Federal Strategies and Procedures Designed to Protect Seniors

On April 30th, President Trump released a statement detailing the many ways that his administration supports America’s seniors during the COVID-19 pandemic. The statement outlines multiple strategies and procedures designed to help keep nursing home residents safe, both while states are closed down and as those states start to open up again.

Required Reporting of COVID-19 Cases

The Centers for Medicare & Medicaid Services (CMS) worked with the Centers for Disease Control and Prevention to establish guidance to help nursing homes keep their residents safe. According to a memo released by CMS on April 19th, nursing homes are required to create and maintain an infection prevention and control program. Nursing homes are also required to immediately grant access to local, state, or Federal public health entities to perform on-site inspections, testing, and related activities.

Additionally, the memo includes details on reporting requirements:

• Nursing homes must notify state or local health departments if residents or staff have suspected or confirmed cases of COVID-19. Facilities must also report if any residents have severe respiratory infection that results in hospitalization or death, or if three or more residents or staff develop new respiratory symptoms within 72 hours of each other.
• The CMS will also require that nursing homes notify their residents and representatives to keep them aware of the situation within the nursing home. Nursing homes must inform residents and representatives within 12 hours of a confirmed COVID-19 case. Updates must be provided weekly, when a new case is confirmed, or when three or more residents or staff develop new respiratory symptoms within 72 hours.

The Coronavirus Commission for Safety and Quality in Nursing Homes

President Trump’s statement also highlighted the creation of a Coronavirus Commission for Safety and Quality in Nursing Homes. The CMS will have this independent commission assess the nursing home pandemic response. A CMS contractor will convene and lead the commission, which will be comprised of:

• Leading industry experts
• Doctors and scientists
• Resident and patient advocates
• Family members
• Infection and prevention control specialists
• State and local authorities

The commission will work to inform both current and future responses to COVID-19 through multiple activities:

• Ensure nursing homes are protected from COVID-19 and improve responsiveness of care to maximize resident quality of life
• Improve regulations to ensure that COVID-19 identification and mitigation is prompt and effective
• Improve federal and state enforcement to ensure compliance with infection control policies
• Identify approaches for using nursing home data to better coordinate efforts to address the current spread and contain the virus within nursing homes
• Identify best practices to address the challenge of COVID-19 in nursing homes

Guidance for Reopening Nursing Homes

On May 18th, CMS, under President Trump’s leadership, announced new guidance regarding the safe opening of nursing homes. These recommendations highlight the multiple steps that nursing homes should take before relaxing the restrictions that have been implemented to help prevent the spread of COVID-19.

These guidelines recommend that state leaders work with local health departments and the state survey agency to decide how to best implement the reopening criteria. Prior to relaxing restrictions, it’s important to review multiple factors, including the status of COVID-19 cases both in the community and in nursing homes, baseline tests of all residents, the access to adequate PPE, and the local hospital capacity.

CMS recommends the following:

• Nursing homes do not relax any restrictions until all residents and staff have had a baseline test.
• State survey agencies inspect nursing homes that had significant outbreaks prior to those nursing homes opening up again.
• Nursing homes remain in the highest restriction state even as local businesses relax restrictions. Nursing homes should be among the last to reopen.
• Nursing homes can admit visitors during phase three, when there has been a sustained decrease in COVID-19 case numbers. Visitors must still be screened and should wear face coverings.

Having recognized the particular threat that COVID-19 poses to nursing homes, President Trump’s administration has released the above guidance, and additional guidance is likely to follow. Check back for updates as new guidance is released.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.