Iowa Health Care Association advises no visitation to long-term care facilities


The Iowa Health Care Association (IHCA) represents most of the state’s more than 790 long-term care providers, including nursing homes, assisted living communities and home health care agencies and has been working closely with its members and state health officials to monitor novel coronavirus (COVID-19) developments in Iowa.
Brent Willett, President and CEO of the IHCA has issued the following statement in response to updated federal guidance from the Centers for Medicare and Medicaid Services (CMS) issued March 13 regarding visitors at long-term care facilities considering COVID-19. The federal government’s guidance supersedes guidance issued by the American Health Care Association, National Center for Assisted Living and Iowa Health Care Association earlier this week.
“We appreciate the federal government’s action last night to protect the lives and safety of nursing facility residents. Everyone is working toward the same goal: To protect the health and well-being of our country’s elderly and most vulnerable residents. What we know about COVID-19 is that it poses a shockingly high risk of serious illness and death to those over 80 and with underlying health conditions, characteristics which most residents in long-term care possess. The new guidance from CMS is critically important to ensuring that only essential visitors enter nursing homes during the COVID-19 crisis. We must take every step possible to keep this virus out of long-term care facilities, and this is an important one.”
The federal guidance states: Facilities should restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation. In those cases, visitors will be limited to a specific room only. Facilities are expected to notify potential visitors to defer visitation until further notice (through signage, calls, letters, etc.).
For individuals that enter in compassionate situations (e.g., end-of-life care), facilities should require visitors to perform hand hygiene and use Personal Protective Equipment (PPE), such as facemasks. Decisions about visitation during an end of life situation should be made on a case-by- case basis, which should include careful screening of the visitor for fever or respiratory symptoms. Those with symptoms of a respiratory infection (fever, cough, shortness of breath or sore throat) should not be permitted to enter the facility at any time (even in end-of-life situations). Those visitors that are permitted, must wear a facemask while in the building and restrict their visit to the resident’s room or other location designated by the facility. They should also be reminded to frequently perform hand hygiene.
Additional guidance:
1. Cancel communal dining and all group activities, such as internal and external group activities.
2. Implement active screening of residents and staff for fever and respiratory symptoms.
3. Remind residents to practice social distancing and perform frequent hand hygiene.
4. Screen all staff at the beginning of their shift for fever and respiratory symptoms. Actively take their temperature and document absence of shortness of breath, new or change in cough and sore throat. If they are ill, have them put on a facemask and self-isolate at home.
Those who work in long-term care facilities are committed to helping residents communicate with family members and friends through alternative means, so they can remain connected to their loved ones. If you have a loved one in a care facility, consider alternative ways to stay in touch with family members - such as phone, Skype, FaceTime and Snap Chat. If an in-person visit is necessary, call the facility first to coordinate your visit and comply with any health screening requests you receive from the facility before visiting.