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Long-Term Care ConsumersFamily MembersAdvocatesCOVID-19

COVID-19 Frequently Asked Questions

COVID-19 has raised a lot of different issues for residents of long-term care facilities and their families.  Below find some frequently asked questions regarding COVID-19 and its impact on this population.  If you have additional questions, please let us know by emailing info@theconsumervoice.org.

Transfers and Discharges/ Leaving the Facility

Is there an order in place restricting new residents or transfers into nursing homes?

Is there an order in place restricting new residents or transfers into nursing homes?

There is currently no federal guidance restricting new residents from being admitted or transferred to nursing homes. Some states are mandating that facilities accept COVID-19 positive patients discharged from hospitals to whatever extent possible. However, there are significant concerns about the impact that will have on the spreading of the virus and the impact on residents. Nursing homes must be able to provide adequate and necessary care for any individual they admit.  In more recent guidance, CMS has told nursing homes to designate specific facilities or units to separate COVID-19+ patients from those with unknown or non COVID-19 positive status. This could lead to new residents entering and current residents being moved to different wings or floors in facilities or between facilities. Nursing homes should be taking steps to help residents and families understand what is happening, prepare residents as much as possible for the move, make sure their belongings move with them, and give them a choice to whatever extent possible. In these specific cases, notice requirements have been relaxed, however that does not apply to non-COVID-19 related transfers. https://www.cms.gov/files/document/4220-covid-19-long-term-care-facility-guidance.pdf

If you or a loved one needs nursing home care, ask questions such as whether anyone in the facility has tested positive for COVID-19, and what steps the facility has taken to protect the residents and staff and prevent the spread of infection.

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Why is my loved one being moved so that her nursing home can become a COVID-19 facility?

Why is my loved one being moved so that her nursing home can become a COVID-19 facility?

CMS and the CDC have issued recommendations that nursing homes establish separate facilities or units for residents who are COVID-19 positive.  This is because the virus is easily transmitted and can spread quickly inside a nursing home.  That said, nursing homes should be taking steps to help residents and families understand what is happening, prepare residents as much as possible for the move, make sure their belongings move, make sure their belongings move with them, and give them a choice to whatever extent possible.  For more questions, contact the Ombudsman program. You can find it at https://theconsumervoice.org/get_help.

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Can residents be involuntarily discharged or evicted from their facility during the COVID-19 pandemic?

Can residents be involuntarily discharged or evicted from their facility during the COVID-19 pandemic?

Unfortunately, there are not currently any additional protections for residents who are discharged from facilities. We strongly feel that involuntary discharges should stop during this time period, but this has not happened in most states.  If you or a family member receives a discharge notice, contact the Ombudsman program as soon as possible, use this link to locate your state program: https://theconsumervoice.org/get_help.

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I want to take my loved one home during this time, should I?

I want to take my loved one home during this time, should I?

Whether or not you bring your relative home from their facility depends on many factors.  Is your home able to handle your loved ones needs?  How will you manage stairs, bathing, lifting and transferring, among other needs? Is someone available to give them the amount of care they require? If outside help is needed, how will you pay for it?  Has your relative been tested to ensure they do not have the virus?  Have you factored in their opinion of whether they want to stay or go?  Is there a plan for what would happen if someone in your home gets infected?  What happens if your loved one becomes ill or needs more care than you can provide once they are in your home? Can your loved one return to the facility once the pandemic is over? Discuss these considerations with facility staff.  Consider their Medicaid eligibility.  Will they have to reapply before going back to a nursing home?  Have a plan in place, be sure you understand and can meet their care needs and be prepared to have your loved one with you for an extended period.

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Are residents still allowed to go outside, within the grounds of their facility – such as in a courtyard, to get fresh air?

Are residents still allowed to go outside, within the grounds of their facility – such as in a courtyard, to get fresh air?

The administration and residents should communicate about needs and expectations around going outside of the facility.  If there are no active or suspected cases of COVID-19 in the facility, and residents are accustomed to going outside, then they should still be allowed to go out, as long as they practice social distancing.  If there are active or suspected cases in the facility, then CDC has issued guidance restricting residents to their rooms except when medically necessary. If a resident leaves a facility to enjoy the outdoors briefly and is not let back in the facility, contact the Ombudsman program. Visit this page to find your state program: https://theconsumervoice.org/get_help.   

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Can a resident refuse a transfer during COVID-19?

Can a resident refuse a transfer during COVID-19?

