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    Nursing homes and assisted living facilities

    Nursing homes and assisted living facilities

    The Most Important Piece of Safety Equipment in a Nursing Home is the Front Door. 

    Our firm is seeing a spike in the number of nursing home residents that have been abused or neglected during the pandemic.  The more visitors a nursing home resident has, the less likely they will suffer from abuse and neglect.

    Once the nursing homes were closed to visitors, many residents in badly-managed homes were at the mercy of their caregivers.  If you suspect that your parent was abused or neglected during the Covid-19 pandemic, call us today.

    Thousands of Florida Nursing home residents have died from Covid-19 during 2020.  They died alone, without their family, because the state of Florida closed all nursing homes to visitors.  Was your parent or spouse one of the victims?  Is a member of your family currently a resident in a home where residents have died?  The Florida Department of Health maintains a list of Covid-19 deaths in nursing homes around the state.  You can look up your loved one’s home here:

    Did Your Parent Contract Covid-19 Due to a Badly-Managed Nursing Home?

    Nursing homes and assisted living facilities continue to be a major source of US COVID-19 cases, with a new analysis from the Wall Street Journal showing that the fatality count in nursing homes has topped 50,000, about 43% of the 116,700 deaths tracked in the country.

    According to the latest CDC guidelines, Nursing Homes have an ongoing duty to protect their residents from acquiring a COVID-19 infection and once the facility is exposed, to control the spread of that infection.  According to department’s website,, Infection Prevention and Control (IPC ) is critical to patient safety.

    According to the CDC guidelines:

    Infection Prevention and Control

    Given their congregate nature and resident population served (e.g., older adults often with underlying chronic medical conditions), nursing home populations are at high risk of being affected by respiratory pathogens like COVID-19 and other pathogens, including multidrug-resistant organisms (e.g., Carbapenemase-producing organisms, Candida auris ).  As demonstrated by the COVID-19 pandemic, a strong infection prevention and control (IPC) program is critical to protect both residents and healthcare personnel (HCP).

    Facilities should assign at least one individual with training in IPC to provide on-site management of their COVID-19 prevention and response activities because of the breadth of activities for which an IPC program is responsible, including developing IPC policies and procedures, performing infection surveillance, providing competency-based training of HCP, and auditing adherence to recommended IPC practices.

    The Centers for Medicare and Medicaid Services (CMS) recently issued Nursing Home Reopening Guidance for State and Local Officials PDF that outlines criteria that could be used to determine when nursing homes could relax restrictions on visitation and group activities and when such restrictions should be reimplemented.  Nursing homes should consider the current situation in their facility and community and refer to that guidance as well as direction from state and local officials when making decisions about relaxing restrictions.  When relaxing any restrictions, nursing homes must remain vigilant for COVID-19 among residents and HCP in order to prevent spread and protect residents and HCP from severe infections, hospitalizations, and death.

    This guidance has been updated and reorganized according to core IPC practices that should remain in place even as nursing homes resume normal practices, plus additional strategies  depending on the stages described in the CMS Reopening Guidance PDF or at the direction of state and local officials.  This guidance is based on currently available information about COVID-19 and will be refined and updated as more information becomes available.

    These recommendations supplement the CDC’s Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19)  in Healthcare Settings and are specific for nursing homes, including skilled nursing facilities.

    Additional Key Resources:

    Core Practices

    These practices should remain in place even as nursing homes resume normal activities.

    Assign One or More Individuals with Training in Infection Control to Provide On-Site Management of the IPC Program.

    • This should be a full-time role for at least one person in facilities that have more than 100 residents or that provide on-site ventilator or hemodialysis services. Smaller facilities should consider staffing the IPC program based on the resident population and facility service needs identified in the facility risk assessment.
    • CDC has created an online training course that can be used to orient individuals to this role in nursing homes.

    Report COVID-19 cases, facility staffing, and supply information to the National Healthcare Safety Network (NHSN) Long-term Care Facility  (LTCF) COVID-19 Module weekly.

    • CDC’s NHSN provides long-term care facilities with a customized system to track infections and prevention process measures in a systematic way. Nursing homes can report into the four pathways of the LTCF COVID-19 Module including:
      • Resident impact and facility capacity
      • Staff and personnel impact
      • Supplies and personal protective equipment
      • Ventilator capacity and supplies
    • Weekly data submission to NHSN will meet the CMS COVID-19 reporting requirements PDF

    Educate Residents, Healthcare Personnel, and Visitors about COVID-19, Current Precautions Being Taken in the Facility, and Actions They Should Take to Protect Themselves.

    • Provide information about COVID-19 (including information about signs and symptoms) and strategies for managing stress and anxiety.
    • Regularly review CDC’s Infection Control Guidance for Healthcare Professionals about COVID-19 for current information and ensure staff and residents are updated when this guidance changes.
    • Educate and train HCP, including facility-based and consultant personnel (e.g., wound care, podiatry, barber) and volunteers who provide care or services in the facility. Including consultants is important, since they commonly provide care in multiple facilities where they can be exposed to and serve as a source of COVID-19.
      • Reinforce sick leave policies, and remind HCP not to report to work when ill.
      • Reinforce adherence to standard IPC measures including hand hygiene and selection and correct use of personal protective equipment (PPE). Have HCP demonstrate competency with putting on and removing PPE and monitor adherence by observing their resident care activities.
        • CDC has created training modules for front-line staff that can be used to reinforce recommended practices for preventing transmission of SARS-CoV-2 and other pathogens.
      • Educate HCP about any new policies or procedures.
    • Educate residents and families on topics including information about COVID-19, actions the facility is taking to protect them and/or their loved ones, any visitor restrictions that are in place, and actions residents and families should take to protect themselves in the facility, emphasizing the importance of hand hygiene and source control.
    • Have a plan and mechanism to regularly communicate with residents, families and HCP, including if cases of COVID-19 are identified among residents or HCP.

    Implement Source Control Measures.

    • HCP should wear a facemask at all times while they are in the facility.
      • When available, facemasks are generally preferred over cloth face coverings for HCP as facemasks offer both source control and protection for the wearer against exposure to splashes and sprays of infectious material from others. Guidance on extended use and reuse of facemasks is available. Cloth face coverings should NOT be worn by HCP instead of a respirator or facemask if PPE is required.
    • Residents should wear a cloth face covering or facemask (if tolerated) whenever they leave their room, including for procedures outside the facility. Cloth face coverings should not be placed on anyone who has trouble breathing, or anyone who is unconscious, incapacitated, or otherwise unable to remove the mask without assistance.  In addition to the categories described above cloth face coverings should not be placed on children under 2.
    • Visitors, if permitted into the facility, should wear a cloth face covering while in the facility.

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