The Centers for Medicare and Medicaid Services has announced new guidance for state and local officials to advance through three phases before reopening nursing homes to family and visitors.
Nursing home residents would be able to reunite with their families and receive visitors only after the facility reached phase three.
The decision to reopen is made at the state and local level.
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MS guidance issued on Monday gives states the ability to assess when nursing homes are taking the appropriate and necessary steps to reopen.
Efforts to limit COVID-19 exposure and to prevent the spread within facilities include infection prevention and control, adequate testing, and surveillance, CMS said.
WHY THIS MATTERS
CMS made the decision in March to bar non-essential visitors from nursing homes and other long-term care facilities where COVID-19 infection has killed more than 28,000 residents and workers.
The virus will continue to pose a threat to nursing homes, CMS Administrator Seema Verma said on Monday.
"The impact on nursing homes has been heartbreaking," she said.
First, CMS recommends that nursing homes not relax any restrictions until all residents and staff have received results from a baseline test.
In addition, CMS recommends that state survey agencies inspect nursing homes that experienced a significant COVID-19 outbreak prior to reopening.
An estimated $81 million in grants for inspections is available, Verma said.
Finally, CMS recommends that nursing homes remain in the current state of highest restriction even when a community begins to relax restrictions for other businesses, and should be among the last to reopen within the community, to ensure the safety of the residents.
Nursing homes may receive visitors during phase three, when there has been a sustained decrease in COVID-19 cases. A variety of factors must go into making this decision, including states not only relying on case count, but assessing the individual nursing home and other local factors. Visitors must be screened and wear a cloth face-covering at all times.
Verma gave no estimate of a date when reopening might happen.
CMS guidance encourages state leaders to collaborate with the state survey agency and local health departments to decide how these criteria should be implemented.
THE LARGER TREND
Starting this past Sunday, nursing homes are reporting to the Centers for Disease Control and Prevention the degree of infection in the facility.
One-third of all coronavirus deaths are tied to nursing homes and long-term care facilities. In 14 states, that has risen to account for half of fatalities, according to The New York Times. The virus has affected some 7,700 facilities.
CMS sets the standards for facilities to get Medicare and Medicaid payment and supports states in licensing requirements and best practices.
CMS guidance released on Monday is part of President Trump's Guidelines for Opening Up America Again.
ON THE RECORD
"Coronavirus has had a devastating impact on nursing homes, and as we reopen America, we want to make sure we are doing everything we can to protect our most vulnerable citizens," said CMS Administrator Seema Verma. "Our focus continues to be the safety and quality of life of nursing home residents and while we are not at a point where nursing homes can safely open up, we want to make sure communities have a plan in place when they are ready to reopen."
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