CMS has given facilities a lot of discretion during this emergency situation, including granting waivers of advance notice and right to appeal when the transfer is related to COVID-19 status.  When a resident with COVID-19 is transferred to a dedicated COVID-19 facility, a resident without COVID-19 is transferred to a non-COVID-19 facility, or  a resident is transferred for a 14-day observation, their rights to advance notice and appeal are waived.  (Residents are still entitled to written notice of transfer as soon as practicable, but not in advance of their transfer.)  This means that it will be very hard, in these specific situations, for a resident to refuse their transfer.  

Remember that while federal requirements have been waived in these situations, that doesn’t mean that facilities have no obligation to their residents, facilities should still make every effort to give as much advance notice as possible and prepare residents and families for the move.  Residents and families should stay in touch with their facilities and LTC ombudsman to have a sense of what might be happening within the facility.  

Additionally, it is important to note that the waivers to not apply to any other transfers.  Residents still have their right to advance notice and their right to appeal transfers that are not related to moving them because of their COVID-19 status.

Consumer Voice has created a summary of these and other waivers in effect during the COVID-19 emergency.

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If a resident is transferred to another facility due to COVID-19, can they return to their original facility or bed?

If a resident is transferred to another facility due to COVID-19, can they return to their original facility or bed?

Ideally, if a resident is transferred based on their COVID-19 status, they should be able to return to their original facility after the emergency situation has ended.  While bed hold rights have been waived during the emergency, residents should be able to return to their facilities under federal guidelines.  They should be able to return to their previous room if it’s available, otherwise to the first available bed. 

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Transparency/Disclosure 

Are facilities legally required to disclose when they have COVID-19+ residents or staff members?

Are facilities legally required to disclose when they have COVID-19+ residents or staff members?

Yes. CMS issued an interim final rule, effective May 8th that requires nursing homes to disclose specific information related to COVID-19.  Facilities are now required to report, weekly, to the CDC suspected or confirmed cases, as well as residents previously treated for COVID-19, and the total deaths as well as COVID-19 deaths among residents and staff.  They are also required to report the amount of personal protective equipment and hand hygiene supplies in the facility, their ventilator capacity and supplies, resident beds and census, access to COVID-19 testing and staffing shortages.  This information will be available to the public at:  https://data.cms.gov/ beginning the end of May.

Additionally, facilities are required to inform residents, their representatives, and families of confirmed or suspected COVID-19 cases among residents and staff in their facility.  The facilities must share this information by 5pm the day after an occurrence of either a single confirmed COVID-19 infection or when there are three or more residents or staff with new respiratory symptoms that occur within 72 hours of each other.  Facilities must also explain how they are mitigating, preventing, or reducing the risk of transmission.   Read the CMS guidance for more information from CMS on this rule.

While assisted living facilities do not fall under this guidance, your state may require them to also disclose cases. It is good practice for all facilities to notify family members when there is COVID in a facility. If you are not receiving communication regarding this from your facility, please contact the Ombudsman program: https://theconsumervoice.org/get_help.

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Stimulus Checks

Can a long-term care resident still receive a stimulus check?

Can a long-term care resident still receive a stimulus check?

Yes.  Anyone, including older adults, who makes a gross income of up to $75,000 qualifies for the full amount of $1,200.  Those who make more will receive a payment on a declining basis up to $99,000. Adults who receive Supplemental Security Income are still eligible for the stimulus payment.  If a resident filed a 2018 or 2019 tax return, their check will be directly deposited into the resident’s bank account, if their bank account is on file with the IRS.  Otherwise the check will be mailed.  If the resident did not have to file a return, they will receive the check the same way they receive their Social Security benefits.  https://www.medicaidplanningassistance.org/covid-19-stimulus-checks-impact/

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Will the stimulus checks count towards Medicaid eligibility for long-term care residents?

Will the stimulus checks count towards Medicaid eligibility for long-term care residents?

No. The stimulus checks are considered “recovery rebates” as tax credits and they are not taxable  income. The recovery rebates may not be counted as income towards Medicaid eligibility for 12 months. For additional information see question 54 of the Families First Coronavirus Response Act (FFCRA), Public Law No. 116-127 Coronavirus Aid, Relief, and Economic Security (CARES) Act, Public Law No. 116-136 Frequently Asked Questions (FAQs) and this fact sheet from the National Conference of State Legislatures (NCSL).  Additionally, it is important for residents to be aware that the stimulus check belongs to the resident and should be used for things the resident needs or wants, whether that is clothing or a television or something else.  It belongs to the resident and cannot be taken by their nursing home.  If your nursing home attempts to take this money or you are concerned, please contact the  Ombudsman program:  https://theconsumervoice.org/get_help.

