Published April 10th, Recommendations Updated April 25th, 2020, introduction updated May 21st
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:
Emergency Action Plan to Save Lives
of Residents of California Long Term Care Facilities
Stop COVID-19 from being introduced to skilled nursing facilities
Order facilities with no known or suspected COVID-19 outbreaks to refuse admission to any outside patients with infectious COVID-19. When COVID-19 enters nursing homes, it is highly likely to spread and kill residents despite precautions.
Designate facilities to provide care to COVID-19 patients after acute hospital discharge
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 skilled nursing facility residents should not be displaced to create COVID-19 dedicated facilities; rather, available empty spaces should be used.
Monitor facilities with residents who have COVID-19 on a daily basis
Assign a CDPH surveyor to conduct daily onsite monitoring visits at each facility with residents or staff who have 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 facility crisis related to COVID-19, send strike teams composed of state and local health departments, local health systems, the National Guard, ombudsman programs and CMS region 9 to provide emergency leadership, medical treatment, care, testing, supplies and equipment to save the lives of residents in overburdened facilities.
Ensure staffing is sufficient to keep residents safe
Require nursing facilities to maintain safe staffing levels and submit daily staffing reports to CDPH, county health departments, ombudsman programs, and CMS.
Employ emergency complaint system to help prevent outbreaks
Implement an emergency state complaint intake system for infection-related complaints with adequate surveyor resources to conduct immediate investigations.
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.
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.
Require complete testing of all staff and residents
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.
Prioritize prevention of infections
Require each nursing facility employ a qualified, full-time infection preventionist throughout the epidemic.
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 nursing homes once the crisis recedes or if their stays at home become unsafe or unmanageable.
Offer workers “hazard pay” so they do not need to work in multiple long term care facilities simultaneously
To help address understaffing and prevent cross-transmission of the virus during the pandemic, require long term care facilities to pay doubletime to health care workers during the crisis, and to provide at least two weeks of paid sick leave.