Articles Posted in Covid-19

Although COVID-19 does not pose the same broad risks in San Bernardino County that it did in the early years of the pandemic, the virus does continue to pose a relatively serious risk to older adults in nursing homes. Even seniors who have been fully vaccinated and boosted are still at higher risk of developing serious symptoms from COVID-19, and nursing homes have a duty to ensure that infection-control measures are in place to prevent the spread of the virus if a resident does become infected. According to a recent story from KQED, some nursing homes and other long-term care facilities are using COVID-sniffing dogs to identify the virus in residents. Can dogs really sniff out COVID? And when can a nursing home be liable for injury or death caused by COVID in a nursing home, assisted-living facility, or another type of long-term care facility?

Learning More About COVID-Sniffing Dogs in California

Can dogs really sniff out COVID? And can this practice make nursing homes and assisted-living facilities safer for residents? According to the KQED story, using COVID-sniffing dogs can be quick and effective, in large part. Indeed, the piece says, “in less than a half hour, dogs can scan hundreds of patients at a nursing home by sniffing their shoes and ankles,” and “if they identify COVID, they will sit down next to the suspected resident.” Facilities are then using rapid antigen tests to “verify the results” provided by the dogs.

Before anyone in San Bernardino County had ever heard the term COVID-19 or thought about the possibility of a global pandemic caused by a coronavirus, individuals and families worried about the safety of Southern California nursing homes and assisted-living facilities. For years, skilled nursing facilities across the state have been cited for nursing home abuse and neglect, and people with aging parents have struggled to feel comfortable with the health and safety records of many nursing homes. Further, many serious safety violations occur at nursing homes with no documented history of abuse, suggesting that it is critical to go beyond ratings and safety histories when selecting a skilled nursing facility. But has the COVID-19 pandemic made such decisions even more difficult, and potentially impossible? 

According to a recent article in The New York Times, the COVID-19 pandemic, and the failure of nursing homes across the country to keep elderly residents safe and healthy, has led many families to rethink nursing home care altogether. Indeed, “even with vaccines, many older people and their relatives are weighing how to manage at-home care for those who can no longer live independently.”

Nursing Home Occupancy Rates are Down

In Riverside County and throughout Southern California, nursing home residents died as a result of COVID-19 infections. For many of these residents and patients, infections and resulting deaths could have been avoided if facilities were properly staffed and if those facilities had engaged in effective and appropriate infection-control measures. However, as a recent Human Rights Watch report emphasizes, the pandemic has exposed not only the serious negligence of facilities related to controlling COVID-19 infections, but underlying problems at facilities that resulted in worse situations during the pandemic. 

Myopic Focus and Lack of Visitors Led to Increased Nursing Home Neglect Injuries

One of the primary points in the report is this: During the pandemic, many nursing homes across the US had a myopic focus on preventing COVID-19 infections and improving infection-control measures, which resulted in a lack of attention elsewhere. That myopic focus, coupled with the ongoing problem of understaffing, meant that many other injuries unrelated to the coronavirus but resulting from nursing home neglect when unnoticed and untreated.

Is a senior in a nursing home at greater risk of suffering a fall-related injury if that senior is more socially isolated as a result of the pandemic? Nursing home staff members are supposed to provide regular and frequent care to nursing home residents, and to ensure that older adults in Los Angeles County nursing facilities are not left unattended for a long enough period of time that a serious or even fatal fall-related accident could happen. Yet according to a recent article in The New York Times, not only can social isolation increase a senior’s risk of suffering a fall injury when that senior is living alone, but social isolation can also put a senior at increased risk of a fall-related injury in assisted-living facilities and nursing homes. 

In short, having fewer people around—friends and family members—can make it more likely that an elderly adult will suffer a fall. Given that the COVID-19 pandemic has resulted in significantly more social isolation for older adults, the pandemic ultimately could lead to more serious and fatal fall injuries among seniors.

New Study Shows Socially Isolated Seniors are More Likely to Fall

Nursing homes in Riverside County and throughout Southern California have been on high alert for COVID-19 infections among residents, given that the coronavirus causing this infection can spread rapidly in skilled nursing facilities and can cause severe infections among older adults. Yet many nursing homes continue to be ill-equipped when it comes to keeping residents safe and free of infection. Given that so many safety advocates have turned their attention to the spread of COVID-19 in California nursing homes, some facilities have been able to implement infection-control measures to help prevent the spread of COVID-19 and to make sure that residents are transported to hospitals as quickly as possible when they show signs of severe symptoms. 

However, according to a recent article from NPR, nursing homes may be encouraging the spread of COVID-19 by hiring nursing home workers that travel from one facility to another. Indeed, according to the article, “staff who work in multiple nursing homes” may in fact be the “source of the spread of infections” in a number of nursing homes to date. When COVID-19 spreads as a result of staff members traveling from facility to facility, what safety requirements must skilled nursing homes implement? Can these facilities be held accountable for nursing home negligence if they do not take additional steps to prevent COVID-19 infections when they employ staff members who work shifts across multiple different nursing homes?

