New CMS Guidance Can Help Assisted Living Buildings Re-Open, Testing an Issue

On Monday, the Centers for Medicare & Medicaid Services (CMS) issued guidance to ensure that nursing homes have safe re-opening plans as states prepare to relax lockdowns stemming from the coronavirus pandemic.

The guidance includes benchmarks that may be adopted by independent living and assisted living communities transitioning from their own access restrictions. But it fails to address assistance in obtaining enough personal protective equipment (PPE) and testing on the facilities — an issue raised by industry associations since lockdowns began in mid-March.

While some of the benchmarks can be adopted by senior living providers, industry groups stress that relaxing restrictions is not uniform and will vary by state, city and care acuity.

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“There won’t be a one-size-fits-all approach,” Argentum President and CEO James Balda said in a statement to Senior Housing News.

The guidance makes clear that nursing homes will be among the last institutions that will relax restrictions on non-essential personnel as the country begins to ease Covid-19 lockdowns. It also places the onus for testing and PPE on the facilities.

Specifically, the guidance mandates that all nursing home residents and staff have the capacity to receive a single baseline Covid-19 test, have arrangements with laboratories to process the tests, that testing continue weekly in communities with a positive case until all staff and residents test negative, and that adequate staffing plans are in place in the event an associate tests positive.

State and local governments have assisted nursing homes and assisted living facilities in obtaining testing and PPE. Independent living communities, meanwhile, are more vulnerable to new outbreaks as communities begin to relax lockdowns, Rogerson Communities President and CEO Walter Ramos said during a May 7 press briefing by LeadingAge. Based in Boston, Rogerson manages 29 facilities throughout the Boston metropolitan area, ranging from independent living and assisted living, to skilled nursing.

Ramos notes that, as states consider reopening, they are increasing the vulnerability of independent living communities to the virus. Many residents in these properties still have to go to the grocery and the pharmacy. Those who do opt for having prescriptions and groceries delivered still have a risk of added exposure when communities open up to non-essential personnel.

“We now know that unless we provide adequate PPE and rapid testing for independent living, while continuing [testing and PPE] in our assisted living and skilled nursing facilities, the pandemic will continue for our residents,” he said.

Industry groups continue to press for access to funding in order to provide increased and continuous testing and protection.

“It is vital that all long-term care facilities receive additional support and funding from state governments to conduct expanded testing. We encourage governors to use the $11 billion that has been allocated to states for expanding testing​ in our nursing homes, assisted living communities and other long term care facilities. States can also assist with logistical support in implementing such a large endeavor, with help from the National Guard or the state’s health department,” American Health Care Association and National Center for Assisted Living (AHCA/NCAL) President and CEO Mark Parkinson said in a statement.

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