While there are many unanswered questions about COVID-19, or coronavirus, one thing is very clear --- older people and those with pre-existing medical conditions are most vulnerable to infection and related adverse outcomes.  COVID-19 is presenting novel challenges for all segments of our society, but the response of long term care providers literally can be a matter of life and death because of the unique vulnerability of residents.

In an effort to assist long term care providers, the Centers for Disease Control, the American Health Care Association (“AHCA”), and the National Centers for Assisted Living (“NCAL”) have published guidance on efforts that long term care providers should take to protect residents from COVID-19.

The AHCA and NCAL guidance issued to long term care providers as of March 9, 2020, includes the following five elements:

1. Restrict entry to only individuals who need entry.  This safety precaution would limit entry to employees and staff needed to maintain operations and meet the needs of the residents; government officials who require entry in their official capacity; or immediate family or friends who need to visit for critical or time sensitive reasons.
2. Restrict activities and individuals with potential for exposure.  Specifically, the guidance advises that facilities restrict visitors when there are confirmed cases of COVID-19 in the surrounding community; cancel activities that take residents into public places; and restrict internal group activities especially if the Facility has residents with respiratory symptoms or if COVID-19 has been diagnosed in the surrounding community.
3. Actively screen all individuals entering the building.  It is recommended that facilities screen all individuals who enter the building.  This recommended screening would include checking for respiratory symptoms (fever, sore throat, cough, or shortness of breath); screening for international travel within the last fourteen (14) days to areas where there are confirmed cases of COVID-19; and determining whether the potential visitor has worked in another health care setting with confirmed COVID-19 cases.
4. Require all visitors to wash their hands prior to entry.  To the extent possible, it is recommended that long term care facilities set up hand-washing stations, or otherwise make alcohol-based hand rub stations available upon entry.  Visitors also should be reminded to practice social distancing while in the Facility, including avoiding handshakes or hugs.
5. Establish processes to allow remote communication for residents and others.  Given the recommended restrictions on visitors, it is critically important to the overall well-being of residents that they are otherwise able to readily communicate with family and friends through alternative means.  Alternative methods could include ensuring that video chat technology is available, that they have access to cell phones for calls and texting, or that they have access to other forms of social media.

Communication is Key.  As long term care providers take these important measures, it is of the utmost importance that they clearly explain the rationale for these precautions to residents, their representatives and family members.  Facilities should proactively communicate these important safety measures and also include signage throughout their buildings explaining their actions.

In addition, it is advisable for facilities to proactively communicate with other health care providers in their communities to coordinate care and ensure that they also are taking measure to protect individuals who receive care in multiple settings.

Both the AHCA and NCAL are offering tools to assist providers to effectively protect residents.  Those tools are accessible here.

The Miles & Stockbridge Health Care Practice helps health care entities, including long term care providers, to effectively operate their businesses in compliance with applicable laws, regulations, and industry guidelines. 

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