The Federal Government Regulates Nursing Homes Through Its Administration on Again
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Why are nursing homes so vulnerable to COVID-19?
Older people are at college risk for COVID-19. So are people with chronic medical conditions, such every bit heart disease, diabetes, kidney disease and respiratory illness. Both groups are heavily represented among the nation's one.3 million nursing home residents.
That concentration is a primal reason why nearly a quarter of U.Due south. deaths from COVID-19 take occurred amidst residents and staff at long-term intendance facilities, representing more than 200,000 pandemic victims, according to the Kaiser Family unit Foundation. But it's non the only one. A number of conditions at nursing homes can exacerbate the spread of the illness:
- frequent physical contact betwixt residents and staff
- understaffing
- employees who work in multiple facilities, increasing chances for exposure
- residents sharing rooms
- transfers of residents from hospitals and other settings
- shortages of personal protective equipment (PPE) such every bit masks and gowns
- lagging COVID-nineteen vaccination and booster rates
These factors make nursing homes potential breeding grounds for viral and bacterial diseases, especially given chronic bug with infection command that predate the pandemic. A May 2020 report from the U.S. Authorities Accountability Role found that four in 5 nursing homes surveyed between 2013 and 2017 were cited for deficiencies in infection prevention and command, leading the Centers for Medicare & Medicaid Services (CMS) to denote tougher rules for infection-command inspections and enforcement.
What'due south being done about information technology?
As the scale of COVID-nineteen'due south toll on nursing homes became articulate during the pandemic, heightened infection-command protocols such equally testing, masking, social distancing, manus hygiene and proper apply of PPE were mandated in facilities. Early on, nursing homes essentially shut their doors in an effort to adjourn coronavirus entry and spread, instituting strict limits on visitation and suspending communal dining and other resident activities.
Residents and staff at nursing homes were in the start priority grouping to go vaccinated when America started rolling out its COVID-nineteen vaccines in late 2020. And residents were prioritized beginning for boosters in fall 2021 past the the Centers for Illness Control and Prevention (CDC).
As vaccinations increased throughout 2021 and every bit the rate of COVID-19 deaths in nursing homes declined, restrictions loosened, allowing more visitation and communal activities. But COVID-19 is nevertheless a threat to nursing dwelling residents and staff, particularly given the rise of the recent omicron variant. Hundreds of residents continue to dice from the virus each calendar month, so some infection control practices remain, such as face coverings and concrete distancing.
AARP and others long-term care advocates are working toward major long-term intendance reforms to ensure another crisis like COVID-xix is avoided. President Joe Biden recently unveiled a slew of proposed changes to how U.Due south. nursing homes are regulated and run, including a vow to adopt federal minimum staffing requirements for facilities, pace upward enforcement of regulations and crevice down on overcrowded rooms. He touched on the reforms during his March State of the Union address, maxim federal officials will "set college standards for nursing homes and make sure your loved ones get the care they deserve and that they expect."
How are nursing home residents and staff getting COVID-nineteen vaccines and boosters?
In late 2020 and early 2021, the federal government contracted with CVS, Walgreens and some regional pharmacies to vaccinate residents and staff at most of the nation'southward nursing homes and other long-term care facilities. COVID-19 vaccines and boosters, which the CDC recommends for those who live and piece of work in long-term care settings, are now beingness allocated to pharmacies partnered with long-term care facilities, with facilities responsible for administering them. Facilities that don't have a chemist's shop partner are encouraged to work with local or state wellness departments or the federal government, if necessary.
A federal mandate at present requires all staff of Medicare- and Medicaid-certified health care facilities — which includes almost all nursing homes — to be fully vaccinated against COVID-19 by springtime. Some state governments and nursing abode companies, however, have already adopted staff vaccination requirements. Medicare- and Medicaid-certified nursing homes are also required to offer all residents and staff COVID-19 vaccines and to publicly written report their vaccination and booster rates. You can find these rates and compare them with country and national averages on Medicare.gov'due south Intendance Compare website.
Tin I visit my loved 1 in a nursing home?
Yes. Guidance released by the CMS in Nov 2021 says that nursing homes "must allow indoor visitation at all times and for all residents," regardless of vaccination status. Visitors tin only be barred when they are positive for COVID-nineteen, are showing symptoms of COVID-19 or currently meet the criteria for quarantine, or in "very limited and rare" situations. The omicron surge spurred the CMS to allow facilities to regulate visits more, like requiring visitors to be tested prior to entry if the facility provides a rapid antigen test.
CMS guidance reinforces that "visits should be conducted in a manner that adheres to the core principles of COVID-nineteen infection prevention and does not increase risk to other residents." Where customs level of transmission is high, for case, all residents and visitors should article of clothing face coverings and physically distance during visits to a nursing home, regardless of their vaccination status.
The guidelines "strongly encourage" all visitors to go vaccinated only it'due south not required as a condition of visitation. If a visitor declines to disclose his or her vaccination status, the visitor should wear a face up roofing or mask at all times.
Read the CMS'south full visitation requirements for nursing homes.
What can I practice to support my loved ane?
Consider getting yourself and your loved 1 in a nursing home vaccinated and boosted against COVID-xix if yous aren't already. Vaccinations profoundly reduce people's risk of contracting the virus and keeps those who do contract information technology from getting seriously sick, the CDC says. And if you and your loved 1 in a nursing dwelling are fully vaccinated, fewer infection-control recommendations, such every bit social distancing and masking, may apply.
