Hamburg’s Anne Kuczkowski has seen all the starts and stops of nursing home visits in New York State over the past 21 months.
There was the initial visitation ban at the start of the COVID-19 pandemic in March 2020, the smooth reopening with outside visits in July 2020, as well as the old rule that nursing homes must interrupt visits for two weeks if they have done so. only one positive case.
âIt was a back and forth, and we never knew from day to day how it was going to turn out,â said Kuczkowski, whose 92-year-old mother, Mary Jane Meinzer, is a resident of the Schofield Residence, a 120 bed retirement home in Kenmore.
More recently, limited visiting hours and the requirement to call ahead have become the norm.
“And then all of a sudden I call to make an appointment and [the nursing home says], ‘Oh, well, you can come anytime you want. Now you don’t need to make an appointment anymore, âKuczkowski said.
Indeed, last month, the United States Centers for Medicare and Medicaid Services, which regulates nursing homes federally, revised their advice require nursing homes to allow visits at all times. The guidelines were released on November 12 and subsequently adopted by the New York State Department of Health four days later.
The guide prohibits limiting the duration of visits, the frequency of visits and the number of visitors. It also prohibits requiring programming in advance.
âThere are no more scenarios related to COVID-19 where visits should be limited,â the guide said.
Kuczkowski said her visits with her mother were “essentially back to where we were” before the pandemic, aside from wearing the mask and temperature checks, which she doesn’t mind. Now she can’t wait to see her mom on Christmas Day.
âLast year we all had to put our gifts in the hallway in a laundry basket and hope they got through to him,â Kuczkowski said. “So being able to hand her the presents and help her open it, watch her open it and see her appreciation, make sure she gets what we bringâ¦ I’m very happy it’s open for the holidays. . “
Yet the lifting of restrictions also comes amid the emergence of a new strain of coronavirus. The Omicron variant became the dominant strain in the United States this week and may be four times more contagious than the previous Delta strain.
West New York, already hard hit by Delta, has a positivity rate of 9% and a rate of new cases of 56.6 per 100,000 people, according to state data. There are currently nearly 500 people in the area hospitalized with COVID, including more than 100 in the intensive care unit.
âI think people need to be extremely careful and judicious during these visits,â said Dr. Thomas Russo, head of infectious diseases at the University of the Jacobs School of Medicine and Biomedical Sciences in Buffalo.
Although 89% of New York City nursing home residents are vaccinated, they often have co-morbidities and weakened immune systems, which can reduce the effectiveness of vaccines, Russo noted.
New York nursing homes saw 30 residents die from COVID last week, a death rate of 0.35 per 1,000 weeks of nursing home residency, according to The data from the United States Centers for Disease Control and Prevention. That was well below a high death rate of 4.44 in January, but up from the low death rate of 0.1 in July.
Russo said he strongly recommends visitors to nursing homes get vaccinated and given a booster dose, wear a properly fitted mask and cancel the visit altogether if they have symptoms. If a visitor is not vaccinated, perhaps a grandchild under five, he recommends getting tested on the day of the visit.
âVaccines are imperfect, our masks are imperfect,â he said, âbut if you use all the measures together – optimal vaccination, high-quality mask used correctly, testing if any, and if you have symptoms , stay at home – this will minimize the risk.
But while masking and screening for symptoms is part of CMS’s new guidelines, vaccines and testing are not. The guidelines say nursing homes should encourage visitors to get vaccinated and tested, but cannot require it.
CMS could certainly reconsider that, Russo said, especially if Omicron proves to be problematic. Notably, the CMS guidelines were released on November 12, exactly two weeks before the World Health Organization identified Omicron as a variant of concern.
âIf we’ve learned anything during this pandemic: Information is dynamic and we’ve had to adapt on the fly and be very fluid with our recommendations,â Russo said.
Nursing homes aren’t asking for a vaccine or testing warrant for visitors yet, but they would like to see some adjustments to the guidelines.
The American Health Care Association (AHCA), a trade group representing more than 14,000 nursing homes and assisted living facilities across the country, sent a letter to CMS last week, asking that facilities be allowed to temporarily restrict visits if they feel it is necessary for the safety of residents.
“We are concerned that outright and unconditional language may pose a risk to nursing homes and their residents, placing skilled nursing facilities in precarious situations when epidemics occur,” the letter said.
Beth Martino, AHCA’s senior vice president of public affairs, said in an email that “we need to carefully balance the risks to our vulnerable residents with the need to make sure they are able to see their loved ones. “.
Regarding a potential vaccine mandate for visitors, Martino said the association at the moment is simply urging members of the public to get vaccinated.
Currently, nursing homes could be subject to citation and enforcement action if they do not follow CMS visiting guidelines. A spokesperson for the state Department of Health did not respond directly to an investigation into whether New York nursing homes have been fined for failing to follow the new guidelines. The latest state and federal data on nursing home penalties dates from before the guidelines came into effect.
If a resident or family member suspects their nursing home is not following the guidelines, they can file a complaint with the state Department of Health online or by calling their hotline, Bria Lewis said, lawyer at the Center for Elder Law and Justice, a non-profit Buffalo law firm that represents residents of nursing homes.
Lewis noted that residents of nursing homes are entitled to have visitors under federal law.
âEven if a resident lives in a retirement home, it is still their home. They should always be allowed to receive visitors and see their family members, âshe said. âIt shouldn’t be limited just because they live in a nursing home. “
Kuczkowski is concerned that visitation restrictions will return. The new focus has made things easier, as she can now visit her mother on weekends instead of just weekday evenings after work. She also likes being able to walk into her mother’s room again, as it makes conversation easier. In addition, she can organize her things.
“I’m still on the edge of my seat waiting for a message [that] it is closed, âshe said. âToday is the day they’re going to say, ‘No, we’re not doing it that way anymore, we’re going to go back to the old way. But I hope it stays that way.
As for the Omicron threat, Kuczkowski said she had been vaccinated and boosted, and even avoided going out in some places, so she could visit her mother safely, but the fear of COVID is still at the back of his mind.
Still, she said not visiting her mother would also be detrimental to her health.
âIt’s a question of quality of life. If we stopped visiting her just because we were worried about making her sick then she might as well not be there, I’ll be honest, âshe said. âIf we stopped going to see her, it would be devastating, it would be worse than getting sick, I think. We are careful, but not to the point of never seeing her.