Push to Suspend Visits at Nursing Homes Grows: Once Test Results Arrive, ‘It May Be Too Late’

Skilled nursing industry leaders on Tuesday doubled down on federal guidelines restricting visits to facilities amid the spread of novel coronavirus, emphasizing the potential for a rapid, severe impact among those most vulnerable to COVID-19.

The American Health Care Association publicly advised operators not to allow visitors unless absolutely necessary, its leaders said on a call with reporters, even if they do not meet the Centers for Medicare & Medicaid Services’s (CMS) increasingly severe restriction guidelines.

“Our recommendation is they should not be visiting,” David Gifford, the trade group’s chief medical officer, said, later adding that his own parents have told him not to visit them.

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AHCA president and CEO Mark Parkinson acknowledged that a complete suspension of visits may be a personal challenge for families and their loved ones in nursing homes, but given the risks that COVID-19 presents to the elderly, he stressed that visits should be limited to vitally important meetings.

The threat of coronavirus, which has a mortality rate that could be north of the 15% reported by the World Health Organization for people over age 80, “is one of the most significant, if not the most significant” problems the nursing home space has faced down, Parkinson said.

Parkinson and Gifford’s commentary came shortly after CMS released a beefed-up set of coronavirus recommendations for nursing homes, expanding the criteria for the people who should be prevented from entering a facility to encompass anyone displaying symptoms of a respiratory infection, among other factors.

Though the federal government has indicated that 4 million coronavirus testing kits will be available by next week, Gifford stressed that for the elderly — particularly those with the kinds of chronic health conditions that require around-the-clock nursing care — prevention likely trumps detection.

“We also know that if you wait too long, and it enters into your facility, by the time you hear test results in the community, it may be too late,” Gifford said.

The nursing home industry has found itself at the center of the national media discussion around coronavirus, with an outbreak at a Kirkland, Wash. facility operated by Life Care Centers of America resulting in 20 deaths as of Tuesday.

Though Gifford acknowledged the novel nature of COVID-19, and the generally small sample size of the current outbreaks, he added that residents have already tested positive at another nursing home and assisted living facility in Washington state, and thus hammered home the importance of “aggressive early social distancing.”

The total number of nursing homes affected in Washington state sat at five as of Tuesday afternoon, according to a report in the New York Times.

Erin Shvetzoff Hennessey, CEO of operator and consulting firm Health Dimensions Group, described the new restrictions as “manageable,” noting that her team was reviewing the updated CMS guidelines — while working to develop appropriate processes and deploy warning signage across the company’s buildings.

The real issue, Hennessey said, may be more emotional than operational.

“Where this will be a major undertaking is to communicate with families and residents as this will be emotional for them to not be able to visit, or have to visit in these ‘clean rooms,'” she told SNN.

Restrictions don’t necessarily stop with visits from family and friends. The Ohio-based CommuniCare has suspended all corporate travel related to regular audits and site visits, with only coronavirus-related response trips allowed, general counsel Fred Stratmann told SNN.

The skilled nursing operator also cancelled its annual meeting, scheduled for early April, and restricted all visits in regions that have seen any positive cases of coronavirus — including Montgomery and Prince George’s counties in Maryland, Marion County, Ind., and Cuyahoga County, Ohio.

“Please note this information is accurate as of this time,” Stratmann said via e-mail on Tuesday. “As additional locations are added, we will implement similar restrictions.”

CommuniCare has asked all potential visitors displaying potential coronavirus symptoms — including fevers and other respiratory issues — to refrain from visiting since last Tuesday, March 3, according to Stratmann.

Maggie Flynn contributed reporting to this story.