Due to the looming danger of the coronavirus pandemic, local and federal authorities have recommended severely restricting the amount of time spent in groups to prevent the spread of the potentially deadly disease. This includes multiple recommendations severely restricting time spent in nursing homes and assisted care facilities.
On March 13, the Centers for Medicare and Medicaid Services (CMS) released a memo providing guidance for minimizing the spread of coronavirus in nursing homes. This comes with several significant recommendations restricting visitation and other safety measures.
The CMS Recommendations in Detail
The CMS memo has recommended stricter measures for curbing potential infections and outbreaks in nursing homes nationwide. This includes:
More extensive screening for those with fever and/or respiratory symptoms
The cancellation of all group activities including communal dining situations
Screen staff members for any health problems they may have
Promoting more stringent hygiene measures to residents
Most importantly, the memo recommends restricting visitation of all visitors and non-essential health care professionals. The only exception would be for certain compassionate care situations, such as in hospice and end-of-life situations.
Does This Violate Any Legal Rights?
Under normal circumstances, these limitations on visitation would be a strict violation of the requirements put forth by CMS – namely, that all residents have a legal right to have visitors of the resident’s choosing.
However, because of the severity of coronavirus, the CMS explicitly notes that any facility who adheres to (or exceeds) these new provisions will not be cited for noncompliance. Extreme preventive measures must be taken in order to minimize the potential spread of COVID-19.
How Serious Is Coronavirus in Nursing Homes?
The thought of restricting time with your loved ones may be hard to bear, but it is important to recognize exactly why we should take such precautions – especially as novel coronavirus is especially dangerous for nursing homes and assisted living facilities.
The elderly are the most vulnerable segment of the population. A March 4 report of the outbreak in Italy reported that the average age of those who died from the virus was 81. Additionally, in Lombardy, the epicenter of Italy’s outbreak, it was reported that only two of the deaths were people under the age of 50.
Those with chronic conditions are further vulnerable to COVID-19. Many in nursing homes are often there because they may have underlying health conditions that require constant care. A report by the World Health Organization on the first outbreak in China found that having a chronic disease (such as diabetes or heart disease) could increase a person’s chances of death by as much as 13 times.
Some nursing homes are not properly trained for such situations. Although many nursing homes employ qualified nurses and other healthcare professionals, they are not hospitals and therefore may not have the proper equipment or training to deal with testing and treatment of a widespread epidemic.
Additionally, nursing homes are incredibly dangerous vectors for spreading diseases. Washington reported the first confirmed case of coronavirus and the first recorded death – and epidemiologists state that Life Care Center, a nursing home facility in Kirkland, WA, was the epicenter of the outbreak. As of March 16, the state is undergoing the worst crisis in the country thus far, reporting 769 confirmed cases and 42 deaths as a result of coronavirus.
What Alternatives Do I Have?
Despite these new restrictions, it is important that residents of a nursing home continue to have social interactions with close friends and family – especially in such uncertain times. In such instances, we recommend the following alternatives to direct contact:
Call them via telephone regularly – or more frequently if your visitation is impacted
Use video chat services via webcam, such as Skype
Create a group text that includes all your loved ones
Interact through FaceTime or some other mobile chat application
It may be difficult for your loved ones to remain isolated from you and your family in this time, so it is incredibly important to remain in close communication with them.
Precautions for Visiting a Nursing Home
If you are in a situation where you are allowed to visit your loved ones in a nursing home, it is highly recommended to take the highest precautions in safety and hygiene. This includes:
Frequently applying hand sanitizer
Washing your hands thoroughly before, during, and after the visit
Limit movement within the facility
Practice social distancing – limit physical contact with any residents, and refrain from hugs and/or kisses
Additionally, do not take part in any nursing home visitations if:
You are feeling ill, have a fever, or show any respiratory symptoms
You were in known contact with someone who has tested positive for COVID-19
You were in a location/event where someone with COVID-19 also attended
You traveled internationally recently
In many cases, some nursing homes may initiate exhaustive visitor screening measures, so they may refuse your request for visitation outright anyway. Still, it is useful to be mindful of your circumstances, so you do not endanger the lives of a more vulnerable population.
It is important to note that the current situation is constantly changing as the pandemic advances. Although this memo only serves as a strongly worded recommendation, in a few days it may become a mandatory order. Being prepared for such significant measures may help you and your loved ones navigate this difficult situation in a calm, reasonable manner.