Tuesday, December 22, 2020

More on SNFs and COVID

It's going to be some time before we see good news stories about residents of SNFs---although the vaccination of SNF residents is good news.  So here are several recent articles regarding SNFS and COVID-but be forewarned, these first two are not easy to read.

51 lost lives: A portrait of the pandemic’s tragic toll in America’s nursing homes

South Dakota’s COVID-19 Surge Is Turning Nursing Homes Into A ‘Battle Zone’

There are just no words....

Then: 

An investment firm snapped up nursing homes during the pandemic. Employees say care suffered.

(Thanks to Morris Klein and Professor Bauer for sending me the link to this article).

and finally

With Vaccine Delivery Imminent, Nursing Homes Must Make a Strong Pitch to Residents.

This last article brings up some interesting issues for class discussion-such as consent, refusal of consent, and inability to consent.

Please everyone-stay safe and remember to thank our first responders, health care professionals and essential workers. And let us never forget those we have lost to this pandemic.

https://lawprofessors.typepad.com/elder_law/2020/12/more-on-snfs-and-covid.html

Advance Directives/End-of-Life, Cognitive Impairment, Consumer Information, Current Affairs, Dementia/Alzheimer’s, Federal Statutes/Regulations, Health Care/Long Term Care | Permalink

Comments

Professor: Below is a redacted copy of the letter I and my siblings sent:

Dear [facility administrator and hospice provider]:

I am receipt of the informational letter from [facility] regarding the future availability of one of the two Covid-19 vaccines. This does, of course, trigger a number of questions. As [hospice provider] is [resident’s] healthcare provider, much of this is incumbent on their medical direction; thus copied.

It is our experience that [resident] has always had contrary reactions to typical side-effects to pharmaceuticals and vaccinations. Her medical history indicates that she has not traditionally taken the annual flu vaccine due to adverse effects outweighing benefits. She is rife with food and inhalant allergies including childhood asthma. Anaphylaxis for those with rampant allergies has been reported as recently at December 20, 2020. In fact, it appears that there have been individualized recommendations of deferring vaccination. The CDC Fact Sheet omits addressing other side-effects. So, it is with some real consternation that we weigh her vaccination. So:

1. What are the [facility] consequences for the residents should vaccination not be permitted?
2. Presuming vaccination, will there be vaccine availability such that there will be a choice as to whether the Moderna or Pfizer vaccines are used?
3. Will there be an individualized “risk assessment” performed prior to vaccination?
4. As [resident] tested positive twice for Covid-19, then negative, will there be an antibody test done prior to a potential vaccination?
5. What will be the observation periods on vaccinated residents and who will be present to assess any reactions?
6. What will be the protocols and response plan in the case of anaphylaxis?
7. What will be the protocols and response in the event of CDC disclosed side-effects?
8. Presuming vaccination, will conventional access be granted for regular and ordinary visits with their family who are residents of [the facility]?
9. Will The Village at Bellevue be requiring the family of their residents to prove vaccination before granting access to the residents?
10. Will the residents be able to make daily home visits to their families?
11. Will the residents be entitled to make “day trips” to restaurants, shopping malls, etc.?

I look forward to a timely response to the above questions so that we can consider the answers before being faced with the decision regarding vaccination.

Posted by: Tom N. | Dec 23, 2020 6:20:34 AM

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