In a scramble to avoid responsibility and accountability, nursing homes are refusing to allow nursing home residents to return to their nursing homes and rehabilitation centers after leaving for hospital visits, routine medical appointments or funerals. Residents are being shut out of long-term-care facilities in California, Florida, Colorado and South Carolina, demonstrating the lengths facilities are going to inoculate themselves from liability.
Nursing home staff say the residents need to provide a negative test before returning out of fear they could import the disease. The nursing homes refuse to conduct the test themselves. Testing shortages at hospitals and limited availability at nursing homes have only exacerbated the challenges.
Anticipating a surge in patients, hospitals are discharging those who do not need extensive care. At the same time, nursing homes are closing their doors to try to prevent the kind of outbreaks that have invaded facilities throughout the nation. Administrators at elder care institutions are navigating conflicting guidance from local, state and federal authorities.
If a nursing home cannot comply with those CDC rules, which include creating isolation wings and using personal protective equipment, CMS guidance says a facility “must wait” until a returning resident has been without fever and respiratory symptoms and taken two negative tests 24 hours apart. If tests are not available, the CDC says a resident can go home after three days without a fever and improved respiratory symptoms and at least seven days after the person first got sick. Further confusing the process, the CDC guidelines also say residents do not need to meet that criteria before being discharged from the hospital.