Pennsylvania should open up nursing homes to visitors
Nursing home residents have suffered terribly during the coronavirus pandemic, isolated from visitors because they are particularly susceptible to getting seriously ill or dying.
But now many of them have been vaccinated. It’s time to allow them to see their friends and relatives, to go out to lunch, to enjoy their lives.
Infuriatingly, state and federal officials have not budged from rules that were set five months ago and in many cases should no longer be relevant.
“This is absurd,” Debbie Wellington of Franconia Township told me. “Why is the vaccine being pushed for these most vulnerable if the situation doesn’t change a thing for them?”
She used go several times a week to see a friend who lives in a personal care home. She would take her shopping. Since the pandemic hit, she’s been able to see her only a few times, under a compassionate care exception.
“Her memory, which was starting to decline, took a nosedive, solely in my opinion due to the isolation,” Wellington said.
She believes the home where her friend lives is doing the best it can. She’s looking for state and federal officials to give facilities the green light to allow normal visitations, under appropriate rules.
Neither has done a thing.
The state Department of Health told me it is waiting for guidance from federal agencies. It currently is following recommendations from the Centers for Medicare & Medicaid Services.
But that agency doesn’t intend to issue more blanket national guidance regarding visitation, according to Zach Shamberg. He’s president and CEO of the Pennsylvania Health Care Association, which represents about 400 nursing homes, personal care homes and assisted living centers.
So its previous guidance — from September, before any vaccinations — still is the rule of the land in Pennsylvania.
And while it allows visitations under some circumstances, Shamberg said the reality is few long-term care facilities meet the criteria for indoor visits. They must not have a new COVID-19 case for two weeks and must be in a county with a test positivity rate of less than 10%.
Visits should be limited to outdoors if those criteria aren’t met, he said. That’s not an option during winter in Pennsylvania.
“Our point of contention is now we are post-vaccine in many cases throughout the state,” Shamberg said. “There needs to be an update to that guidance.
And the state can do that.”
Other states are allowing visits to resume.
On Friday, Rhode Island allowed nursing homes to set their own rules for visits, though visits must cease for two weeks if a resident or employee tests positive for COVID-19.
Homes in North Dakota are operating similarly. The Grand Forks Herald reported this month that 74% of the state’s skilled nursing facilities were permitting some sort of indoor visitation.
Shamberg said he’s raised the issue with state legislators in recent hearings.
“The number one question that we’re receiving from our members is when can they safely reopen their doors because that is the number one phone call, email, question that they’re getting every day from the family members of their residents,” Shamberg said. “When can I see my grandmother, grandfather, father, mother?”
He believes a system similar to what was used early in the pandemic is an option. Nursing homes were sectioned into red, yellow and green zones, based on who had tested positive; who had tested negative but had been exposed within the previous 14 days; and who had tested negative and not been exposed.
Zones could be established for residents who have been vaccinated, who have gotten one shot and are waiting on the second, and who haven’t gotten any.
“Why shouldn’t those who have been vaccinated, as long as a family member is producing a negative test when they arrive or even a proof of vaccination, why shouldn’t we be able to facilitate visitation with that resident and their family member?” Shamberg said.
Wellington told me she’d be willing to be tested weekly if that’s what would be necessary to see her friend, who has been vaccinated.
“I am infuriated,” she said. “What they are doing to our seniors is despicable.”
Recent national research from the American Health Care Association and National Center for Assisted Living indicates vaccines are protecting nursing home residents.
It compared infection rates in homes that had their first vaccination clinic against the rate of homes in the same county that hadn’t held a clinic.
The homes with clinics had a 48% decline in new cases three weeks later, compared to a 21% decline in the other homes. Staff cases also were lower.
“If verified with additional data, this could expedite the reopening of longterm care facilities to visitors, which is vital to residents’ health and well-being,” Dr. David Gifford, chief medical officer for AHCA/NCAL, said in a statement.
Many of Pennsylvania’s nursing homes and personal care homes are participating in a federal program to have vaccinations done by CVS and Walgreens pharmacies.
CVS completed its work at all 548 participating nursing homes, where it gave 201,797 doses. It has nearly completed the first doses at 1,834 assisted living and other long-term care facilities and is working on the second doses, according to data on its website.
Walgreens administered 38,085 doses to nursing home residents and 17,734 doses to residents of assisted living and other facilities as of last Thursday. Its clinics are continuing.
The Pennsylvania Health Care Association has been hearing anecdotally from members that 75% of residents have been signing up for the vaccine.
So there’s a large number who should be able to safely have visitors, with appropriate safeguards.
Pennsylvania needs to allow that to happen.