Jarred by reports of the rapid spread of COVID-19 among fragile nursing home residents, the Trump administration on Thursday issued a new set of “critical recommendations” to operators and their governing entities.

The administration made clear that it wants every single person within a nursing home to have his or her temperature checked, and be screened for other possible signs of the novel coronavirus. Trump also said that COVID patients should have their own buildings or units, and dedicated staffing teams.

Another recommendation calls for all nursing home personnel to don a face mask “for the duration of the state of emergency in their State.”

“Nursing homes have become an accelerator for the virus,” the Centers for Medicare & Medicaid Services noted in a statement detailing the new guiding statements. “Hundreds of facilities across the country are experiencing increased numbers of cases among residents.”

Some of the recommendations have already been in place at many nursing homes in many states. But Thursday’s announcement adds the official imprint and weight of federal authorities, and reiterates some earlier federal actions.

SNF hand washing still lagging

An initial wave of surveys this week found that more than one-third (36%) of facilities still did not follow proper hand washing guidelines and one-fourth did not use personal protective equipment properly, CMS noted. This, despite the agency recently announcing it had suspended all regular survey activity to concentrate more on infection control-focused investigations.

“Both of these are longstanding infection control measures that all nursing homes are expected to follow per Federal regulation,” CMS officials said in a statement.

As a result, the agency’s first recommendation Thursday simply stated, “Nursing homes should immediately ensure that they are complying with all CMS and CDC guidance related to infection control.”

The second recommendation is a boost to operators’ efforts to gain respect in obtaining more safety materials. It notes that because nursing homes “are a critical part of the healthcare system,” state and local leaders should keep them in mind whenever distributing PPE supplies and COVID-19 tests.

Any person in a nursing home, whether they’re staff, residents or visitors, must submit to a temperature check before being allowed in, the recommendations specify. And top management should supply appropriate PPE  to be used any time staff members interact with residents.

In addition, the administration formally called on facility managers to pursue consistent assignment of separate staffing teams (for infected and non-infected residents) “to the best of their ability.” As with recommendations regarding PPE, officials hedged on the firmness of their advice, tacit acknowledgement that providers should do their best in light of PPE and worker shortages in many places.