tracing Policy Covid 19 Pandemic 7.22.20

NYC Nursing Home Emergency Surge Staffing

  • Surge Staffing – Facility Terms and Conditions – Final
  • NYC HCF Staffing Needs
  • HR Onboarding Certification Requirements

SAMPLE RESPIRATORY PROTECTION PROGRAM rev [1]

  • OSHA Hospital Respiratory Protection Toolkit

COVID-19 Inservice Education Curriculum

PP Medically Necessary Consultant Services

NYSDOH DAL – Required COVID-19 Testing for all Nursing Home and Adult Care Facility Personnel

Covid Testing Letter Employee

PP COVID-19 Response and Updates

Weekly Letter to Families

Facility Daily Messaging

PP Paid Feeding Assistants COVID-19

OSHA Information

OSHA4120 ETS Summary

OSHA4123 Fact Sheet

COVID-19_Healthcare_ETS_Model_Written_Plan

COVID-19 Healthcare ETS 504 Mini Respiratory Protection Program Employee Training

COVID-19 Healthcare ETS 502 Employee Training

OSHA COVID

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