Assisted Living

The COVID-19 pandemic is hitting senior living facilities hard. In many states, almost half of COVID-19 deaths are related to long-term care facilities, like assisted living facilities and nursing homes. The combination of an elderly population and enclosed, indoor spaces means it’s difficult to curb the spread of the virus in these facilities. Assisted living facilities (ALFs) are home to over 800,000 residents, most of these elderly and at risk of serious COVID-19 complications if they contract the disease.

Since March, the Centers for Medicare & Medicaid Services (CMS) have issued and updated sets of rules and regulations to prevent the spread of the novel coronavirus to nursing home residents and workers. However, these regulations do not apply to assisted living facilities, because nursing homes are federally regulated, and assisted living facilities are not. It is up to state governments and the assisted living facilities themselves to establish safety protocols for the COVID-19 crisis. Some states have adopted the federal nursing home regulations for assisted living facilities. Other states have developed their own protocols, following the Centers for Disease Control and Prevention (CDC) guidelines for assisted living facilities.

Protocols for Visitation Limits

To prevent COVID-19 from entering the facility, most ALF are limiting visitors and reducing visitation hours. In over half of the states (26), assisted living facilities aren’t admitting visitors. In another 21 states, regulations recommend that facilities ban visitors. The CDC’s recommendations for ALFs include encouraging “alternative methods” for communication with residents, like videoconferencing. Visitor bans also include prospective residents taking tours of the facilities. Most ALFs are recommending that future residents take a virtual tour online instead of actually visiting the facility.

PPE (Personal Protective Equipment)

Most states are either requiring or recommending employees to wear personal protective equipment while caring for residents. This equipment can include respiratory facemasks, eye protection, medical gowns, and gloves. Sixteen states (and Washington, D.C.) require staff to use PPE in the facilities. Twenty seven states recommend PPE, and seven states haven’t issued guidance on PPE in assisted living facilities. The CDC also recommends that residents wear cloth face masks whenever they’re around others in the facility; or even when they leave the facility for medical appointments.

Screening of Employees and Residents

Most states (27) recommend daily screening protocols of staff for illness, while 17 states and Washington, D.C. require the daily screening. Six states haven’t issued guidance about staff screening. The CDC recommends sending home any employees who have a fever of 100 degrees or more. Most facilities also screen residents daily for symptoms and ensure that residents are aware of all symptoms.

Social Distancing

Like the rest of us, assisted living residents and staff are encouraged to maintain a distance of at least six feet between themselves and others, when possible. This means that many social events have to be modified or canceled. Trips outside the facility to public places, as well as visits from groups, like school groups or bands, are discouraged.

Communal areas like dining rooms have had to make changes. Staggered mealtimes mean that fewer residents eat at the same time. Facilities are also offering more “grab and go” meal options that residents can pick up and eat in their rooms and room-delivered meals to reduce the number of people in the dining area.

Disinfecting

The CDC recommends that assisted living facility staff clean and disinfect surfaces in common areas at least once a day. Staff focus on surfaces that many people touch throughout the day. This includes door handles, faucets, light switches, remote controls, and shared exercise equipment.

Responding to an Infection

If a resident shows or reports symptoms of COVID-19, the CDC recommends they immediately self-isolate in their own living area. The ALF must contact the health department, and the resident should be prioritized for testing. All other residents are encouraged to self-isolate, too, if COVID-19 is suspected to be in the facility. In many states, assisted living facilities are not required to report COVID-19 cases to the National Healthcare Safety Network (NHSN) like nursing homes are, but most states recommend that they do report cases.