Recent rulings from the Centers for Medicare & Medicaid Services (CMS) protect the rights of nursing home residents by continuing to require nursing homes to give ombudsmen access to residents during COVID-19. How that access is provided, however, depends on a variety of factors.
Nursing home ombudsmen act as liaisons between residents, residents’ families, and nursing home management to ensure that residents’ rights are protected. Legally, nursing homes are required to give ombudsmen access. Because of the public health emergency that COVID-19 has presented, CMS acknowledged that in-person access to residents may be limited. In cases where infection control and transmission of COVID-19 concerns are present, in-person meetings may be inadvisable; however, facilities must still facilitate communication between the residents and ombudsmen.
How that access will be provided is a hot topic among facilities as they try to decide whether those meetings should be held in person, virtually, or on the phone, and if in person, what precautions can be taken to protect both parties. HIPAA does not allow facilities to require an ombudsman to share their COVID-19 testing results; however, the facilities are allowed to ask ombudsmen routine screening questions, including their symptoms, and use this information to develop a plan for resident access.
Carol Marshall, OmniSure consultant, encourages her clients to conduct preemptive meetings with their ombudsmen to assess risk and then plan whether to allow virtual or in-person visits. Some of her clients have used in-person methods such as outdoor visiting or plexiglass walls in a room to protect residents from possible exposure.
As a reminder to all Medicare and Medicaid certified nursing homes, they are required under law to allow residents access to ombudsmen, whether it be through direct contact or virtually. Nursing homes are also required to allow an ombudsman to examine a resident’s medical, social, and administrative records, a policy that continues to stand during this public health emergency.
For information on how to decide whether to allow in-person access, see this memorandum from CMS. In general, CMS advises the following to be considered when making a plan:
- Case status in the surrounding community
- Case status in the nursing home(s)
- Staffing levels
- Access to adequate testing for residents and staff
- Personal protective equipment supplies
- Local hospital bed capacity
If you’re looking for guidance on how to handle ombudsmen access to residents, OmniSure is here to help. Navigating risk during this public health emergency isn’t easy, and we’re ready to guide you.