On July 10, the New York State Department of Health (NYSDOH) changed the guidance for allowing nursing home visitation. The changes allow indoor visitation if personal protective equipment (PPE) is worn and social distancing is observed, provided the facility has been free of COVID-19 for 28 days. However, family members of residents in most New York long-term care facilities feel that this guidance is too restrictive.
An example of the frustration families and loved ones are feeling came from a woman who has not been able to visit her 96-year-old godmother since March. She expressed her frustration saying, “Maybe I’ll get a call that she has passed, and it’s very upsetting. They put out these guidelines, and it’s just forget it if it’s unattainable and you can’t meet the challenge of 28 days.”
The woman contacted her assemblyman who is both a NY state representative and a pharmacist. He expressed that he believes the guidance is too restrictive and suggested that the NYSDOH consider changes that will allow families to visit, while still keeping people safe. He said, “I think family members following the proper protocols should be able to visit their loved ones. It’s time.” The assemblyman also indicated that his current aim is raising awareness with the NYSDOH regarding the negative effects that keeping families from visiting has on residents, even to the point of shortening their lives. He also stated his belief that guidance should be changed to allow visitation if the resident has been free of COVID-19 for 28 days.
A spokesman from the NYSDOH sent this statement in response to being contacted:
“As we said from the beginning, science and safety would guide our decision to resume visitations to nursing homes, and it has. The number of facilities that are eligible to reopen to visitors, and the number that have taken the next step, shows they are appropriately adhering to CMS guidelines with smart and cautious plans for visitation. Given the increase in cases nationally, we commend them for all they – and all New Yorkers – have done to flatten the curve and to stay safe.”
The NYSDOH spokesman provided this data regarding nursing homes and visitation:
- 190 of the state’s 613 nursing homes are eligible for visitation
- 71 of those have submitted their plans and can start visitation
- 423 nursing homes are still not eligible for visitation under the new guidelines.
Compliance Perspective
Failure by nursing home staff to follow state and federal COVID-19 guidelines that would lead to allowing families to resume visitation under their state’s department of health’s specific requirements could result in reintroducing the Coronavirus back into the facility, placing residents in immediate jeopardy. The negative effect that isolation has on residents who have not been able to visit with their loved ones for long periods of time may pose serious risk for premature death. Both instances, to some extent, violate the rights of residents to receive or deny visitors and to be free from involuntary seclusion, which could be considered provision of substandard quality of care in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures regarding the state’s guidelines for visitation, and develop a plan of implementation that addresses concerns about the negative effects on the health and well-being of residents that are caused by isolation.
- Train staff on ways to interact with residents to counteract the negative effects on their health and well-being brought about by isolation.
- Periodically audit to determine how the facility is addressing the adverse effects of isolation on the health and well-being of residents. Address in resident care plans opportunities to meet the socialization needs of residents while maintaining social distancing requirements.
