What is a coronavirus?
Coronaviruses are a large family of viruses which may cause illness in animals or humans. In humans, several coronaviruses are known to cause respiratory infections ranging from the common cold to more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus causes COVID-19, which stands for coronavirus disease 2019.
At the end of 2019, the novel coronavirus COVID-19 was identified as the cause of a cluster of pneumonia cases in Wuhan, a city in the Hubei Province of China. It rapidly spread, resulting in an epidemic throughout China, followed by an increasing number of cases in other countries throughout the world. In February 2020, the World Health Organization designated the disease COVID-19. The understanding of COVID-19 is evolving.
How is COVID-19 transmitted?
Epidemiologic investigation in Wuhan, China, at the beginning of the outbreak identified an initial association with a seafood market that sold live animals, where most patients had worked or visited and which was subsequently closed for disinfection. However, as the outbreak progressed, person-to-person spread became the main mode of transmission.
The primary way it is spread is through respiratory droplets, which are tiny liquid droplets that shoot out from a cough or sneeze. COVID-19 can also be spread by touching a surface that an infected person coughed or sneezed on.
It also appears possible that infected persons can spread the disease before they develop fever and cough.
What Government agencies have learned from the Kirkland, Washington, nursing home
The Life Care Center nursing home in Kirkland was at the epicenter of the outbreak in Washington state. The Centers for Medicare and Medicaid Services (CMS), along with the Washington Department of Social & Health Services, issued a press release on March 23, 2020, detailing the findings of an investigation conducted following the outbreak.
The government inspectors found three “immediate jeopardy” situations, which are situations in which a patient’s safety is placed in imminent danger: (1) the facility’s failure to rapidly identify and manage ill residents, (2) failure to notify the Washington Department of Health about the increasing rate of respiratory infection among residents, and (3) failure to possess a sufficient backup plan following the absence of the facility’s primary clinician, who fell ill.
The Washington nursing home is far from the only nursing home affected by COVID-19. According to data from the Centers for Disease Control, as of March 23, 2020, there were 147 nursing homes across 27 states which had at least one resident with COVID-19.
Although 147 is a small fraction of the over 15,000 nursing homes across the country, given the disproportionate effect on our nation’s older population, this is a cause for concern.
Government Protections of Nursing Home Residents from Infections like COVID-19
The federal government has issued new guidelines in an attempt to protect nursing home residents from COVID-19. A new guidance paper (CMS Guidance Ref: QSO-20-14-NH) directs nursing homes to do the following screen visitors for the following:
- Screen visitors for international travel within the last 14 days to restricted countries; signs or symptoms of a respiratory infection, such as a fever, cough, and sore throat; and for anyone who has had contact with someone with or under investigation for COVID-19. Any visitors who are positive for these screening questions should be refused entrance.
- Screen nursing home staff using the same questions as above, and do not allow them to work if they are positive for the screening questions.
- For suspected COVID-19 infections, notify the local health department.
- Accept already diagnosed COVID-19 patients as long as the nursing home can follow CDC guidance for transmission-based precautions.
- Admit individuals from facilities where COVID-19 was/is present as normal if the individuals are not affected.
- Increase availability of hand-sanitizer, face masks, and tissues; post signs to remind staff of infection prevention measures; and clean and limit sharing of medical equipment and workspace.
How are these guidelines different from what was required to protect Nursing Home Residents before COVID-19?
As noted on the CDC webpage discussing COVID-19, “the general strategies CDC recommends to prevent the spread of COVID-19 in Long Term Care Facilities are the same strategies these facilities use every day to detect and prevent the spread of other respiratory viruses like influenza.”
These strategies are found in the long-standing regulations issued by the federal government: 42 CFR § 483.80. These regulations require nursing homes to have standardized written policies that cover such things as:
- hand-washing rules;
- preventing sick staff from infecting residents;
- preventing sick residents from infecting other residents through isolation;
- preventing visitors from infecting residents.
How can I keep a loved one in a Nursing Home safe from COVID-19?
On your computer: For purposes of initial background, the Centers for Medicare and Medicaid Services have an already existing tool, Nursing Home Compare, that allows you to learn if a particular nursing home is better or worse than other nursing homes on a national average.
In person,when you visit the nursing home, look for these things:
- Did nursing home staff ask you screening questions before allowing entrance?
- Are hand-sanitizers readily visible and available?
- Are residents placed close together without sufficient distance to prevent the spread of germs?
- Do you observe staff who are visibly ill?
- Do you see staff disinfecting themselves, surfaces, and residents frequently and regularly?
What to do if a loved one has been harmed by the Nursing Home?
McGrady Law has experience representing residents of nursing homes after a loved one has been injured by a nursing home or assisted living facility.
If you or a loved one has been the victim of nursing home abuse or neglect, you should contact McGrady Law to help you take action against the responsible parties.