Published April 10th, Introduction updated May 21st, Recommendations Updated June 24th, 2020,
The last few months have been an unimaginable tragedy for many long-term care facility residents and their loved ones throughout California. Thousands of residents have died, suffered severe illnesses, or been hospitalized as COVID-19 outbreaks sweep through their facilities. Locked away from their loved ones, residents are suffering and dying alone in facilities that are not prepared or staffed to keep them safe during this pandemic.
Governor Newsom and public health officials have been slow to address the crisis in long term care facilities, adopting measures that are weeks too late or do not go far enough to keep residents safe right now.
CANHR is calling on the Governor and state officials to take emergency actions to help prevent further outbreaks and loss of life. Please join CANHR in this call to action by contacting the Governor by email and urging him to implement CANHR’s emergency action plan to save the lives of residents of California long term care facility residents. You can also help by asking your State Senator and Assembly Member to support CANHR’s recommendations, which are set out below.
Email Governor Newsom: https://govapps.gov.ca.gov/gov40mail/
State Senators and Assembly Members: http://findyourrep.legislature.ca.gov/
Please note that when you email the Governor or your State Legislators, it will be via an online form which does not allow attaching of files. To include the entire list of our recommendations, please copy this link and then paste it at the end of the email text you type into the online form:
CANHR COVID-19 Action Plan to Save Lives of Residents of California Nursing Homes and Assisted Living Facilities
End the ban on visitation
The visitation ban has harmed residents by isolating them and contributing to unmet needs and neglect. Give every resident the right to at least one support-person visitor to visit in-person until the time when full visitation rights can be restored. Establish reasonable infection control precautions for support-person visitors and provide training on safe visitation. Visitation saves lives!
Stop COVID-19 from being introduced into long term care facilities
Order facilities with no known or suspected COVID-19 outbreaks to refuse admission to any outside patients who have tested positive for COVID-19. When COVID-19 enters long term care facilities, it is highly likely to spread and kill residents despite precautions.
Designate facilities to provide care to COVID-19 patients after they are discharged from hospitals
Establish COVID-19 dedicated post-acute care facilities in counties and require all hospital post-discharge patients to be tested for COVID-19 and if positive, transferred to such facilities. Current facility residents should not be displaced to create COVID-19 dedicated facilities; rather, available empty spaces should be used. Set strong standards for dedicated facilities. Ban operators and facilities with poor track records or histories of outbreaks or non-compliance from designation. Post information on designated facilities.
Monitor on a daily basis facilities with residents or staff who have COVID-19
Assign an inspector to conduct daily onsite monitoring visits at each facility with residents or staff who have active COVID-19 and at facilities with poor compliance histories to ensure infection control practices and staffing levels are safe and to sound the alarm on the need for immediate intervention if they are not.
Deploy strike teams to intervene at facilities when residents are endangered
At the earliest sign of a facility crisis related to COVID-19 that endangers the lives of residents, send strike teams composed of state and local health departments, local health systems, EMS, the National Guard, ombudsman programs and CMS Region 9 personnel to provide emergency leadership, medical treatment, care, testing, supplies and equipment to save the lives of residents in overburdened facilities. Each strike team should give daily public reports describing its actions, findings, resources needed and the status of residents and staff in the facility.
Ensure staffing is sufficient to keep residents safe
Require all long term care facilities to maintain safe staffing levels; to submit daily staffing reports to CDPH or CCLD, local health departments, ombudsman programs, and CMS; and to post the daily reports on facility, state and local health department websites.
Provide “hazard pay” and paid sick leave to workers so they do not need to work in multiple long term care facilities simultaneously or need to work while sick
To help address understaffing and prevent cross-transmission of the virus during the pandemic, require long term care facilities to pay double-time to health care workers during the crisis, and to provide at least two weeks of paid sick leave.
Restore full inspections and investigate all complaints at long term care facilities
Inspectors and investigators are the last line of defense for facility residents who are being mistreated, neglected or abused. Require regulatory agencies to carry out comprehensive inspections and to investigate all complaints in accordance with the law.
Enforce infection control standards and residents’ rights
Impose immediate sanctions on facilities that jeopardize residents’ lives through poor infection control or other substandard care, illegal evictions or other violations of the law. Direct inspectors to identify and document violations. Post inspection findings and sanctions on existing state websites.
Mandate transparency on infection levels
Require facilities to inform residents, families, staff members, state and local health departments and the local long-term care ombudsman when residents or staff test positive for COVID-19 and when residents or transferred residents die due to confirmed or suspected cases of COVID-19, along with the steps the facility is taking to treat infected residents and to protect other residents. Impose strong penalties on facilities that fail to report or submit false data.
Fully inform the public on outbreaks at long term care facilities
Direct state and local health departments to identify long term care facilities that have residents or staff members with positive COVID-19 test results, to fully track and report deaths of residents at each facility or following transfers, and to publicly report and update the status of facility infections and deaths on a daily basis.
Test all staff and residents frequently
Ensure availability of testing with rapid results at all long term care facilities statewide. Impose strong penalties against facilities that fail to comply with testing requirements. Report facility-specific findings publicly and update data daily. Implement contact tracing procedures when a positive result is discovered.
Ensure availability of personal protective equipment (PPE) at long term care facilities
Give long term care facilities high priority for distribution of PPE.
Enable residents to go home temporarily if they are able to do so
Give residents who wish to return home temporarily the means to do so by expediting assistance to provide home caregivers, making testing readily available, and giving residents the right to return to their long term care facilities once the crisis recedes or if their stays at home become unsafe or unmanageable.
Suspend nursing home and assisted living evictions
During the COVID-19 crisis it is nearly impossible for vulnerable people being evicted from nursing homes and assisted living facilities to find new places to live. Prevent homelessness by temporarily suspending evictions from these facilities during the pandemic.