Woman holding stop sign in a hallway

Assisted living communities should limit access to only those individuals who are critical to the operational or care needs of their buildings in order to prevent “dire consequences” that could result from a coronavirus disease 2019 (COVID-19) outbreak, the American Health Care Association and National Center for Assisted Living recommend in new guidance. The associations issued similar guidance for skilled nursing facilities.

A press conference about the actions came on the same day that Argentum and the country’s largest senior living company, Brookdale Senior Living, canceled planned events due to virus-related concerns.

AHCA / NCAL President and CEO Mark Parkinson noted in the Tuesday press event that his groups’ recommendations were “unprecedented action.”

“As every day unfolds, it becomes clear that the skilled nursing sector and the assisted living sector face one of the most significant challenges, if not the most significant challenge, in our histories,” he said, “and that is because the evidence has become overwhelming that the mortality rate to COVID-19 for people that live in our buildings is shocking.”

Recent data from China, where the first cases of the virus were seen in 2019, indicate that 14.8% of those aged 80 or more years who have the illness die from it, compared with 8% for those in their 70s, 3.6% for those in their 60s, 1.3% for those in their 50s and less than 1% for those who are younger. Parkinson called it an “alarming reality” that the death rate for those over 80 in the U.S. could end up even higher.

Even though the death rate for younger people is low, “because this virus is so unusual, young people can have the COVID-19 virus and not know it or have very limited symptoms and then spread it to an older person, which can have dire consequences,” he said. “We’re asking for cooperation among the public to help us limit this healthcare risk by limiting visits to just people that absolutely have to be in our buildings.”

Deborah Meade, AHCA Board of Governors chair and CEO of Warner Robins, GA-based Health Management, which has independent living, assisted living and skilled nursing residents, said the company’s communities have limited “nonessential” visitors to immediate family members and “responsible parties,” and all outside activities have been canceled. The decisions are being communicated to family members via phone and mail, and residents and staff members are being educated about the reasons for the actions and ways to minimize risk, she said.

“We are getting overwhelmingly positive remarks from families thanking us for taking the initiative to keep their family members safe,” Meade said. She also is an ex-officio member of the NCAL Board of Directors.

If possible, all people entering assisted living buildings should be asked whether they have any symptoms of COVID-19, whether they have worked in a place where someone tested positive for COVID-19 or whether they recently have traveled to an affected area, AHCA / NCAL Chief Medical Officer David Gifford, M.D., MPH, said.

In addition to limiting access to buildings and restricting activities, AHCA / NCAL also recommends that assisted living communities require all staff members to wash their hands or use a hand-sanitizing station upon building entry and to encourage all essential visitors to do so as well. And the groups additionally recommend that assisted living communities set up a process to allow remote communication for residents and others.

Meade said her company’s communities have cordless cell phones available for residents to use to speak with their families and that employees are offering their smartphones to residents so they can video-chat with their loved ones.

Gifford said AHCA / NCAL also is working with vendors, state health departments and the Department of Health and Human Services to help ensure that caregivers have adequate supplies; stressing with officials that long-term care workers and residents should be a priority for testing, especially to prevent the unnecessary sidelining of needed workers who display symptoms but may not to have the virus; and asking governors to review their state licensing laws to ensure that nurses, physicians, respiratory therapists and other healthcare professionals can practice across state lines if needed. Law in Washington state, the hardest-hit in the country with 267 coronavirus cases and 24 deaths, according to media reports, currently does not contain such a provision, he said. The deaths include nursing home and senior living community residents.

Argentum fly-in, Brookdale investor day canceled

Both Argentum and Brookdale announced Tuesday night that they were canceling upcoming events due to issues related to the coronavirus.

Argentum’s Public Policy Institute & Fly-In was scheduled for Monday and Tuesday in Washington, D.C.

“We believe canceling this event is in the best interest of our attendees and will allow policymakers to continue to focus on COVID-19 efforts,” the association said in a statement. “Now more than ever, advocacy for the industry remains critically important, and we will continue to advocate for the industry during this challenging time.”

Argentum said that an extended recess is being discussed on the Hill and that many offices of members of Congress are canceling and restricting meetings among elected officials and staff members. “They are also working to implement telework options for the foreseeable future,” the association said.

Brookdale’s investor day, scheduled for March 31 in New York City, was postponed “in light of general recommendations from public health authorities to restrict travel and large group gatherings in the current environment.”

“Our highest priority is the health and safety of our residents, patients and associates. We believe that delaying this event is the right thing to do at this time,” Brookdale President and CEO Lucinda “Cindy” Baier said. The company will announce a new date “as soon as practicable.”