The State of New Jersey is developing a “whole-of-government” approach to help nursing homes deal with the COVID-19 crisis. The State’s Health Commissioner reports that out of the 375 long-term care facilities in New Jersey, 188 now have at least one resident who has contracted the virus, and that number is rapidly increasing.
Because some of these facilities lack the necessary resources and staff to provide the care needed by their residents, the Health Commissioner said, “It will require in some cases for patients to be moved around, and that’s extremely disturbing to elderly individuals.” However, she added, “For those that have not been exposed, we want to keep them safe. And, for those that have been exposed or perhaps diagnosed positively, we want to make sure that they get cared for.”
The plan is to develop an algorithm that can identify residents’ conditions in order to allow their transfer within the various nursing homes. The algorithm will consider factors regarding residents’ conditions and COVID-19. These factors will include whether residents are “asymptomatic, no exposure; asymptomatic, exposure; symptomatic but test negative; symptomatic and test positive.” After residents are assigned a classification, the most appropriate location for them will be identified.
Infection control precautions will be taken within all of the settings where residents are relocated. Additionally, to alleviate some of the problems that have been the result of staff members going from facility to facility and even moving within different areas of one facility, residents and caretakers will be assigned to stay in one specific area of the facility where they are placed.
No timetable has been established for completion of the plan.
Compliance Perspective
Failing to evaluate the condition of residents with regard to COVID-19 to prevent further exposure for both residents and staff members by segregating those without exposure with their care givers may be considered provision of substandard quality of care in violation of the Centers for Medicare & Medicaid Services (CMS) April 2, COVID-19 Long-Term Care Facility Guidance. This Guidance instructs facilities to avoid transmission within long-term care facilities by using separate staffing teams for COVID-19-positive residents to the best of their ability, and working with State and local leaders to designate separate facilities or units within a facility to separate COVID-19 negative residents from COVID-19 positive residents and individuals with unknown COVID-19 status.
Discussion Points
- Review policies and procedures to ensure that the most current recommendations regarding the COVID-19 crisis have been put into place. (https://www.cms.gov/files/document/4220-covid-19-long-term-care-facility-guidance.pdf)
- Train staff regarding Infection Control, use of personal protection equipment (PPE), evaluating, and separating residents who have not contracted or been exposed to the Coronavirus along with their consistent care giving staff.
- Periodically audit to ensure that all CMS recommendations regarding COVID-19 are being observed.
