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Transfers & Arrangements

COVID-19
Home COVID-19 Transfers & Arrangements

Important Advisories

  • Your local and/or state public health officials may be making recommendations for the care of decedents and/or public gatherings that are more stringent than what the CDC and federal government have recommended. In these cases, you should defer to your state and/or local public health officials.
  • The CDC has advised if you think you have been exposed to COVID-19 and/or develop a fever and symptoms, such as cough or difficulty breathing, call your healthcare provider for medical advice. If you are concerned about a potential exposure, this risk assessment for healthcare personnel (HCP) from the CDC may be useful.

Transfers & Arrangements: Interacting With Families

Updated: November 5, 2020

While many funeral directors feel like they can control their exposure to COVID-19 when caring for the body of someone who died from the virus (during the transfer and embalming and preparation) through the use of PPE and other environmental and engineering controls, what causes concern is potential exposure through contact with healthcare providers in hospitals and other healthcare facilities and with members of the decedent’s family during the transfer and arrangement conference. 

NEW: Letter Verifying Critical Infrastructure Worker Status

On March 19, the Department of Homeland Security (DHS) issued guidance to states naming mortuary workers as “critical infrastructure workers. Many states have adopted the DHS recommendations. One thing this order suggests is that critical infrastructure worker should be exempt from “shelter-in-place” mandates.

Because states are adopting “shelter-in-place” or “safer at home” mandates, NFDA has prepared a Certification of Employment document you can show to authorities verifying your status as a critical infrastructure worker.

This Certification of Employment document should be printed on funeral home letterhead, filled out completely, and signed by an owner or manager of the funeral home.

Transfers

When making a removal at a hospital, nursing home or other healthcare facility: Per CDC guidelines, follow Standard Precautions when making a transfer from any facility. See: Frequently Asked Questions about Personal Protective Equipment (CDC).

When the healthcare facility contacts you about making a removal, ask whether there are any precautions, guidelines or procedures you need to follow when you arrive.

When making a removal in a home: If you know the decedent died of a confirmed or suspected case of COVID-19, any staff entering the home should don a face mask and proper PPE. See: Frequently Asked Questions about Personal Protective Equipment (CDC).

Regardless of the location of the removal, you may wish to let the family know that, for your protection and theirs during this pandemic, that your staff will be wearing appropriate personal protective equipment. This will set their expectations so they are not caught unaware when you arrive. 

For technical guidance on conducting transfers, visit the "Technical Information" page.

CDC Guidance on Death Certificates

  • NVSS COVID-19 Formal Reporting Guidance, includes a link to the Guidance for Certifying Deaths Due to Coronavirus Disease 2019 (COVID–19)
  • Webinar entitled "Guidance for Certifying Deaths Due to Coronavirus Disease 2019 (COVID-19)" hosted by CDC COCA program provides detail on guidance. 
  • Video: Certifying Deaths Due to Coronavirus Disease (COVID-19) - CDC National Center for Health Statistics
  • Other guidance and trainings -- https://www.cdc.gov/nchs/nvss/training-and-instructional-materials.htm, including: 
    • Guidelines for Reporting Occupation and Industry on Death Certificates
    • Funeral Director’s Handbook: Death Registration and Fetal Death Reporting, includes information on reporting age, sex, race and ethnicity, education, and occupation and industry
  • General guidance for filling out cause of death on death certificates, including:
    • Improving Cause of Death Reporting: Online Training Module, https://www.cdc.gov/nchs/training/improving_cause_of_death_reporting/
    • Cause of Death Mobile App, https://www.cdc.gov/nchs/nvss/mobile-app.htm
  • Coronavirus Disease (COVID-19) Death Data, https://www.cdc.gov/nchs/nvss/covid-19.htm) from the National Vital Statistics System (NVSS) at the National Center for Health Statistics (NCHS).
  • From the CDC, Understanding the Numbers: Provisional Death Counts and COVID-19

Arrangement Conferences

Arrangement conferences often put funeral directors in close contact with families. If the decedent is a victim of COVID-19, it may be possible that surviving family members may have been exposed and/or be contagious. Even if COVID-19 is not the cause of death, surviving family may have been exposed and/or be contagious.

Each funeral home must decide the approach with which it is most comfortable:

In-person Arrangements

If you are comfortable with in-person arrangements, consider the following:

  • When you set the appointment, ask, for safety of funeral home staff, whether anyone is feeling ill or is know to have been exposed to COVID-19. Gently request that those who are ill stay home or join in the discussions by teleconference.
  • You may wish to share, in advance of the arrangement conference, information about funeral and memorial service options available to the family and current state and federal guidelines for public gatherings. Some resources include: 
    • Remembering A Life COVID-19 Information Hub - Remembering A Life is NFDA's family outreach and education initiative
    • Grieving Alone & Together booklet, developed by the Funeral Service Foundation & Remembering A Life
    • CDC: Funeral Guidance for Individuals and Families 
    • CDC: Frequently Asked Questions: Funeral and Burial Services for American Indians and Alaska Natives
  • Limit the number of people who come to the funeral home for the arrangement conference. Other family members could join in the discussions by teleconference.
  • Request that, for their safety and that of funeral home staff, that family members wash their hands when they come into your facility (or use hand sanitizer) and again before they leave.
  • Have tissues and hand sanitizer available in the arrangement conference room.
  • When you make the appointment with the family, politely explain that, for their safety and that of funeral home staff, you will not be able to shake their hand as you normally would.
  • Maintain social distance of at least 6 feet at all times; you may wish to let the family know in advance of your firm’s commitment to social distancing.
  • When the family leaves, thoroughly clean the funeral home in accordance with CDC guidance, paying special attention to high-touch surfaces the family may have come in contact with during their visit. 

Virtual Arrangement Conferences

Some firms may, depending on the risk of exposure, choose to meet with some or all families virtually. This can be done via tools such as:

  • Telephone
  • Skype
  • Facetime
  • Google Hangouts
  • What’sApp
  • Zoom

This article offers helpful overviews of various tools.

When making arrangements virtually, it’s important that you give everyone a chance to speak and share their perspective, especially if the family has not gathered in one location; however, be sure you know who the legal next-of-kin is and confirm all decisions with him or her.

If arrangements are made online or over the phone, there is no requirement in the Funeral Rule for presenting or transmitting price lists to the consumer. The requirement to hand out a price list is only triggered by a face-to-face discussion. Of course, funeral homes can email their price lists or post them online so consumers have access to them when planning a funeral over the phone or electronically.

You may also wish to email copies of or links to various product catalogs.

If funeral arrangements are made, a Statement of Funeral Goods and Services Selected does have to be sent to the purchaser. This can be done by text, email, fax, or by mail. The Funeral Rule does not require the Statement to be signed, although most funeral homes require this so they have a written contract with the family.

All states recognize the validity of electronic signatures by consumers as long as it clear on the document they sign that they are binding themselves to a contractual obligation by applying their electronic signature. A tool like DocuSign (https://www.docusign.com) can be helpful in obtaining the needed signatures.


Please take time to review the Visitations and Funerals page in our COVID-19 information hub for information of public gatherings and suggestions about how you can accommodate the needs and wishes of families during the pandemic. 

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