Long-term Care and Skilled Nursing Facility COVID-19 Liability Risk Management

During the COVID-19 pandemic, long-term care facilities/skilled nursing facilities have received much attention, unfortunately due to the rapid spread of COVID-19 and a staggering number of infections and deaths that have occurred in these facilities since the outbreak. As a result, state and federal government agencies which regulate, monitor and evaluate these facilities have stepped up their attention and monitoring.

Providers and staff need to ensure that they are aware of regulations that were already in place as well as updated guidelines, regulations and requirements in force during the pandemic. The following resources discuss the challenges affecting long-term care facilities as well as provide guidance and recommendations to help reduce risk and keep residents safe.

Strategies to Prevent and control COVID-19 infection in Long-term Care Facilities

• In a Johns Hopkins article, a geriatric nurse practitioner discusses challenges that COVID-19 poses for nursing homes.
  
  
• The CDC provides detailed strategies to prevent and control COVID-19 in Long-term Care Facilities including:
  • Keep COVID-19 from entering your facility
  • Identify infections early
  • Prevent spread of COVID-19
  • Assess supply of personal protective equipment (PPE) and initiate measures to optimize current supply
  • Identify and manage severe illness
  
  
• CMS has launched a national training program for frontline nursing home staff and their management to strengthen infection control practices. This training is accessible through the CMS Quality, Safety & Education Portal (QSEP). Instructions for access are included on this page.
  
  
• The CDC offers a checklist to be used as a tool in developing a comprehensive COVID-19 response plan.
  
  

Nursing Home Visitation Guidance

• The Center for Medicare and Medicaid Services (CMS) provides detailed guidance regarding restrictions on visitation of all visitors and non-essential healthcare personnel in nursing homes.
  
  
• The CDC provides a sample letter for communicating visitation restrictions to families, friends and volunteers to help keep patients safe.
  
  

Telemedicine for Long-term Care Facilities

• CMS developed a Long-Term Care Nursing Homes Telehealth and Telemedicine Tool Kit
  
  
• Additional telemedicine and COVID 19 resources from NORCAL Group
  
  

COVID-19 Reporting and Notification Requirements

• CDC National Healthcare Safety Network Long-Term Care Facilities (LTCF) Component allows long-term care facilities to track COVID-19 infections, prevention process measures, and vaccination among residents and HCP.
  
  

Other Considerations for Long-term Care Facilities

• Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes
  This document is a compilation of actions employed by organizations, including state governments, in the United States and outlying territories to assist nursing homes in meeting the needs of nursing home residents since the onset of the COVID-19 pandemic recognized in early 2020.
  (This compendium is not intended as guidance from CMS. It does not replace or serve as a substitute for CMS requirements and policy. The actions outlined in this document have not been evaluated for effectiveness by CMS or any government agency. This compendium is solely an informational product offered by CMS to nursing homes as well as state and local officials during the National Public Health Emergency.
  
  
• IHI: COVID-19 Vaccine Education: A Guide for Conversations with Nursing Home Team Members and an accompanying slide presentation to guide leaders in conversations with staff members and residents. These materials are designed to help each individual think through whether they would like to receive the COVID-19 vaccine and to address any questions or concerns.
  
  
• CDC: Long-Term Care Facility Toolkit: Preparing for COVID-19 Vaccination at Your Facility
  
  
• Just prior to the start of the COVID-19 pandemic, the Department of Justice Launched a National Nursing Home Initiative to "bring to justice those owners and operators who have profited at the expense of their residents, and help to ensure residents receive the care to which they are entitled.”
  
  
• The Importance of Addressing Advance Care Planning and Decisions About Do-Not-Resuscitate Orders During Novel Coronavirus 2019 (COVID-19)