The family of an 86-year-old resident in an Alabama nursing home has made allegations regarding the facility’s failure to inform them about the resident’s deteriorating condition due to complications from contracting COVID-19. They also allege that staff members brought the virus into the nursing home, and administrators did not properly test and quarantine staff members. Additionally, the family claims that staff members with positive or pending tests were allowed to work if they were asymptomatic.
The resident died on July 11 after being hospitalized at the family’s request. While hospitalized, the resident’s condition deteriorated, and his lungs were severely damaged by the Coronavirus. His pacemaker prevented his placement on a ventilator; therefore, he was transferred to hospice care where he later died.
When questioned about whether the facility had informed other families and residents at the facility about the deaths of residents due to the COVID-19 virus, no answers were provided by the Tennessee-based parent company regarding residents’ and staff members’ deaths. The company did issue a statement that included this information: “At the time of the first confirmed COVID-19 positive cases, our center already had extensive policies in place with regard to COVID 19 and infection control, and were reporting data on our infection rates directly to the Center for Disease Control (CDC) per regulations.”
The communications director for the Alabama Nursing Home Association (ANHA) gave this statement regarding COVID-19 notification requirements: “Effective May 8, 2020, a rule from Centers for Medicare & Medicaid Services (CMS) set requirements for notifying residents and resident representatives. Facilities must notify residents, their representatives, and families of those residing in facilities by 5 p.m. the next calendar day following the occurrence of either a single confirmed infection of COVID-19, or three or more residents or staff with new onset of respiratory symptoms occurring within 72 hours of each other.”
In Alabama, 3,760 residents of long-term care facilities have been diagnosed with the virus. Additionally 2,140 long-term care facility employees have been diagnosed, according to July 30 data provided by the Alabama Department of Public Health.
Compliance Perspective
Issue
Failure to notify residents, their representatives, and families in accordance with published CMS requirements and guidance, and allowing staff members who are awaiting COVID-19 test results or who have tested positive but are asymptomatic to continue working may increase the spread of the virus and result in allegations of neglect and resident harm. This could result in the filing of complaints and lawsuits and be considered provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points
- Review policies and procedures regarding CMS guidelines for communicating with residents, representatives, and families according to guidance timelines, and the need to quarantine staff members from working whose status is unknown or who are COVID-19 positive but asymptomatic. A summary of CMS requirements and guidance effective May 8, 2020 may be found at: https://www.ahcancal.org/facility_operations/disaster_planning/Documents/Notifications-Confirmed-Cases.pdf
- Train staff regarding the importance of not working if they are exhibiting known symptoms of COVID-19 or if they have contracted the virus but are asymptomatic.
- Periodically audit to determine if the facility is adhering to CMS communication guidelines and the protocol for testing staff to ensure that potentially infected or COVID-19 positive staff members do not spread the virus within the facility.
FOR MORE INFORMATION ON THIS TOPIC view: COVID-19 FACILITY PREPAREDNESS SELF-ASSESSMENT
