Piecing together the various Department of Health and Human Services messages about long-term care is challenging for some nursing homes as they deal with a major health danger to their residents in the new coronavirus.
Many long-term care facilities started putting precautionary measures into action weeks ago, as national nursing home groups like the American Health Care Association began circulating best practices.
The HHS on Friday instructed nursing homes to significantly limit visitors and other communal activities to stop the spread of the virus, which causes the lung disease Covid-19. The directions largely mirrored earlier recommendations from health associations.
The disease is particularly dangerous for older people who have other medical problems. Symptoms of Covid-19 can include fever, cough, and breathing trouble. In the broader population, most people who contract the virus develop only mild symptoms. But some people, usually those with other medical complications, develop more severe symptoms, including pneumonia, which can be fatal.
The emergency procedures already in place at nursing homes are daunting. They include things like posting staff at main entrances to screen visitors and ask questions: Have they traveled internationally? Taken a cruise recently? Been in contact with anyone who’s tested positive for the new coronavirus? Some homes are taking people’s temperature outside the facility, for both staff and visitors.
The Florida Health Care Association has been sharing best practices with members on state-wide conference calls/social media/the group’s dedicated Covid-19 webpage in as close to real-time as possible, said Communications Director Kristen Knapp. Over 1,000 people participated in a March 3 call with Florida Gov. Ron DeSantis (R), she said.
Knapp said Florida’s nursing homes are sorting through President Donald Trump’s emergency declaration and House lawmakers’ virus relief package. The increased federal infusion for Medicaid in the House bill is top of mind.
“Right now we’re just waiting for a lot more information to come down from Washington,” she said.
Access to Testing, Telehealth
Argentum, the nation’s largest senior living group, is asking government agencies to prioritize nursing homes in terms of access to testing, personal protective supplies like gloves and masks, and telehealth options, according to CEO James Balda.
Some homes can limit access to their facilities by closing all but one point of entry. Argentum facilities began curtailing visitors weeks ago as a cautionary measure. “Due to the plans they already have in place for emergencies, they are able to immediately implement policies to restrict visitors,” he said.
Members of the California Association of Health Facilities are restricting all non-essential personnel, setting up washing/sanitizer stations in the lobby for everyone who enters, putting signs on doors, and increasing communication with concerned family members, according to the group’s public affairs director, Deborah Pacyna.
“Obviously this is an unprecedented situation with the potential for serious consequences for our population, and our providers have intensified their infection prevention efforts,” she said.
The AHCA, which represents long-term care and rehabilitation facilities nationwide, offers suggestions for visitors who demand entrance, such as offering them an alternate way to communicate with the person they want to see and talk with the resident about the visitor.
So far, the restrictions don’t require a complete ban on visitors, which can cause loneliness and other problems for seniors. The AHCA’s guidelines also say staffers should “use best judgment and assess extenuating circumstances for entry.”
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