CMS Relaxed Restrictions on Nursing Home Care

A conflict between hospitals and nursing homes is merging as the COVID-19 disease spreads throughout the country. Hospitals need to clear outpatients who no longer need acute care, but nursing homes don’t want to take discharged patients from hospitals for fear they’ll bring the Coronavirus with them.

“It’s a huge and very difficult issue,” said Cassie Sauer, president of the Washington State Hospital Association, whose members were hit early by the coronavirus

Hospitals need to free up beds for critically ill coronavirus patients. The goal is to “allow hospitals to reserve beds for the most severely ill patients by discharging those who are less severely ill to skilled nursing facilities. They are also trying to move coronavirus patients out of the hospital as quickly as possible. The Centers for Medicare & Medicaid Services a few weeks ago relaxed rules restricting which Medicare patients can receive nursing home care.

Nursing homes are alarmed at the prospect of taking patients who may have coronavirus infections. The consequences could be fatal. The first nursing home known to have COVID-19, saw the virus spread like wildfire. It killed 37 people.

The American Health Care Association said nursing homes can accept patients “who are COVID negative or do not have symptoms.” If someone has symptoms such as a dry cough or fever, they “should be tested before being admitted to the facility.” If someone is COVID positive, they should be kept only “with other COVID positive residents.”

But nursing home doctors worry this doesn’t go far enough, saying nursing homes should not have to take patients known to have the coronavirus unless “they have two negative tests that are 24 hours apart, OR 10 days after admission AND no fever for 72 hours.” A new AMDA resolution echoes this caution.

For their part, hospital leaders say an emphasis on testing patients who no longer need acute care before discharging is impractical, given the shortage of tests and delays in receiving results. We have an obligation to our patients to draw the line.

 From a workforce perspective, Home Health Agencies immediately began planning for work shortage by cross-training staff members and developing family contingency plans.

Home Health Care News reported: “The first thing home health providers must do is educating their staff, building awareness is extremely important, but it’s also important that there isn’t panic among health care workers. Companies must designate time to educate their workers on symptoms, prevalence and how to identify patients with symptoms and properly screen them.”

Keeping calm in moments of crisis is strength for many home health providers, some of which routinely deal with natural calamities like flooding, tornadoes and hurricanes while caring for patients. Doing the same with Coronavirus patients is essential.

Experts say: Depending on how COVID-19 develops in the U.S., home health providers may want to begin preparing for a sudden influx of patients. As the virus spreads, many hospitalized individuals will likely have a need for home health services after discharge. So the burden on us as an industry to protect our patients and equally protect our employees is much higher.” It’s still too early to conclusively say how home health providers will be affected by the spread of COVID-19, but industry insiders are beginning to think through the most likely scenarios

Author
Terri Edwards
Marketing Director
Mir Home Care Inc.
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