Nursing homes all across America currently face two critical threats—the coronavirus, or COVID-19, and the negligence lawsuits that may follow. If your loved one contracted coronavirus or COVID-19 at a nursing home and you want to know if you can file a lawsuit, ask yourself the following questions:
- Did the nursing home maintain a clean environment that was regularly sanitized?
- When, if ever, were the residents subject to mandatory quarantine?
- If an outbreak did occur, how quickly did the nursing home act to prevent the spread?
- When were you notified that someone at the nursing home contracted the coronavirus, or COVID-19?
The coronavirus, or COVID-10, will disproportionately impact residents of nursing homes. This will undoubtedly result in countless lawsuits throughout the United States against nursing homes concerning quality of care and negligence. Call (877) 238-4175 or email firstname.lastname@example.org to speak to an attorney for free about the coronavirus.
The novel coronavirus, also known as COVID-19, has begun to affect nearly every aspect of American daily life. As the pandemic continues, no population is more vulnerable than senior citizens and individuals with underlying health conditions. This became startlingly clear when the Life Care Center nursing home in Kirkland, Washington saw at least two dozen deaths because of the virus. The facility had 120 residents and 180 staff members on February 19, but by March 16, 26 residents had died of coronavirus and 66 more had been hospitalized, while 46 staff members had tested positive for the virus. Delays in testing likely led to the silent spread of the virus among the elderly and the staff who care for them.
Under normal circumstances, nursing home residents are prone to infection. Their advanced age and underlying health conditions, combined with substandard staffing levels in many homes, make infection a common occurrence. Reuters reports that nursing homes have long been plagued with infection control problems. 1.7 million seniors who live in nursing homes, and patients will experience between 1.6 million and 3.8 million “serious infections” annually, resulting in an average of 380,000 deaths. The coronavirus pandemic has strained the situation even further.
What can be done to prevent COVID-19 in nursing homes? How are nursing homes responding to COVID-19 and what can families do to keep their loved ones safe?
Follow the CDC Preparedness Checklist
The CDC has issued a COVID-19 Preparedness Checklist for nursing homes and long-term care facilities. The eight-page checklist includes a plethora of instructions to nursing homes. The CDC instructs nursing homes to, among other things, do the following:
- Add COVID-19 to emergency preparedness plan
- Create a planning team, including a “COVID-19 response coordinator”
- Develop a written COVID-19 plan that is easily accessible to staff, families, and residents
- Provide necessary equipment (hand sanitizer, soap, masks, personal protective equipment)
- Have a process to identify, isolate, and treated infected patients and isolate infected staff members
- Have a plan for restricting visitors
- Have non-punitive sick leave policies
- Have plans to provide education to residents, healthcare workers, and residents’ families
- Identify minimum staffing levels needed; conduct a daily assessment of staffing needs
- Estimate how much equipment (i.e. ventilators, intravenous pumps, pharmaceuticals) will be needed for eight weeks; develop a plan to address shortages
- Make a plan for postmortem care, including identifying an area in the facility that could be used as a temporary morgue
Educate Staff, Residents, and Families
When it comes to preventing the spread of COVID-19 in nursing homes, education is one of the most powerful tools at a facility’s disposal. Residents, residents’ families, and nursing staff should all become well-informed about coronavirus and how to prevent infections. Deviating from the nursing home’s established protocols or from government guidance could expose the facility to liability and lawsuits.
Personal protective equipment (PPE) is a vital tool in the fight against coronavirus, but it is useless if not used properly. Thus, nursing homes have a responsibility to make sure that healthcare providers know how to use personal protective equipment, including face shields, masks, and gowns. Supervisors should mandate that all staff demonstrate competency with these tools. This competency is even more important in light of reports that many healthcare facilities are facing a shortage of equipment. If a nurse is forced to reuse a mask, will they know how to properly sanitize it? Facilities should start their education campaigns early and check for understanding and adherence throughout the outbreak.
While there has been a lot of talk about personal protective equipment, the power of good old fashioned soap and water cannot be underestimated as a first-line defense. Nursing homes should impress upon staff the importance of continuing, and maintaining, high standards of hygiene, including handwashing.
If nursing staff do fall ill, nursing homes have a responsibility to make sure that healthcare providers do not come to work. In addition to screening their healthcare providers on a twice-daily basis when they are working, facilities should educate staff on how to monitor their own symptoms.
Nursing homes also have a duty to educate residents about COVID-19. Residents should be made aware of the symptoms, which can include but are not limited to, dry cough, a fever, and shortness of breath. Residents experiencing cognitive decline may find this to a very confusing and overwhelming time, and facility staff should try their best to calm the residents and cultivate a culture of preparedness, not panic.
Similarly, nursing home staff also have a responsibility to the families of residents. They should be in regular contact with families, updating them on what the facility is doing to address COVID-19 and how families can help with the effort. If possible, a staff social worker should also be available to help families deal with this tumultuous situation, especially in light of recent facility restrictions on visitation.
One of the core ways to prevent the spread of COVID-19 in society has become “social distancing.” While it is impossible for nursing home staff, including doctors, nurses, and nursing aides, to maintain the recommended six feet distance between individuals, nursing homes have implemented social distancing another way: by restricting visitors to the facility. Failing to restrict visitors to the nursing home could give rise to lawsuits if the nursing home was negligent.
