​The summer season, along with its potential for fluctuating high temperatures, is approaching. The Licensing and Certification (L&C) Program reminds all health care facilities that the elderly and other health-compromised individuals are more susceptible to extremes in temperature and possible dehydration. Facility administrators should monitor weather predictions for fluctuations in extreme temperatures and take extra precautions to be sure appropriate air conditioning equipment is well maintained and operating effectively.

Facilities must have contingency plans in place to deal with the loss of air conditioning, or in the case when no air conditioning is available, and take measures to ensure patients and residents are free of adverse conditions that may cause heat-related health complications. Facilities should use portable fans and other temporary cooling devices when indicated.

The L&C Program recommends facilities review "Fast Facts: Preventing Summer Heat Injuries" and implement the following measures to keep residents and clients comfortable during extremely hot weather:

• Dress in lightweight, loose-fitting clothing
• Keep residents well hydrated with particular attention to dependent residents
• Minimize physical activities during the hottest parts of the day
• Stay indoors and out of the sun during the hottest parts of the day
• Use fans as indicated in the attached “Fast Facts” sheet on preventing summer heat injuries
• Open windows where feasible if screens are intact, to allow fresh air to circulate
• Use cool compresses, misting, showers, and baths to promote cooling
• Avoid hot foods and heavy meals
• Encourage frozen treats such as “popsicles” between meals
• Keep a hydration station readily available to residents, family, and staff
• Be alert to adverse changes in patient and resident conditions that may be heat related
• Develop and implement a system to monitor hydration status and be prepared to take appropriate
  interventions
• Pay special attention to patients with medications that make the patient susceptible to high
  temperatures, e.g., psychotropic medications

Hot weather brings mosquitoes and the risk of contracting West Nile Virus. If mosquitoes are abundant, residents and clients should remain indoors in the early morning and at twilight, when mosquitoes are most active. Use repellents cautiously, especially on children and the elderly. For additional information on the use of chemical repellents, administrators or infection control practitioners should consult the Centers for Disease Control and Prevention web site at:

CDC - Natural Disasters and Severe Weather

Licensing regulations require facilities to report all emergency and/or disaster-related occurrences that threaten the welfare, safety, or health of patients to the L&C Program. If the extreme heat conditions affect your facility by compromising patient health and safety and/or require an evacuation, transfer, or discharge of patients, you must contact your L&C district office. Please follow these guidelines for reporting such occurrences:

 
Pursuant to Title 42 of the Code of Federal Regulations section 483.15(h)(6), skilled nursing facilities must have comfortable and safe temperature levels. Facilities initially certified after October 1, 1990 must maintain a temperature range of 71-81°F. The State Operations Manual, Appendix PP, clarifies that temperatures may exceed the upper range of 81°F for facilities located in geographic areas of the country where that temperature is exceeded only during rare, brief unseasonably hot weather.

If you have any questions regarding the content of this AFL, please contact your respective L&C district office.

Sincerely,

Original signed by Jean Iacino

Jean Iacino
Deputy Director

Attachment: "Fast Facts: Preventing Summer Heat Injuries"