Failure to separate residents with COVID-19 from those without the virus resulted in placing residents in immediate jeopardy according to findings from inspectors making an unannounced COVID-19 Focused Survey between May 21-28. The inspectors also found that the āfacility staff failed to implement standard and droplet precautions to prevent the spread of COVID-19.ā According to the report, at the time of the inspection, 81 of the facilityās 130 residents had contracted COVID-19 and 9 of those infected residents had died.
When one staff member was questioned about the cohorting of infected and non-infected residents, the response was, āYes, we do have positive and negative together.ā
The facilityās administrator issued a statement in defense of their keeping residents with COVID-19 together with non-infected residents based upon what he described as varying opinions regarding cohorting. He also indicated that the nursing home had been following guidance from the local health department and had implemented infection control practices that they suggested. He indicated that the facility had been advised to āshelter in place,ā and they assumed that moving the residents throughout the building posed a greater risk of spreading the Coronavirus.
While the facility is currently reported by the local health department and the facilityās administration as being free of COVID-19, the news media reports that there are discrepancies in the reporting of cases to state and federal agencies.
Virginia is one of several states that have passed immunity measures for nursing homes. The Senior Vice President of Government Affairs at AARP responded to this immunity measure saying, āWe are absolutely opposed to this, and I think it is outrageous.ā
Compliance Perspective
Failure to adhere to the Centers for Medicare & Medicaid Services (CMS) āNursing Home Reopening Guidance for State and Local Officialsā issued May 20 and found at https://www.cms.gov/files/document/qso-20-30-nh.pdf and the Centers for Disease Control and Prevention (CDC) revised guidelines updated June 25, titled āPreparing for COVID-19 in Nursing Homesā that can be found at https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html#background, could be considered provision of substandard quality of care, in violation of state and federal guidelines.
Discussion Points:
- Review policies and procedures and the implementation of CMS and CDC guidelines for navigating the various phases involved with COVID-19.
- Train staff regarding the implementation of standard and droplet precautions for preventing the spread of COVID-19 and the importance of separating COVID-19 negative and positive residents and their assigned caregivers.
- Periodically audit to determine if the CMS and CDC guidelines are being followed for the current COVID-19 phase of nursing home operations.
