The Middletown Press (Middletown, CT)
Elderly care restriction excludes assisted living
The state is focusing its fight against the coronavirus on places that care for and house the elderly, but not every facility falls under strict new rules announced this week.
While nursing home patients with COVID-19 are being separated from those who test negative for the virus, residents at the state’s hundreds of assisted-living facilities are exempt from that disruptive, yet potentially lifesaving process.
That includes Benchmark Senior Living at Ridgefield Crossings, an assisted-living facility that has lost nine residents in coronavirus-related deaths.
The difference centers around licensing, state control and the landlordtenant relationship at assisted-living facilities.
The hospital-like admission process at a nursing home, where patients require physician certification to be admitted, comes with stricter state regulatory oversight and control, said Mairead Painter, the state’s long-term care ombudsman.
An assisted-living facility, on the other hand, is essentially a private apartment building that provides inhouse care and other services residents may need, Painter said.
Those services are provided by a statelicensed entity, while the apartment side of the facility is not licensed by the state, she noted.
“It’s a different agreement,” Painter said of assisted-care facilities.
Av Harris, a Department of Public Health spokesman, confirmed the order released Monday to create “positive” and “negative” nursing homes is only directed at nursing homes.
“Currently, the relocation is for nursing home residents but can be subject to change based on the situation,” said Harris.
Asked how many of the state’s nursing home patients are infected with COVID-19, Painter said “there are many.”
Different roles
After announcing the nursing home restrictions earlier this week, Gov. Ned Lamont said the facilities “can be a petri dish in terms of transmission of the virus.”
Nursing homes provide similar services as
hospitals. These facilities are capable of providing non-surgical ambulatory services and patients receive varying levels of skilled medical care, depending on their needs.
An assisted-living center only offers basic nursing services while focusing on helping residents live as independently as possible. Residents sign leases with the building owner, as would any apartment dweller. Only the services provided to the residents are licensed by the state, not the facility itself.
“At assisted living, you buy into the service that you may need,” Painter said. “Assisted living services are licensed under the Department of (Public) Health. The apartment is a separate contract — DPH doesn’t license that.”
While a nursing home is inspected yearly, an assisted-living facility is inspected by the state every two years.
Nursing homes must have a registered nurse at the facility 24 hours a day. An assisted-living facility has a registered nurse on call round-the-clock, Harris said.
Benchmark Senior Living at Ridgefield Crossings is divided into two sections, one with assisted-living units and the other housing a memory care unit for people suffering from Alzheimer’s disease and other forms of dementia. It is in the Alzheimer’s unit where COVID-19 has taken nine lives.
Alyssa Scott, a spokeswoman for Benchmark, said the facility has moved many patients who tested negative for coronavirus to a local hotel.
“We have and will continue to cooperate fully with the guidance of state health care authorities,” Scott said.
“We are exceeding state and federal guidelines, including guidance from the U.S. Centers for Disease Control and Prevention,” Scott added. “We continue to consult with medical experts and the DPH on additional ways to protect the health and safety of our residents and our associates.”
Scott said Benchmark has reduced the exposure memory care residents have with each other and staff.
Other states have also seen deadly outbreaks at similar facilities. An assisted-living facility in Missouri, called Morningside of Springfield East, has lost five of its residents in the pandemic.
Connecticut’s nursing homes are seeing virus related deaths; as of Wednesday three people have died in a nursing home in Stafford Springs.
According to the CDC, as of earlier this week more than 400 long-term care facilities across the country, including nursing homes, had reported cases of residents testing positive for coronavirus.
Similar challenges
Assisted-living facilities are becoming increasingly popular. “They are popping up all over the place,” Painter said.
With that popularity comes challenges and concerns over close living conditions in the face of a pandemic, she said.
“I’m very concerned because it is challenging, just like congregate living,” Painter said. “Anytime you have residents living in close proximity… that is concerning. Agencies are doing their best to be as careful as possible.”
Services typically offered at an assisted-living facility include assistance with daily activities, including bathing, moving around, dressing, eating, meal prep, transfers, bowel and bladder care and self-administration of medication, Harris said.
“Residents who need additional or specialized care may access in-home services,” he added, referring to outside nurses or therapists who visit cllients to provide care.
By contrast, a nursing home, or chronic and convalescent home, provides highly skilled care under direct medical supervision. Nursing home staff provide nonsurgical treatment and dietary procedures for chronic diseases, convalescent stages and acute diseases or injuries, Harris said.
Painter said the state is encouraging assisted-living residents to go out only when necessary.
At Ridgefield Crossings, Benchmark has placed all residents in quarantine and is not accepting visitors. But it’s generally up to management companies of assisted-living facilities to decide, since residents are tenants, not admitted patients.
“Some are not on meal plans so they go out and shop and go to CVS to get medicine,” Painter said. “We are telling people that if you can get someone to do that, or put in orders through one group and get it delivered.”
Painter said some facilities are restricting visitors but noted the state didn’t issue an order to do so. Nursing homes were ordered to restrict visitations.
Benchmark manages 17 other sites in communities across the state, including Middletown, Hamden, Fairfield, Milford, Brookfield and Stamford. It also has a mix of assisted-living and independent-living facilities in nearby states, including Massachusetts and New York.
Independent-living facilities provide residential housing for people over 55 years old.
“The tenants are in private homes,” Harris said.
Nora Duncan, director of the Connecticut Chapter of the American Association of Retired Persons, said the agency is very concerned about both nursing home patients and assisted living residents, who are often at higher risk of becoming seriously ill and now find themselves with limited contact with others.
“This is going to exacerbate feelings of social isolation and loneliness, which were already a big problem with this population, and which can have serious negative consequences for people’s mental and physical well-being,” she added.