Nursing home visit limitations relaxed
For the first time since March, families can now visit their loved ones indoors at nursing homes as the state relaxed its restrictions on Monday.
The state Department of Public Health’s new order, rescinding the restrictions on indoor visits, came following a directive from the Centers for Medicaid and Medicare Services, the federal Health and Human Services agency that oversees nursing homes.
Gov. Ned Lamont ordered restrictions on nursing home visitation in March, amid a surge of deaths and COVID-19 infections tied to a nursing home in Kirkland, Wash.
Since the pandemic began, nursing homes have set up virtual visits between residents and their families through video chat services, and began allowing outdoor visits in the late spring. Others set up window visits, where family members would come up to a ground-floor window to see a resident.
But visitors have otherwise been pro
hibited from coming indoors except under special circumstances — typically end-of-life care.
The news of indoor visits was celebrated at the Nathaniel Witherell, the Greenwich-owned and -operated skilled nursing and short-term rehabilitation center. “We’re very pleased and happy this is happening,” Executive Director John Mastrondardi said. Demand is high for this opportunity, he said.
“Certainly this is very good for our residents and their families as well as very good for our staff because we want to make sure that our residents are experiencing the kind of visit with their loves ones that they want,” Mastronardi said. “This is going to be great for everyone’s morale.”
Witherell’s Board of Directors Chair Larry Simon said visits have been a “big issue” since the pandemic began.
“This is something that is very important to our residents,” Simon said. “When you can see your family and your loved ones it can do a lot of good for your mental health.”
It will take a week or two before the Witherell can welcome visitors, Mastronardi said. Residents will likely be limited two guests at a time, with the meetings taking place inside the facility’s auditorium, he said.
The Witherell will likely set up eight tables, which will not all be used at the same time, he said. The visits will be staggered throughout the day and done by appointment. Simon said all guests will be screened.
In addition, more employees will be needed to transport residents from their rooms to the auditorium, a task that can be done only by workers, not volunteers, during the pandemic, Simon said.
“I am hoping that we will be able to have all our residents get at least one visit a week,” Simon said.
Mastronardi said the facility was looking into whether to install Plexiglass in parts of the auditorium but wanted to consult with the state Department of Public Health.
The Witherell has been expecting the state’s announcement and said they had already been preparing.
After visitors were banned in March, the Witherell began doing virtual visits between residents and friends and family by using iPads and apps such as Zoom. In the spring, prearranged visits were held outdoors between residents and limited guests in the Witherell’s rose garden.
“As the weather gets cooler, using the rose garden is not going to be viable for much longer,” Mas
tronardi said. “They have been able to get some fresh air and sunshine in the garden and we’re going to keep doing this as long as weather permits.”
Paul Liistro, managing partner of Manchester Manor Health Care Center in Manchester and Vernon Manor Health Care Center in Vernon, said the lack of visits took an intense emotional toll on residents and families.
“Not seeing your family in a (nursing facility) is not like not seeing your child who goes off to college. There is a high probability of seeing (your) kid in the future,” he said.
Patricia E. King, vice president of Healthcare Services and Continuum Integration at Masonicare, praised the decision to allow indoor visits again.
“We are working now to ensure it will be done safely and with the well-being of residents, their families and our staff foremost in mind,” King said in a statement. “We will be communicating with family members immediately on new safety procedures that will be in place when we welcome them back to visit their loved ones in person.”
The order comes with some restrictions.
Nursing homes must have had no new cases of COVID-19 in the last 14 days. Indoor visits will be suspended if a new case appears among staff or residents.
Homes also must abide by infection control procedures — including cleaning and disinfecting surfaces, quarantining residents who are sick from those who are healthy, and restricting visitors to the resident’s room or visiting area once they go inside.
The visitation rules also allow other caregivers to go inside. The restrictions established in early spring had locked out social workers, volunteers and hairdressers, among others.
Liistro said the announcement was expected, but scheduling, screening and cleaning visiting areas will all be challenges.
“It is one more variable of risk. Essentially, fewer people we see allow us to control the environment. At the end of the day, we are living with the virus, not controlling it,” he said.
The directive from the federal agency overseeing nursing homes claims the decision was made based on concern over the mental and emotional health of nursing home residents.
“While CMS guidance has focused on protecting nursing home residents from COVID-19, we recognize that physical separation from family and other loved ones has taken a physical and emotional toll on residents,” the directive said. “Residents may feel socially isolated, leading to increased risk for depression, anxiety and other expressions of distress.”
Two trade organizations representing nursing homes said the move is especially important as temperatures drop, making outdoor visits no longer feasible.
“Moving to add the indoor visitation option, with the care and caution that is reflective in the new rules, is very well timed,” Matthew Barrett and Mag Morelli said in a joint statement.
Barrett heads the Connecticut Association of Healthcare Facilities, an organization that represents for-profit nursing homes. Morelli heads LeadingAge Connecticut, an organization for nonprofit homes.
The challenge will now be ensuring homes have adequate supplies — including protective equipment — to continue indoor
visits safely, said state Rep. Vincent Candelora, RNorth Branford.
He also expressed concerns about the long-term welfare of residents who have been isolated with limited visits from family.
“The isolation for nursing homes was to prevent the spread of the virus. In reality, isolation does kill our elderly population,” Candelora said.
In a statement, the governor defended his decision to lock down nursing homes in the first place.
“Making the decision to limit in-person visits at nursing homes is one of the hardest things I’ve had to do as governor, but amid the outbreak of this pandemic that is impacting the lives of so many people in our senior population, I knew it was the right thing to do,” Lamont said.