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Understanding the CMS Recommendations for Reopening Nursing Homes

Keeping Nursing Homes Safe During COVID-19

There’s no question that COVID-19 has impacted all of our lives, but in nursing homes and long-term care facilities, the virus has taken an exceptionally devastating toll. Because nursing home residents are living in close quarters, more vulnerable to the disease, and more likely to suffer from pre-existing health conditions, it is vital for nursing home staff to take proper safety precautions against the virus – and ensure that their facilities are completely ready before relaxing any COVID-19 restrictions.

To help nursing homes with the difficult task of reopening, the Centers for Medicare & Medicaid Services (CMS) has issued a set of recommendations outlining how long-term care facilities should approach this process. These recommendations follow the Guidelines for Opening Up America Again, issued by the White House in coordination with the Centers for Disease Control and Prevention (CDC). As the CMS notes, however, it is still important for every nursing home to evaluate unique risk factors and be prepared to

Below is an overview of the three stages for phased reopening that the CMS recommends. At Brown & Barron, LLC, our attorneys encourage all nursing home staff members, residents, and family of residents to review the full guidelines on the CMS website as well.

Phase 1

This is the “mitigation” phase, meaning that there is still a pervasive risk of COVID-19 infection and the larger community has not met the guidelines for reopening (i.e a downward trajectory in new symptom reports and confirmed cases for at least 14 days.) The CMS recommends the “highest level of vigilance” during this period.

At this point, nursing homes should:

  • Restrict nearly all group activities
  • Limit communal dining and enforce social distancing
  • Prohibit visitation aside from compassionate care situations
  • Require all visitors and staff to wear face coverings
  • Provide 100% screening for all staff, visitors, and residents before shifts and throughout the day (temperature checks, questionnaires, and observation of symptoms)
  • Offer comprehensive personal protective equipment (PPE) for staff
  • Restrict entry for non-essential healthcare personnel
  • Avoid non-medically-necessary trips outside the building
  • Create a dedicated space for managing COVID-19 cases
  • Test all staff members weekly

Phase 2

When there has been no rebound in COVID-19 cases in the community for at least 14 days – and there are no new cases in the nursing home itself for that period – a long-term care facility may begin to relax some restrictions, but only in certain areas (and with the utmost caution.) Additionally, facilities must continue to observe the CDC recommendations and provide adequate staffing, medical supplies, PPE, access to testing, and access to hospitals with bed capacity.

Some areas where restrictions may be slightly relaxed:

  • Allowing entry for limited numbers of non-essential healthcare workers and continuing to allow compassionate care visitors
  • Restricting group activities to no more than 10 people with strict social distancing guidelines
  • Continue to perform 100% screening for staff before each shift, but on a daily basis for residents

Phase 3

Once the community case status meets the criteria for Phase 3 and there are no new nursing home COVID-19 cases in 28 days, even more restrictions may be relaxed. This is again contingent on having appropriate staffing levels, testing, PPE, and access to medical resources.

Nursing home staff may be able to relax restrictions further in these areas:

  • Allowing visitors to see their loved ones with screening, social distancing, and testing in place
  • Permitting group activities and outings, but only if social distancing guidelines can be maintained and capacity is kept low
  • Allowing the entry of volunteers with screening, social distancing, and testing in place

Has Your Loved One’s Nursing Home Reopened Early?

As you can see from this overview of the CMS guidelines, even the reopening process for nursing homes should be taken with extreme caution, care, and diligence to avoid harming the vulnerable populations inside these facilities. As nursing home attorneys serving in Baltimore and Maryland, our team at Brown & Barron, LLC, can help you explore your options if your loved one developed COVID-19 or passed away due to negligent conditions at their facility. While it’s important to keep in mind that some nursing homes may be protected from civil litigation in this area, we are intimately familiar with the laws in Maryland and can help you fight for fair compensation after a loss.

Contact us at (410) 698-1717 for more information or to speak with an experienced nursing home lawyer.

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