Use the newfound visitation liberties to engage and connect with your loved one in a safe way. Socialization is crucial for residents' well-existence — physically and emotionally — peculiarly at present, after pandemic-induced lockdowns. Isolation "tin can accept very real and serious wellness impacts" for nursing dwelling residents, says Megan O'Reilly, AARP's vice president of health and family policy.
As restrictions loosen, communal life is returning to facilities, so encourage your loved one to participate in group dining or activities in a safe way. 1 of the contempo challenges for nursing homes is reengaging residents who are experiencing increased rates of depression or worsened physical debilities acquired by extended isolation during the lockdown, says Carla Perissinotto, 1000.D., associate chief of clinical programs in geriatrics at the University of California, San Francisco.
"Exist aware of who is lone as a result of [the pandemic] and find out from each person what may assistance them," she says.
Where in-person visiting may be unsafe or logistically difficult, try virtual visits using video-conversation or videoconferencing platforms like Zoom, FaceTime and Skype to stay in touch. Ask the nursing home what it can exercise to facilitate communication. Does it have tablets that residents can apply for televisits? Can staff assistance those who have mobile devices simply aren't familiar with video-chat apps? With smartphone cameras and video apps, you tin take a loved one for a walk, share a virtual meal or picket a movie together.
You can as well support loved ones by staying informed about what's going on at their facility. Place a point of contact on the staff for when you have questions and concerns. AARP has a list of key questions to ask about circumstances at your loved one'due south nursing dwelling house.
Volition the nursing home tell me if it has COVID-xix cases?
It should. The CMS requires nursing homes to tell residents and their families or representatives within 12 hours if a COVID-nineteen instance is confirmed on-site. The information must as well be reported to the CDC and is compiled in an online data ready where y'all can search for calendar week-by-week case numbers.
Don't be shy about contacting a nursing home to ask if information technology's had COVID-19 cases and deaths or almost what protective measures it's taking, including infection-control practices and vaccination rates. If the facility is not forthcoming or if you have a business organisation or complaint, contact your land's long-term care ombudsman.
How are nursing homes regulated?
They are regulated by the federal government, specifically the Centers for Medicare & Medicaid Services (CMS), in collaboration with u.s.a..
Land survey agencies conduct inspections of nursing homes on behalf of the CMS to check that they're complying with federal laws and standards in areas such as staffing, hygiene, record-keeping, and residents' intendance and supervision. Facilities must be deemed compliant to exist certified by the CMS and eligible for payments from Medicare and Medicaid. State surveyors as well ensure compliance with land laws, which frequently go beyond federal requirements.
What if I have a complaint or concern?
Get-go, attempt talking to the nursing abode. Learn every bit much as yous tin can virtually the situation you desire to address and have specific questions prepare. AARP provides extensive information and coverage of the crunch in nursing homes, likewise as resources on broader bug concerning long-term intendance.
If the facility is not responsive, reach out to your country's long-term care ombudsman. Ombudsmen programs were established by the federal Older Americans Human action in all 50 states — plus the Commune of Columbia, Puerto Rico and Guam — to address problems related to the health, safety, welfare and rights of residents of nursing homes and long-term care communities.
Staff and volunteers at ombudsmen offices advocate for residents of long-term care facilities and investigate and resolve complaints. AARP has a directory where you lot tin find contact information and a website link for your state ombudsman.
If an issue persists, yous tin can file a complaint with your state survey agency, which inspects nursing homes to determine if they're complying with CMS regulations. Keep in listen that infection control is getting priority attending, so other concerns may have longer to resolve.
What are nursing home residents' rights?
The CMS has a listing residents' rights and protections nether federal and country laws. Broadly speaking, these include the right to:
- be treated with dignity and respect
- be free from corruption, neglect and discrimination
- have friends and family unit visit and participate in your intendance
- take role in activities
- make complaints without fear of punishment
- receive proper medical care
- take a doctor, family member or legal representative notified of changes in your condition or handling
Keep in listen that land statutes on resident rights often go beyond federal rights. The National Consumer Voice for Quality Long-Term Care has helpful resources on the rights of long-term care residents and how the pandemic may exist affecting them.
Practice these answers apply to other long-term intendance facilities, such as assisted living?
Different nursing homes, assisted living, memory care and other senior care facilities are regulated by the state rather than the federal CMS. Therefore, they are more often than not not subject field to federal oversight. For example, the CMS rules on disclosing COVID-19 cases to residents and family members do not use to other long-term care facilities. Also, the federal mandate requiring vaccination of employees in health intendance facilities participating in Medicare and Medicaid applies to nursing homes, but non to all other long-term care facilities. Instead, they are subject area to country vaccine mandates, which vary.
But many assisted living facilities and other senior care communities accept implemented policies that mirror much of the federal COVID-nineteen guidance for nursing homes, including infection-prevention practices and vaccination requirements.
CDC guidance for nursing homes generally also applies to other long-term care facilities. If you lot have a loved one in an assisted living customs and have questions or concerns nearly its COVID-19 caseload and response, contact the facility and enquire to speak to an ambassador. You tin also bring issues to your state's section of health or department of crumbling.
Editor's Note: This story was updated on March xvi, 2022 to reverberate new information.
Source: https://www.aarp.org/caregiving/health/info-2020/nursing-homes-coronavirus-faqs.html