The CDC’s latest Morbidity and Mortality Weekly Report released Wednesday, March 18, 2020, reiterated that both residents and the workforce of long term care facilities remain most vulnerable to the exposure and spread of COVID-19.  According to the Report, “[s]ubstantial morbidity and mortality might be averted if all long-term care facilities take steps now to prevent exposure of their residents to COVID-19. The underlying health conditions and advanced age of many long-term care facility residents and the shared location of patients in one facility places these persons at risk for severe morbidity and death.”

While the CDC, CMS, and state health departments have authored guidance primarily for skilled nursing, policies and procedures to combat COVID-19 remain just as critical for assisted living communities.  Accordingly, the Husch Blackwell post-acute and long term care team offers the following Frequently Asked Questions to guide assisted living operators and providers in preventing and safeguarding against the exposure and spread of COVID-19:

  1. Is there mandatory federal guidance for assisted living communities?

No.  However, many state health departments and authorities recommend that assisted living communities, as a best practice, adopt and follow controlling CDC and CMS guidance for skilled nursing.  For example: Arizona and Wisconsin have modeled recommendations for assisted living communities after CMS’ Guidance for Limiting the Transmission of COVID-19 for Nursing Homes (March 13, 2020).  This Guidance includes:

  • Facilities should restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation. In those cases, visitors will be limited to a specific room only. Facilities are expected to notify potential visitors to defer visitation until further notice (through signage, calls, letters, etc.).
  • Cancel communal dining and all group activities, such as internal and external group activities.
  • Implement active screening of residents and staff for fever and respiratory symptoms.
  • Remind residents to practice social distancing and perform frequent hand hygiene.
  • Screen all staff at the beginning of their shift for fever and respiratory symptoms. Actively take their temperature and document absence of shortness of breath, new or change in cough, and sore throat. If they are ill, have them put on a facemask and self-isolate at home.

Meanwhile, states such as Texas have published guidance specifically for assisted living communities.  In any event, assisted living operators and providers should stay apprised of all state and county health department advisories and bulletins that may go beyond CDC or CMS guidance.  For example, visitors are restricted from assisted living communities in Colorado.

  1. Will state surveys at assisted living communities continue as normal?

Check with your individual state health department, but thus far, most states, such as Arizona, are not suspending state survey activity for assisted living communities.  States may re-prioritize surveys in the future, much like CMS has done with surveys for skilled nursing facilities.  COVID-19 safety protocols, as discussed above, should be utilized to screen surveyors prior to entering a facility.

  1. How can residents’ behavioral and mental health issues be treated due to isolation and social distancing?

Providers continue to turn to telehealth to render mental health treatment to residents affected by social distancing.  The pandemic has triggered expansion of telehealth services, making it easier and more affordable for residents to receive needed treatment while maintaining safety measures to prevent the exposure and spread of COVID-19.  Please see Husch Blackwell’s telehealth advisories here:

New Coronavirus (COVID-19) Considerations for Telehealth Providers

Trump Announces Expansion of Telehealth Services Through Medicare

  1. How can assisted living facilities respond to employee health, compensation, and workplace shortage issues?

Husch Blackwell’s labor and employment team offers advice and guidance concerning employment issues during the pandemic:

Workplace Issues and COVID-19 – Health Inquiries, Medical Exams, Exclusions from the Workplace and Compensation Issues (page updated frequently)

Your employee tested positive for COVID-19. Is that an OSHA-recordable illness?

Coronavirus/COVID-19: Update for Employers (webinar)