Health officials are seeing a need for improved communication channels and rapid testing and reporting at nursing homes and other long-term care facilities in order to control COVID-19 cases in those facilities across the country.
Dr. Shari Ling, deputy chief medical officer at the Centers for Medicare and Medicaid Services, said there is an unrelenting threat of COVID-19 that exists outside of long-term care facilities, with the most vulnerable people most at risk through actions of others within their communities.
“The challenge that we are continually faced with is that vulnerable individuals are living in close proximity where there is community spread — the staff who reside in communities come in, and the virus can really take root and spread even without symptom development,” Ling said during a Nov. 9 meeting with the Advisory Council on Alzheimer’s Research, Care, and Services. The group comprises members from both federal agencies and external organizations.
“It has not only taken a physical toll on those who have been affected by COVID, but also an emotional toll on staff who have experienced grief and post-traumatic stress that has been really quite devastating,” she added.
While nursing home residents are susceptible to severe COVID-19 complications, with a majority of residents elderly people and many with multiple chronic conditions like dementia, they're also among those the virus disproportionately impacts. Nursing homes and other long-term health care facilities account for about 1% of the U.S. population, but they represent 39% of all COVID-19 deaths, according to the COVID Tracking Project.
To keep nursing home residents safe and combat the spread of COVID-19, CMS partnered with the MITRE Corporation to facilitate an independent commission of public health experts, Ling said.
Called the Coronavirus Commission for Safety and Quality in Nursing Homes, the board members collected, gathered and shared lessons learned to manage nursing home staff and mitigate harm to residents, which were ultimately compiled into a final report released Sept. 16.
Of the report's 27 recommendations, the commission uncovered 10 themes tied to data, technology, financing and accountability, workforce, facility design and governance/management processes:
- Securing testing and screening capabilities
- Increasing personal protective equipment supply and use
- Rethinking cohorting practices
- Prioritizing visitation activities
- Supporting nursing home communications with residents and families
- Strengthening the workforce ecosystem
- Strategic reinforcement for the workforce
- Catalyzing technical assistance and quality improvement
- Enhancing facility design
- Making data more actionable
“Nursing home management and staff can be more effective if provided with streamlined communications, reporting capabilities, and access to funds that will support myriad additional costs, and can reduce the trauma of some emergency measures by communicating policies in advance and providing advance notice when activated,” according to one report recommendation.
In response to this guidance, CMS designed a new, streamlined website to help providers, partners, caregivers and residents find the latest information on guidance and resources specific to COVID-19 and nursing homes in one accessible place, called the Nursing Home Resource Center.
With reports of new COVID-19 cases every day, Ling emphasized the importance of timely and accurate communication to the public among federal agencies to prevent unnecessary death among nursing home residents and communities.
“[There] is no one solution that will be applicable across the board, so we have depended on not only the commission, but also communication vehicles and resources across our federal partners to really get information out and gather solutions in as much as we can," said Ling.