The Current Situation Due to continued quality of care violations, Laguna Honda has been threatened with loss of its ability to get paid by Medicare and Medi-Cal. Most Laguna Honda residents have their care paid for by Medicare or Medi-Cal. But nothing is settled at this point. Laguna Honda announced that it is filing a new application to be paid by Medicare and Medi-Cal.
On April 6, 2022, the National Academy of Sciences, Engineering and Medicine’s Committee on the Quality of Care in Nursing Homes released a 605 page report – The National Imperative to Improve Nursing Home Quality; Honoring Our Commitment to Residents, Families and Staff – that is meant to be a blueprint for desperately needed reform of nursing home care.
On December 31, the Department of Public Health issued an order requiring all nursing home and assisted living facility visitors to provide proof of a negative COVID test before visiting with their loved ones. Due to the difficulty in finding tests, the new rule has led to widespread lockouts in many facilities, casting residents into the depressing isolation. Shortly thereafter, the State permitted COVID-positive long term care facility staff to continue to come to work, creating a ridiculous situation where COVID-positive staff are providing care to residents while vaccinated and boosted visitors who do not have COVID are locked out.Compounding the State’s missteps, a lack of enforcement regarding visitation has led to facilities across the state illegally shutting down all visitation, leaving residents and visitors scratching their heads. Long term care facilities are not allowed to shut down visitation at their discretion. If your facility has shut down all visitation, immediately file a complaint with the Department of Public Health (for nursing homes) or the Department of Social Services (for assisted living – email complaint to firstname.lastname@example.org)
A state public health order went into effect today that essentially shut down visitation in long term care facilities in California. The order requires all visitors to have a negative COVID test in the past 2 days (PCR tests) or 1 day (antigen tests) in order to visit. Given the substantial challenges to test access, this is tantamount to a visitation lockout.
The Centers for Medicare & Medicaid Services (CMS) announced in a September 21, 2021 press release that it has added a new feature to its Care Compare website to make it easier to check COVID-19 vaccination rates for nursing home staff and residents. The information is intended to help people make informed decisions when choosing a nursing home. To access the vaccination rate data, search a nursing home’s zip code or city on Care Compare, click on the name of the nursing home, then scroll down to click “View COVID-19 Vaccination Rates” to see the data.
Despite the ongoing pandemic, in-person visitation is mandatory in California long term care facilities. However, a number of facilities are shutting down all in-person visitation indefinitely when a staff member or resident tests positive for COVID-19. Generally, these visitation lockouts are illegal. The only time a facility may temporarily shut down in-person visitation is when a local public health authority has directed that visitation be stopped or in nursing homes under very specific circumstances outlined by the Centers for Medicare and Medicaid Services.
The State of California has taken an important step to safeguard the wellbeing of residents of long term care by mandating that virtually all facilities providing care in congregate settings take steps to ensure that their workers are vaccinated. In an order issued July 26, the State mandates that hospitals, skilled nursing facilities, and adult and senior care facilities verify the vaccination status of all employees, and that they require that all unvaccinated employees submit to testing twice weekly in skilled nursing and intermediate care facilities and once weekly in assisted living facilities.
It may be fewer than you would expect. According to federal data as of July 11, 2021, less than 80 percent of current nursing home staff in California were vaccinated. However, variation from facility to facility was extreme, ranging from 0 to 100 percent. While 827 California nursing homes reported that 75 percent or more of staff are vaccinated, over 350 facilities fall below that rate.
Despite plummeting rates of COVID infections and deaths in nursing homes and the lifting of public health-oriented restrictions, long term care facilities throughout the state are still limiting visits from families and friends to a measly 30 minutes per week. Other facilities, in stark contrast, are permitting extensive daily visitation. The wide range of visitation policies among facilities has been enabled by the State’s continued waiver of laws that normally require broad visitation access for residents. Potential residents and their loved ones are strongly encouraged to speak with the managers of facilities they are considering and ask for written copies of their visitation policies.
CANHR has reviewed the various federal and California guidance regarding visitation in long term care facilities and synthesized the rules into a new fact sheet to guide residents and their families. The fact sheet highlights the types of visitation nursing homes and residential care facilities for the elderly must provide and under what conditions as well as the infection control protocols facilities may impose during visits. Download the Fact Sheet HERE (PDF)