Clarification of Staffing Options for Congregate Care Facilities Experiencing Staff Shortages

Health care workers (HCW) who have experienced a high-risk exposure to a person with COVD-19, or who themselves have a confirmed case of COVID-19, need to be excluded from work. HCW can return to work following the Centers for Disease Control and Prevention (CDC) guidelines.

• CDC: Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2

HCW provide essential care that must occur around the clock every day. When multiple HCW experience high-risk exposures or test positive in a single health care facility, acute and extreme staffing shortage can develop. CDC guidance outlines suggested contingency and crisis capacity strategies for addressing staffing shortages. Existing Minnesota guidance outlines when and how to appropriately implement components of the CDC guidance. Congregate care facilities must refer to the Minnesota Department of Health (MDH) guidance and to their facility contingency staffing plan when responding to staffing shortages and crises.

• Defining Crisis Staffing Shortage in Congregate Care Facilities: COVID-19
• CDC: Strategies to Mitigate Healthcare Personnel Staffing Shortages

It is vital for all long-term care facilities to complete a crisis staffing plan that minimally incorporates the following list of staffing options. Access to a template can be found at Long-term Care (LTC) Emergency Preparedness: COVID-19.

Staffing options to consider during shortage situations

Existing guidance outlines the progression that a facility should follow to address extreme staffing crises. These options may be considered only as a last resort when a staffing crisis persists even after all other normal means of filling shifts (e.g., bonuses, leadership assisting with direct resident care, 12-hour shifts vs. 8-hour shifts, hazard pay, etc.) have been attempted:

1. Call back asymptomatic quarantined staff. Refer to the "Options for quarantined health care workers" section below for more information.
2. Contact related facilities or partners including sister facilities and hospital partners.
3. Contact supplemental nurse staffing agencies.
4. Contact other nearby health care facilities, partners, or local university/college health career centers.
5. Contact trade association to assist in obtaining staff.
   • LeadingAge of MN
   • Care Providers of MN
6. Contact your Regional Health Care Preparedness Coordinator (RHPC) for assistance.
7. Contact the local Medical Reserve Corps (MRC) coordinator.
8. Explore emergency management options through your county.
   • Homeland Security and Emergency Management: County Emergency Managers

Options for quarantined health care workers

As part of their contingency and crisis staffing plans, facilities should refer to CDC guidance on use of HCW who have been exposed to COVID-19.

CDC: Strategies to Mitigate Healthcare Personnel Staffing Shortages

Options for health care workers with confirmed COVID-19

As part of their contingency and crisis staffing plans, facilities should refer to CDC guidance on use of HCW who are COVID-19-positive.

CDC: Strategies to Mitigate Healthcare Personnel Staffing Shortages