The family of a New York nursing home resident who had lived in the facility for about eight years reported they were shocked over her death, and that they were notified by the funeral home instead of the nursing home. A nursing home representative called around 9 a.m. on May 20 to inform the family that the resident had tested positive for COVID-19 but was not showing any signs or symptoms. Then, just before 1 p.m. that same day, the family received a call from the funeral home asking their preference for arrangements for care of the resident’s body.
The vice president of the facility explained the situation by saying that one staff member was instructed to notify the family of the resident’s death, and another staff member was told to call the funeral home. The funeral home reached the family by phone first.
According to New York State data, 46 of the facility’s 75 residents and 10 percent of the staff members tested positive for COVID-19. As of May 25, only one resident in the 80-bed nursing home died from the Coronavirus.
The family is pushing for the nursing home to be more transparent in its communication regarding the status of the residents in light of the COVID-19 crisis.
CMS requires nursing homes to inform residents and their representatives weekly, or each subsequent time a confirmed infection of COVID-19 is identified and/or whenever three or more residents or staff with new onset of respiratory symptoms occurs within 72 hours. Facilities are to include information on mitigating actions implemented to prevent or reduce the risk of transmission, including if normal operations in the nursing home will be altered. They are to keep residents and their representatives up-to-date on the conditions inside the facility, such as when new cases of COVID-19 occur. Current requirements at 42 CFR 483.80 and CDC guidance specify that nursing homes notify their State or Local Health Department about residents or staff with suspected or confirmed COVID-19, residents with severe respiratory infection resulting in hospitalization or death, or ≥ 3 residents or staff with new-onset respiratory symptoms within 72 hours of each other. (See https://www.cms.gov/files/document/qso-20-26-nh.pdf).
Visit https://www.cdc.gov/nhsn/ltc/covid19/index.html for more information on mandatory CDC reporting requirements.
Compliance Perspective
Issue
Failing to notify a resident’s family on a timely, transparent, and considerate basis regarding the resident’s COVID-19 status may be considered a violation of the Centers for Medicare & Medicaid Services (CMS) requirements to “notify residents and their representatives to keep them up-to-date on the conditions inside the facility, such as when new cases of COVID-19 occur.”
Discussion Points
- Review policies and procedures to ensure that the facility is in compliance with all CMS and CDC guidelines for reporting and has appropriate protocols for notification regarding the death of a resident.
- Train staff to ensure that the family or the resident’s responsible party are notified about the death of a resident before the funeral home is notified.
- Periodically audit to ensure that the facility is following the CMS guidelines for keeping residents, families, and responsible parties aware of the conditions inside of the facility during crises like the Coronavirus pandemic, and that required CDC reporting is occurring.
FOR MORE INFORMATION ON THIS TOPIC view: COVID-19 FACILITY PREPAREDNESS SELF-ASSESSMENT
