Nursing Homes at High Risk for Coronavirus Outbreaks

COVID-19 is a disease caused by a respiratory virus first identified in Wuhan, Hubei Province, China in December 2019. COVID-19 is a new virus that, previously, had not caused illness in humans. Worldwide, COVID-19 has resulted in thousands of infections, causing illness and many deaths. Cases have spread to countries throughout the world, with more cases reported daily. COVID-19 is thought to be able to spread like the cold or flu through:

• coughing and sneezing, which creates respiratory droplets
• close personal contact, such as touching or shaking hands
• touching an object or surface with the virus on it

Symptoms of COVID-19 include:

• fever
• coughing
• shortness of breath
• in more severe cases, pneumonia (infection in the lungs)

In many cases, nursing homes serve over 100 patients at any given time, often with patients sharing rooms. Nursing homes serve the elderly and those with serious health conditions. These conditions make nursing homes particularly susceptible to the coronavirus.

Nursing homes across the country are struggling to cope with the coronavirus pandemic. Recently, Maryland Governor Larry Hogan said his state has identified coronavirus cases in sixty different nursing home facilities and multiple correctional facilities across the country

It was recently reported that 77 of 95 residents of Pleasant View Nursing Home in Carroll County tested positive for the coronavirus. Of 63 staff members, 18 have tested posited. A total of five people linked to the nursing home have died. According to the Baltimore Sun, the administrator of the facility, Rebecca Travels, asked state officials what they should be doing to protect residents from harm. The state told Ms. Travels that they could not spare the testing resources on her facility. Governor Hogan believes it was an employee without symptoms who caused the outbreak.

ArchCare, a nursing home chain in New York, has been forced to outfit staff members in rain ponchos and beautician gowns to stretch their dwindling supply of protective gear, according to Scott LaRue, president and CEO of the company, which is affiliated with the Archdiocese of New York. Employees are given one N95 mask — meant to be single-use — to last an entire week.

A nursing home in Virginia, Canterbury Rehabilitation & Healthcare Center in suburban Richmond, recently announced that 20 patients have died from the coronavirus. 90 patients have tested positive in total, and the facility only houses 158 residents. The facility has received poor grades on Medicare’s five-star rating system for health inspections:

The Maryland Department of Health recently released a guidance Preparing for and Responding to Covid-19 in Long-term Care and Assisted Living Facilities. According to the guidance, long-term care and assisted living facilities should enact several preventative measures, including:

• Restriction of visitors except for in extenuating circumstances, such as resident dying
• Visitor screening prior to entry
• Requirement that visitors wear PPE
• Cancellation of communal activities
• The use of PPE for patients suspected as having coronavirus
• Cleaning frequently-touched surfaces three times per day and as needed
• Using standard, contact, and droplet precautions when caring for ill residents
• Create a plan for cohorting residents with symptoms of respiratory infection

The Virginia Department of Health has released a similar guidance titled Outbreaks in Nursing Homes and Long-Term Care Facilities. Virginia has listed a serious of steps to take before and after an outbreak have occurred. Prior to an outbreak, VDH requires nursing homes to:

• Review CDC recommendations regarding covid
• Develop a structure for planning and decision making
• Develop a written COVID-19 plan
• Restrict visitors and volunteers
• Actively screen healthcare providers for fever and respiratory symptoms before each shift
• Encourage sick leave
• Identify infections early

Steps to take during an outbreak include:

• Immediate notification to the local health department
• Testing to confirm outbreak
• Cleaning and disinfecting
• Suspension of new admissions
• Consideration of short-term closures
• Universal use of facemasks and PPE if inventory allows

Nursing homes that do not take the necessary steps to prevent coronavirus from spreading can be held legally responsible for damages and death caused by the virus. For example, if an infected nursing home staff member exposes a nursing home resident to the virus after not wearing protective gear, the nursing home resident may have a valid claim for a negligence lawsuit.