U.S. nursing homes are under lockdown until further notice — which means no more visits from family and friends for isolated elderly residents. In fact, all outside visitors and nonessential staff are barred from nursing homes as the facilities implement guidance issued on March 13 by the Centers for Medicare and Medicaid Services.

The intention of the guidance is to protect America’s most vulnerable from the coronavirus pandemic which began with a highly publicized outbreak at the Life Care Center nursing home in Kirkland, Washington. Out of 120 Kirkland Life Care residents, 80 contracted COVID-19 and more than 37 people linked to the facility have died, The New York Times reported.

Coronavirus outbreaks have since been reported at nursing homes in multiple states, according to The Wall Street Journal.

“As we learn more about the coronavirus from experts on the ground, we’ve learned that seniors with multiple conditions are at highest risk for infection and complications, so CMS is using every tool at our disposal to keep nursing homes free from infection,” CMS Administrator Seema Verma said in a news release.

One potential flaw with these nursing home lockdowns, however, as pointed out by Law360, may be “the underpaid and overworked staffers.” Low-wage CNAs (certified nursing assistants) are the primary providers of direct care to nursing home residents. They’re often employed part-time and at more than one facility.

An analysis of the Kirkland nursing home coronavirus outbreak conducted by the U.S. Centers for Disease Control and Prevention found that staff members who worked at multiple facilities contributed to the spread of coronavirus within the Life Care nursing home and potentially to other nursing homes. According to the same report, at least 34 staff members tested positive for COVID-19, and many treated patients while exhibiting symptoms.

"Working at multiple facilities increases the spread, but at the same time there are only so many certified nursing assistants out there, and hiring new people puts some patients at risk,” Attorney Tara Devine, partner with Salvi, Schostok & Pritchard in Illinois, told Law360. 

With the ongoing critical shortage of coronavirus testing, there’s no way to ensure that newly-hired CNAs are not themselves infected.

"Our experience has been that the root cause of the many problems of nursing homes is that you have too few workers with too little time,” Kenneth Connor, founding partner with Connor & Connor in South Carolina, told Law360.

With nursing home understaffing unlikely to be resolved anytime soon, and with elderly residents highly vulnerable to the coronavirus, nursing homes will have to walk the line between having sufficient staff to maintain their facilities and unnecessarily exposing their residents to the coronavirus pandemic.