Federal government releases guidelines on nursing home visitation

Grant Boone
May 23, 2020

One nursing home in Harder's district, the Turlock Nursing and Rehabilitation Center, has reported 18 coronavirus deaths as of Wednesday and more than 100 positive cases. A Democratic senator says there's a need for big changes in how nursing homes care for seniors.

No state has a higher percentage of COVID-19 deaths from nursing home residents than Minnesota.

"There is no question, in Pennsylvania and all across the world, long-term care facilities have been places where this virus has wreaked absolute havoc".

We can't know for certain if this approach will completely halt the devastating progress of SARS-CoV-2 across the nation. "I think in hindsight there are a lot of things that maybe we'll learn, and I hope we do, that we can do better".

"For months now, we have been advocating for expanded and priority testing in nursing homes to protect our residents and caregivers, but this is a significant undertaking and cost for nursing homes to shoulder on their own", he said in a statement. That does not include the additional cost of testing assisted living centers and would be sufficient only to test every nursing home resident and employee one time.

Brighton had no immediate comment Tuesday. That is about one-third of the reported US deaths related to the virus.

The number is an undercount, because some states did not report death data. The facilities were advised to contract with commercial laboratories for ongoing testing - presumably at the nursing home's expense. It would cost $36 million to test more than 240,000 nursing home residents and staff in California, the group said.

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"We feel every death poignantly". But there are experts who have given their life's work to these topics, and we need to empower them to work out the details about how to implement testing programs in nursing homes while ensuring that a focused national effort provides the needed resources to support this effort.

Gov. Ron DeSantis announced last week that he would like to reopen Florida's nursing homes, which have been closed to visitors since March 14. The facility also immediately placed all six of its units into quarantine.

In Phase 1, all residents and staff should receive baseline COVID-19 tests to detect any cases in the facility.

But Christopher Laxton-executive director of AMDA, the Society for Post-Acute and Long-Term Care Medicine-called CMS' guidelines "reasonable", saying they "allo [w] for flexibility based on the status of each facility" (Cirruzzo, Inside Health Policy, 5/18 [subscription required]; CMS release, 5/18; CMS guidance, 5/18; Choi, Associated Press, 5/18; Wilde Mathews, Wall Street Journal, 5/18; Goldstein et al., Washington Post, 5/18; Brady, Modern Healthcare, 5/18). "But they still had that whiff about them", Eskildsen said, referring to potential negative publicity. Under Phase 1, visitors generally would not be permitted at the facilities. Officials cited patients' right to privacy for the decision.

Phase 3, or reopening, can begin when the community has had no rebound in cases during Phase 2; the nursing home has had no new-onset COVID cases for 28 days, no shortage of staff or PPE, and continued ability to test for COVID-19; and referral hospitals have bed capacity. In fact, Minnesota's 81.9 percent is 40 percent higher than the 41 percent average in those 36 states for COVID-19 deaths from nursing home patients. CMS also said states should check to ensure facilities have adequate access to personal protective equipment (PPE) for staff.

But if you test only a small sample of residents and don't bother to test staff, you are bound to miss positive cases, Wasserman said.

Still, he said he was not aware of a nursing home that accepted an infected resident despite being unprepared to do so.

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