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Visitation, Communication, Staying in Touch

How can I stay in touch with my loved one, when visitation to their facility is restricted?

How can I stay in touch with my loved one, when visitation to their facility is restricted?

Contact with friends and family is always important, especially during this pandemic. Speak with facility staff to see if they can assist with facilitating calls or video chats between you and your loved one.  You can email, make phone calls, or leave notes for your loved one.  Review this consumer fact sheet and website for additional ways to stay in touch.  If the facility does not help you communicate with your loved one, contact the Ombudsman program. Visit this page to locate your state program: https://theconsumervoice.org/get_help.

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I know visitation is currently restricted, but are there any circumstances where I can visit my loved one?

I know visitation is currently restricted, but are there any circumstances where I can visit my loved one?

Visitation is restricted for friends and family members except in “compassionate care” situations.  CMS did not define compassionate care but indicated that it should be evaluated on a case by case basis, and be based on the individual needs of the resident. However, when your loved one is very ill or dying, we believe that CMS’s intention was for you to visit. This consumer fact sheet provides additional information about visitation restrictions and communicating with your loved one. If your facility will still not let you visit, contact the Ombudsman program. Visit this page to locate your state program:  https://theconsumervoice.org/get_help.

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Does the Ombudsman program still have access to residents and facilities?

Does the Ombudsman program still have access to residents and facilities?

Ombudsman program access in-person, like visitors, is currently restricted. Ombudsman programs are still investigating complaints they receive and providing information and assistance to residents, family members, the public, and long-term care staff.  Ombudsman programs are proactively reaching out to residents and family members as well as facility staff by phone, email, and/or video calls to check-in.  If you have questions or concerns, contact the program in your state, found here:  https://theconsumervoice.org/get_help.

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Can facilities accept food for residents prepared by restaurants or families during this time?

Can facilities accept food for residents prepared by restaurants or families during this time?

To our knowledge, the Centers for Medicare and Medicaid Services (CMS) has not provided guidance about accepting food for residents from outside of the facility. However, based on the information from the Centers for Disease Control (CDC) there appears to be no reason to ban food provided from outside of the facility.

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Can I still send mail and packages to my family member in a facility?

Can I still send mail and packages to my family member in a facility?

We encourage families to send mail to residents.  Some facilities may hold mail or wipe it down upon delivery, but according to the CDC and the World Health Organization there is currently no evidence that COVID-19 is spread through the mail (USPS statement). 

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Is there a specific video chat/conferencing app or software that is recommended for video conferencing with residents in long-term care facilities? Are there HIPAA violations when using video conferencing to speak with residents?

Is there a specific video chat/conferencing app or software that is recommended for video conferencing with residents in long-term care facilities? Are there HIPAA violations when using video conferencing to speak with residents? 

We cannot recommend a specific video service, however some frequently used applications that are acceptable include Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, WhatsApp video chat, Zoom, or Skype. The good faith provision of telehealth during the COVID-19 crisis will not subject providers to any penalties related to HIPPA.

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Can resident councils still meet during the COVID-19 crisis?

Can resident councils still meet during the COVID-19 crisis?

Resident councils are when residents in a facility come together to form a united voice to work on common issues, communicate concerns to their facility and work towards resolutions and improvements.  While residents in nursing homes are socially distancing, there are still ways for resident councils to meet.  Residents can hold phone meetings with each other or, if they have access to internet and video devices, they can hold their meetings via Zoom or other video conferencing services.  If residents do not have their own devices, they can ask for assistance from staff to get set up. Visit Consumer Voice’s Resident Council Center.

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Do all nursing homes have family councils?  How can I get involved with a family council?

Do all nursing homes have family councils?  How can I get involved with a family council?

Family councils are groups of family members and friends of nursing home residents that advocate and work with the facility to improve the quality of care their loves ones receive.  Not every nursing home has a family council, but if yours does not, you can join with other families to start one.  Visit Consumer Voice’s Family Council Center for more information.  If you need help, reach out to your LTC ombudsman:  https://theconsumervoice.org/get_help

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What is a “compassionate care” situation for allowing a family member in?

What is a “compassionate care” situation for allowing a family member in?

Visitors are allowed to enter nursing homes in “compassionate care” situations.  CMS has not defined “compassionate care,” however, they have acknowledged that there are times, other than when a resident is dying, when visits should be allowed and that residents, families, facilities, and health care providers should work together to identify when a visit is needed.  Examples they’ve given are when a resident is on hospice care and their health is sharply declining, or even when they are not on hospice care but their health status has sharply declined.  It is important for families and friends to advocate for themselves in these situations and to work with their facility to ensure their visit happens safely.  If facilities are denying visits in what you believe is a compassionate care situations, families should reach out to their LTC ombudsman:  https://theconsumervoice.org/get_help

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How can a nursing home obtain funds for purchasing electronic devices to assist with video chats and communication between residents and families?  Can assisted livings or other settings apply for these funds?

