Push grows for family nursing home visits

Citing isolation of nursing home residents, the federal government laid out new guidelines for how nursing homes could start letting loved ones in, and a state leader said her department is working on indoor visitation plans.

Vulnerable residents who live in assisted living or nursing home communities are at a high risk while coronavirus spread remains high in the community. At the same time, visitor restrictions meant to protect residents from the coronavirus have led to a different challenge of social isolation.

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Ohio Department of Aging Directory Ursel McElroy told Gov. Mike DeWine late last week at his press conference that she is looking forward to being able to “announce very soon what we have in store for indoor visitation.”

In Ohio, only outdoor visits are allowed for now at nursing homes and assisted living facilities and those visits are short visits, sometimes hampered by poor weather. Some facilities have chosen not to resume visits or started and then stopped out of concern about widespread cases in surrounding towns where the residents' visitors are coming from.

McElroy also said the state wants there to be transparency with visitation policies and is working on some kind of public dashboard where the public can see what kind of vitiation exists in their community.

No specific plans for indoor visitation have been shared yet in Ohio. But within the past week, a federal commission that was tasked with reviewing nursing home safety and quality during the pandemic shared its findings which include that visitation is “a vital resident right.”

Some of the findings of the independent commission, Coronavirus Commission on Safety and Quality in Nursing Homes, includes recommending the federal government:

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- Provide updated guidance on in-person visitation that immediately enables nursing home leaders to adjust protocols and safely increase in-person visitation based on emerging and established evidence.

- Outline how to adapt visitation policies based on local prevalence of COVID-19 cases.

- Require nursing home owners and administrators to encourage residents to designate an “Essential Care Partner” who can visit in-person when other visitors may not be allowed. Some other states such as Minnesota have taken an “essential caregiver” approach, recognizing that some family members are more than just visitors and provide essential care that a nursing home resident needs.

After the commission’s report came out, U.S. Centers for Medicare & Medicaid Services, which regulates nursing homes, laid out guidance for how to do both indoor and outdoor visitation.

“While we must remain steadfast in our fight to shield nursing home residents from this virus, it is becoming clear that prolonged isolation and separation from family is also taking a deadly toll on our aging loved ones,” said CMS Administrator Seema Verma.

The federal guidance recommends indoor visits be restricted to facilities with no new onset of COVID-19 cases in 14 days and safety measures like limiting the number of visitors at a time and having visitors go directly to their loved one’s room or a designated visiting area.

It is difficult to protect vulnerable residents when there is high levels of coronavirus spreading in the surrounding community and the guidelines say if over 10% of local coronavirus tests are coming back positive, indoor visits should only occur in compassionate care or end-of-life type of situations.

Older adults in Ohio can now return as of Monday to senior centers and adult day cares that can meet state requirements.

McElroy said for adult day care, this includes testing for staff and participants every other week. Senior centers will have regular testing for staff and participants will only need testing if they start having symptoms.

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