Opening nursing homes again

Information from this post comes from a Forbes Magazine article, “The Trump Administration may reopen nursing homes to visitors, but it must be very careful.” May 11, 2020.

The painful and isolating experience of living in a Covid-19 quarantine continues.  Until there is an adequate access to testing, until there is a proven treatment or vaccine, the common good will continue to call for restricted contact.

Howard Gleckman lays out political considerations that may underlie plans being set forth by the Centers for Medicare and Medicaid Services (CMS) and then says plainly, “If not done carefully, this would be folly, and could put residents, staff, and families at risk.”

The possible move on the part of the Trump Administration (thus, CMS) has surprised nursing home operators and their professional trade groups, LeadingAge and American Healthcare Association. These two trade organizations have also been working to create universal guidelines for their members, with the expectation that they would be not be finalized until late June or July.

“Facilities (Nursing homes) could begin allowing limited visits once they report no cases for 14 days. They could   increase access, as well as communal activities, if they go another two weeks without an active case.

“The problem, of course, is a facility (nursing home) may go weeks with no cases. But if a visitor brings COVID-19 in, it will spread like wildfire.”

“Residents are paying a severe price for being isolated in long-term care facilities. While we don’t know for sure, it is likely that they are suffering from more loneliness and depression. They also are at greater risk because their families are not able to advocate in person for them —an especially important role in the difficult environment COVID-19 when care is likely to go wrong.

“But it makes absolutely no sense to reopen facilities to visitors now. Nursing homes still don’t have enough coronavirus tests. Assisted living has even less. And tests often take many days to produce results. Absent immediate results—like those available to the White House staff—opening care facilities puts staff and residents at risk from visitors, while at the same time placing those visitors at risk.”

“Reopening also requires an ample supply of masks, gowns, and gloves for all visitors, and proper training in their use.  

“Nursing home and assisted living operators at horrified at the idea of reopening prematurely to visitors. Some are reluctant to have family members adding to what already is a chaotic situation, with staff shortages and jury-rigged efforts to isolate COVID-19 residents.”

“Facilities (Nursing homes), families, and state, federal, and local government need to work together to design a safe way for families to visit their loved ones. But this has to happen in a careful, well-considered, and properly timed way. And it should be based on careful benchmarks that all parties adhere to. The US has failed to establish coherent, enforceable protocols for much of its COVID-19 response. It would be a tragedy if it fails to do so when it comes to opening up long-term care facilities that have seen so much death already.”