How can a nursing home obtain funds for purchasing electronic devices to assist with video chats and communication between residents and families?  Can assisted livings or other settings apply for these funds?

Nursing facilities can request Civil Money Penalty (CMP funds) to purchase electronic devices, such as tablets and webcams to assist communication between residents and families.  Facilities can request up to $3,000 in funds to purchase one device per 7-10 residents as well as accessories such as screen protectors and protective covers.  Facilities need to contact their state agency’s CMP contact to apply and must include:  the name of the facilities, the total number of residents in the facility, the types of devices, the cost per device, the number requested and the total funds requested.  Facilities need to clean and disinfect devices between uses.

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How can I advocate for my family member during this time?

How can I advocate for my family member during this time?

We recognize that it can feel overwhelming when you are concerned about your family member and you are unable to visit.  Stay engaged.  Communicate with your loved one by phone or video chat if possible.  Ask the facility staff to help coordinate the call if your loved one needs help.  Ask if there are other opportunities to engage with your loved one, such as window visits, outside visits in courtyards during nice weather, or other options.  Listen to what they say, observe their appearance and their surroundings. Ask questions about how they spend their day, about meals, and getting help when they need it. Document what you are seeing.  Concerns should be raised with staff.  Ask for a meeting to review the care plan and revise it, as necessary.

Talk regularly with staff and administration.  Ask whether they have enough staff working and what they are doing to keep the residents’ and staff safe.  If the administration is not providing regular updates on facility conditions, ask that they do so either through an email or phone chain, video conference, or other mechanism to keep all families informed.

Despite ombudsmen not entering facilities during the crisis, they are still hard at work and available to respond to concerns, handle complaints, and share information.  If you have any questions or concerns about your family member’s facility or the way they are being treated, contact the ombudsman program in your state:  https://theconsumervoice.org/get_help

We also recommend that you reach out to your state survey agency if you need to file a complaint.  While surveyors are entering facilities only in limited situations, it’s still important that complaints are filed. Additionally, consider reaching out to your local elected officials.  It’s important they know what’s happening on the ground and they should know when there are troubling conditions in facilities in their state. 

Also, take advantage of family councils!  If your facility has a family council, consider joining it.  If your facility does not have one, consider starting one.  Find more information on family councils.

Sign up as a Consumer Voice member and with our Action Network.  Consumer Voice often shares advocacy strategies, opportunities to comment on legislation and regulations, and information and best practices that can be adapted by others.  Learn more about membership.

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Where to Find Additional Information

Are there any ideas for activities that facilities could be engaging residents in individually while group activities are suspended?

Are there any ideas for activities that facilities could be engaging residents in individually while group activities are suspended?

Visit the National Certification Council for Activity Professionals website for activity ideas.

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Where can I find information on how to protect and support my loved one during the COVID-19 pandemic?

Where can I find information on how to protect and support my loved one during the COVID-19 pandemic?

Visit the Consumer Voice webpage for updated information and guidance on how to protect your loved one during this time.

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Where can I find updated information from CMS about COVID-19?

Where can I find updated information from CMS about COVID-19?

Visit the Consumer Voice webpage to find the most recent CMS guidance and summaries of that guidance.  You can also visit the CMS COVID-19 page.

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Where can I find information about supporting my loved one with dementia during COVID-19?

Where can I find information about supporting my loved one with dementia during COVID-19?

Visit the Alzheimer’s Association to find information about dementia care during this time.

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Where can I find information for Ombudsman programs regarding COVID-19?

Where can I find information for Ombudsman programs regarding COVID-19?

The Consumer Voice operates the National Long-Term Care Ombudsman Resource Center (NORC). Visit the “Coronavirus Prevention in Long-Term Care Facilities: Information for Long-Term Care Ombudsman Programs” page on the NORC website.

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As a Guardian for a resident, how can I best advocate for that person?

As a Guardian for a resident, how can I best advocate for that person?

For information about how guardians can best advocate for their resident, see Frequently Asked Questions by Guardians About the COVID-19 Pandemic.

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Where can I go to learn more specific information about what's happening in my state?

Where can I go to learn more specific information about what's happening in my state?

CMS has released a toolkit that lists information about strike teams, reporting of information, and other issues state by state.

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More COVID-19 Info for Residents and Families