Recent Study Suggests Nursing Home Staff Members Could be Spreading COVID-19 Infections to Patients

California received its first batch of Covid-19 vaccinations and began vaccinating people according to recommendations from the California Department of Health. First, the vaccine is being given to health care workers and residents of skilled nursing facilities, assisted living facilities and similar facilities for older and medically vulnerable patients.

NursingHomeVaccine-300x200Currently, there are more than 400,000 people living in skilled nursing facilities (nursing homes, rehabilitation centers, convalescent hospitals) in California. Questions arise over how to obtain consent for the vaccines for the elderly who suffer from dementia or Alzheimer’s or in some other way lack the capacity to give consent. Obtaining written consent from the patient him or herself would be the best, but that is not going to be possible for many residents of nursing home and assisted living facilities.

People are worried about the safety of vaccines, and some discount the severity of the virus itself. The federal government has not provided clear direction on how to best encourage people to consent to taking the vaccine. It is easy to imagine that within families there might be disagreement over whether a loved one should be vaccinated in the first place. These disagreements will need to be worked out because there is an urgent need to vaccinate the elderly who are disproportionately affected by Covid 19 and require hospitalization at higher rates than the rest of the population when they do get infected.

Whether you are concerned about COVID-19 risks in Los Angeles County nursing homes or at facilities elsewhere in Southern California, it is critical to learn more about why skilled nursing facilities are frequently coronavirus “hot spots” and to find out what you can do if an elderly loved one suffers a severe infection. According to a recent article from the California Health Care Foundation (CHCF), dozens of elderly residents at nursing homes in San Diego County, Los Angeles County, Riverside County, and across the state are testing positive for COVID-19 despite the fact that many facilities say they are taking precautions.

 
What is happening, and why are nursing homes so dangerous? Are there specific qualities of nursing homes, assisted living facilities, and residential care facilities for the elderly (RCFEs) that make these places more hazardous for older adults who are at risk of severe infection from the virus? Or is the quality of care insufficient?

 
More than 40% of COVID-19 Deaths are Nursing Home Residents or Workers

Prior to the start of 2020, nobody was considering the ways in which a global pandemic could impact a senior’s risk of suffering injuries as a result of nursing home abuse and neglect. Yet the coronavirus pandemic has, for many older adults, made things worse. According to a recent article in MarketWatch, the pandemic has meant that “many older adults have become more vulnerable” and are suffering harm that otherwise could have been prevented.

 
Whether you currently live in a nursing home in San Bernardino County or have an elderly loved one in a skilled nursing facility in Southern California, it is essential to learn more about elder abuse risks during the pandemic and what can be done to mitigate them.

 
Facilities Refusing to Allow Residents to Reenter

Nursing homes in Riverside County and throughout California and the country are facing lawsuits related to COVID-19 infections and deaths among residents. Many nursing homes are arguing that they could not have taken any additional steps to prevent the spread of the coronavirus, yet skilled nursing facilities are required to have particular infection-control measures in place.

 
In fact, in early April, the Centers for Medicare & Medicaid Services issued guidance to nursing homes and other long-term care facilities about the types of infection-control methods that would be necessary “to keep patients and residents safe.” The guidance helps to provide clarity for the types of actions (or inactions) for which a nursing home or assisted-living facility may be liable if a patient contracts COVID-19 and suffers a serious infection or dies as a result of that infection.

 
Actions to Prevent the Spread of COVID-19 at Nursing Homes and Assisted-Living Facilities

Virus_Outbreak_California_Nursing_Homes_57249-300x208One of the great tragedies of the coronavirus pandemic is the disparate impact it has had on some of our most vulnerable citizens including elderly patients residing in Southern California nursing homes. Thousands of elderly nursing home residents across the country have died from coronavirus. Indeed, one of the first coronavirus outbreaks occurred in a nursing home in Kirkland, Washington where 129 residents, staff, and visitors fell ill with covid-19 and 40 died. In an unexpected twist of logic, many nursing homes are discharging long-term residents to care for patients with coronavirus. Why? Money, of course, even though this presents an increased risk to other residents of nursing homes and to their staff.

Caring for a patient sick with Covid-19 earns a Los Angeles nursing home, for example, significantly more money than can be charged for a non-Covid-19 patient who needs assistance with long term more mild conditions. In the fall of 2019, Medicare funding changed offering increased payments to nursing homes caring for patients who have recently been discharged from the hospital. The first weeks after their discharge, nursing homes earn up to four times of the daily amount offered for a long-term resident. For example, a nursing home can earn $800 per day for a COVID-19 patient while earning only $200 per day for a patient with dementia.

Thus, nursing homes have great incentive to attract those patients recently released from hospitals who are severely ill and require skilled nursing. To have the space to care for those patients, nursing homes must free up beds in their facilities. How does that happen? The long-term, less valuable patients are discharged, often under conditions that imperil their health and safety. Families of the soon to be discharged patients are called and told their loved one will be discharged sometimes in as few as 10 days, leaving no time to plan for or to find appropriate alternative housing for the patient. Little consideration is given to a patient’s level of income or to their well-being. Instead, the nursing homes while turning their backs on their vulnerable long-term residents tout their care of Covid-19 patients as a public benefit.

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