At the start of the outbreak, staff, volunteers, and visitors had their temperature checked before entering; now essentially all visitors and volunteers are banned from the facilities. Facilities have restricted all volunteers and non-essential personnel (such as barbers) from entering the facilities. They have also cancelled all group activities, including communal dining.
Most significantly, facilities have restricted all family visitation, except in certain extenuating circumstances, such as end-of-life care. This unprecedented move has caused significant emotional strain on residents and their families. Heartbreaking images have emerged of families separated by windows as traditional visitation has been suspended. To ease the emotional strain, some facilities have begun to use iPads and video calling apps such as FaceTime to help keep families connected. But as staff become increasingly overburdened, they may not have time to facilitate these high-tech interactions, so the phone is still the best way to stay connected.
The coronavirus also has also exacerbated a silent epidemic that has long plagued nursing homes: loneliness. One nursing home intern wrote a first-person account of measures their facility is taking to keep seniors engaged. As activities are cancelled, chaplains and family members become the first line of defense in the fight against loneliness.
Some loved ones have found creative ways to stay in touch. The husband of one resident came to his wife’s window with balloons and a sign to celebrate their 67th wedding anniversary. Stories like this remind us that even amidst the chaos of the coronavirus, the human spirit is strong, and despite restrictions, there are still ways to stay connected.
Refocus Inspections on Infection Control Procedures
To slow the spread of coronavirus within nursing homes, facilities are intensifying their infection control efforts. Many nursing homes have long been plagued with infection control deficiencies; Kaiser Permanente reports that 61% of nursing homes were already previously cited for infection control deficiencies. So the coronavirus threatens to overwhelm facilities that are already struggling with infection control. What are facilities and the government doing to mitigate this problem?
“We’re going to be refocusing all of our inspectors on infection control, particularly looking at those institutions that have had some concerns in the past or there’s been previous violations,” Seema Verma, Administrator of the Centers for Medicare & Medicaid Services (CMS), told NPR on March 6.
Nursing homes are used to dealing with the seasonal flu, but they have had to intensify their infection control procedures in recent weeks. Flu shots have long been mandatory for all staff and hand sanitizer stations are common throughout facilities, but more intense measures must be put in place if nursing homes have any chance of preventing the spread of the virus. Failing to implement these more intense measures may result in increased litigation and lawsuits if the nursing home acted negligently.
Ensure that Facilities Have Adequate Supplies and Personal Protective Equipment
Nursing homes should provide sufficient supplies, including increased hand sanitizing stations. Hand sanitizer with 60-95% alcohol should be available in every resident room. Sinks should be well-stocked with soap and paper towels (these may seem like common-sense measures, but 61% of nursing homes have historically been cited for infection control deficiencies, so it is of paramount importance that they take these steps to control the spread of COVID-19). Nursing homes should ensure that hospital-grade disinfectants are being used on a regular basis to sanitize surfaces.
What about personal protective equipment (PPE)? Nursing homes should ensure that personal protective equipment is available in areas where resident care is provided (i.e. resident rooms). They should put trash receptacles outside these areas so that staff can easily discard PPE after use. What PPE should nursing homes have? Facilities should ensure that they are well-stocked with:
- Face masks
- Face shields or goggles
As stated earlier, reports are emerging of healthcare facilities not having enough personal protective equipment. In light of these reports, nursing homes should make every effort possible to make sure that they receive these vital supplies. If a facility finds itself facing a shortage, supervisors should have a plan in place for how staff should proceed, as recommended by the CDC. In some cases, the shortage may be caused by the nursing home’s own negligence, which may form the basis for a lawsuit.
Actively Screen Residents and Staff for Fever and Respiratory Symptoms; Isolate Infected People
While a shortage of coronavirus test kits has made it difficult to do formal testing COVID-19, nursing homes should still be actively screening residents and staff for respiratory symptoms.
Staff should have their temperature taken at the beginning of their shifts, and again at the end. If they have a fever or respiratory symptoms, they should not report to work. Sick leave policies should not be punitive. Some nursing home staff work at multiple facilities; they should be asked if other facilities they work at have confirmed or suspected cases of COVID-19. If nursing staff begin to fall sick, facilities—many of which are already dealing with understaffing and high rates of employee turnover—may face staffing shortages. Nursing homes should have written plans in place detailing how to deal with staffing shortages. Nursing homes that do not following their written plans may face the prospect of negligence lawsuits.
While nursing staff who have COVID-19 should not stay in the facility, what about residents who test positive? They should be placed in their own room with their own bathroom. If their symptoms worsen, they should be transported to the hospital. For example, 66 of the 120 residents at the Life Care Center in Kirkland, Washington have been hospitalized. Breathing difficulties are a clear sign that a patient’s condition has worsened, and homes should be ready to transfer patients to hospitals if that happens.
Coronavirus is on everyone’s mind. While anyone can fall victim to COVID-19, the elderly are particularly vulnerable and the mortality rate from COVID-19 among those 70 and older stands at 8%. If your loved one contracted COVID-19 while at a nursing home, they may have also been a victim of nursing home neglect. Call (877) 238-4175 or email email@example.com to speak to an attorney today.