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Well some aspects of our lives are getting back to normal. Of course it is still important to practice social distancing, hand washing and wearing masks when in public. But more businesses are opening and some of our public amenities are accessible again such as beaches (but review the rules before you go!) One of the aspects we deal with in our practice will be slowest to return to normal: visiting family in nursing homes. Obviously nursing homes by definition were at greatest risk of catastrophe from Coronavirus. Like a land-based cruise ship, each facility houses older people in close quarters. Most residents have some health impairment (or they would not be there). It is easy to imagine one positive Covid case spreading through a nursing home. Most of our local facilities have been very careful (and maybe also lucky) and have averted a worst-case scenario. But if you have a loved one in a facility, you are aware of the restrictions visiting family. Activities have also been curtailed to manage the risk of outside infection.

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The Centers of Medicare and Medicaid Services (CMS) issued guidelines for nursing homes to reopen safely. State and local officials can use these guidelines to move back to a pre-Covid operation plan when visiting family was possible. The guidelines provide guidance for a safe transition out of the most restrictive lockdown protocols, and can be reviewed here.

CMS provides a level of flexibility within their recommendations. For example, states may choose to wait on easing into one phase until all facilities have met the criteria for that phase, or allow facilities in a certain region to move through phases at different times. The latter option may be more appropriate for a state like Florida where certain counties (Dade and Broward) were much more affected by the virus than the rest of the state. Finally a state may choose to let individual nursing homes move through the phases independently based on each facility’s compliance with the criteria for each phase.

CMS recommends moving through a three phase transition to normal family visiting.

Phase One

assumes that facilities are at their highest level of vigilance. Family visitation is not allowed, non-essential personnel are not entering, no communal dining or trips outside (except as medically required). Staff and everyone entering have temperature checks and wear face covering. All residents have temperature checks and monitoring for other symptoms of Covid at least daily. All staff are tested weekly and wear PPE such as gloves and gowns and facemasks. Only this level of testing and separation can safely contain an outbreak by isolating a resident or employee before they can interact with others and spread the virus. Our level of testing has not reached the desired level of weekly. Anecdotally some facilities are beginning to go through their first phase of universal employee and resident testing. Since the guidelines provide for a 14 day period before moving on to the next (less restrictive) phase, it is safe to assume that Collier and Lee county facilities will be in Phase One for at least two more weeks. If any new nursing home onset case of Covid infection is identified within a facility, that facility is directed back to the highest level of mitigation to start over. If this happens, visiting family will be further delayed.

Check with our blog next week when we will cover Phase Two.

We are available to help families navigate the healthcare system and to plan for the future. Visit our website or give us a call at 239 434-8557.