Understanding the Coronavirus in Missouri Nursing Homes and What Facilities Must Do About It

It is official: The World Health Organization (WHO) has declared the coronavirus infection known as COVID-19 is a pandemic.  This viral, respiratory infection is in at least 114 countries and has killed more than 4,000 people.  There are now almost 3,000 cases in the United States and over 135,000 worldwide.  Some believe that the US epicenter of the coronavirus outbreak is a nursing home in Washington State, where more than 50 residents and staff members have tested positive and reportedly 25 people associated with the Life Care Center of Kirkland in Seattle have died of the coronavirus.  The coronavirus in Missouri nursing homes could be the next big issue for our state.

The coronavirus has proven to be particularly deadly for elderly patients and in nursing homes which is why the Centers fo Medicare and Medicaid Services (CMS) has wasted no time in addressing this deadly virus.  The Missouri Department of Health has also echoed many of the sentiments of CMS, including sending investigators to check on each nursing home to ensure compliance.  

What is the Coronavirus?  

Officially known as COVID-19, a coronavirus is a disease or infection that is spread from an animal to a human.  This is known as a zoonosis. There are many different types of coronaviruses which include SARS.  This strain of coronavirus, COVID-19, is currently causing minor symptoms in most people such as the common cold.  More severe cases resemble the flu.  However, some patients are developing flu-like symptoms which take a sudden and aggressive turn to the lungs and can result in organ failure and death.  While the good news is that for the most part, young children and healthy adults are not suffering these conditions. However, many elderly patients, smokers, or individuals with pre-existing conditions are being hard hit by this virus.

How is COVID-19 Spread in Nursing Homes?

Like other ailments, this strain of coronavirus is spread through respirator droplets that are projected into the air after a cough or sneeze.  Another individual who inhales those droplets or comes into contact with those droplets and then deposits them on their face, eyes, mouth, a wound, nose, or other vulnerable areas could contract the condition.  Most individuals are contagious because they show symptoms which is how they are spreading the condition to others around them at home or at work.  After infection, it can take up to 14 days for symptoms to develop, meaning that you can spread the disease before you even feel sick and before you even know you are infected.  Most people are recovering quickly, but others are ill for long periods of time.

What is CMS Requiring Nursing Homes Do?

CMS has released a guidance labeled as QSO-20-14-NH to respond to the threat posed by COVID-19.  This includes clinical guidance for infection control and prevention in nursing homes, assisted living facilities, long-term care facilities, and other rehabilitation centers.  Some of the key points include the following:

Restricting visitors – CMS has issued an instruction that visitor are not allowed to visit nursing homes if they meet the following criteria:

1. Show signs or symptoms of a respiratory infection such as a fever, cough, shortness of breath, or sore throat—all of which are common symptoms of COVID-19.
2. Within the last 14 days have had contact with someone who has tested positive for COVID-19, or is someone who is either a) under investigation for COVID-19, or b) currently has a respiratory illness.
3. Individuals who have engaged in international travel within the last 14 days to countries with sustained community transmission which the CDC is routinely updating the list of countries.  Such counties presently include China, Italy, South Korea, and Iran.  OR
4. Individuals who are residing in a community where community-based spread of COVID-19 is occurring, which include areas such as Washington State and Kings County, New York and particularly Westchester County and NYC, and other areas in the United States.

In addition, even if individuals do not meet these criteria, nursing homes may require visitors to where face masks or other personal protective equipment.  

Limiting Visitations – Nursing homes may also limit or restrict access to residents and facilities where the facility is in a community that has community spread.  This includes areas where there is active infections and increasing infections occurring.  CMS allows for limiting visitors during this time.  This includes visitors that are direct family, not sure friends.

Discouraging visits – Even nursing homes in areas which are not under active community spread may very well discourage visitation from guests in the abundance of precaution to protect the residents.

Monitor the Door – CMS is allowing nursing homes to monitor guests and individuals coming into and out of a nursing home, including offering temperature checks, increasing use of hand sanitizer, offering face masks, and limited areas for visitations such as not allowing guests into hallways with rooms but only in communal areas.

Monitoring Contractors – Not only does CMS want nursing homes to monitor guests and visitors, but also to monitor contractors and others coming to the facility such as mail carriers, delivery people, repair persons, and other individuals having official business in a facility.

Encourage Alternative Means of Communication – CMS has encouraged nursing homes to set up more telephones or video conferencing/voice calling areas. Of course, communal telephones must be disinfected after each use.

Limiting Physical Contact Between Guests and Residents – Even if a visitor is allowed in, CMS is advising nursing homes to discourage physical contact such as hand shaking or hugging.

Monitor Staff Health – CMS wants nursing homes to monitor the health of all healthcare workers and to immediately stop them from working with patients if staff develops any signs of a respiratory infection.

Confirmed Cases, Contact Local Hospital and Health Department – Instead of immediately transferring a resident, or instead of not transferring a patient, nursing home should contact a local health department to assess whether a resident needs to be transferred.  Some mild cases should not be transferred and may only make matters worse by spreading, while other matters may be required to transfer to save the life of the resident.

Nursing Homes Are Still Required To Meet Each Resident’s Needs Even In The Midst Of A National Emergency

The coronavirus is a serious condition that is affecting residents of nursing homes and can be fatal to elderly residents. CMS and the Missouri Health and Senior Services Department are working hard to provide the guidance nursing homes need to protect their residents. This is not a time for nursing home companies to focus on budgets and profits like they usually do. This is a time when they need to step up ensure resident safety. Some employees are likely to quit because they are afraid of getting sick. Nursing homes should offer significant payment incentives, higher hourly wages and bonuses to get new employees and to keep current employees. They should offer incentives to employees (like trips to Disney World) that kick in once the crisis is over (and it will be over). This is a time when the nursing home industry can and must go above and beyond to protect the elderly people who live in their facilities and rely upon them to provide a safe environment.

Do You Have Questions About The Rights of a Missouri Nursing Home Resident? 

If you have questions or if you believe a loved one is at a nursing facility that is violating CMS guidelines or endangering your loved one, ask our St. Louis nursing home abuse and neglect lawyer at the Terry Law Firm to investigate.  The coronavirus in Missouri nursing homes could be a serious problem for elderly residents and nursing homes must take steps to protect them.  If a loved one has been seriously injured in any nursing home for any reason, especially for the coronavirus, ask for a FREE consultation by dialing (314) 334-1439 to learn how we can help today.