Residents of long-term care facilities and their families are asking when they can visit again, as parts of the country open up.
Assisted-living and nursing-care communities, home to the most vulnerable to the coronavirus, have been in lockdown since March 13, when the Centers for Medicare and Medicaid Services banned nonessential visitors, including family and friends. Though it isn’t clear when federal and state regulators will lift the restrictions, operators are planning how to resume visits safely. In some places, that means installing cubicles with clear plastic dividers between a resident and guest that are expected to remain in place until a vaccine is available.
Maura McGinn said her mother, who lives in a San Francisco assisted-living community with her father, who has dementia, calls her three times a day wondering when they can get together. “She is going absolutely bonkers,” said Ms. McGinn, who drops off packages for her parents but isn’t allowed to see them.
In the U.S., there have been more than 10,000 coronavirus-linked deaths in long-term care facilities, including nursing-care and assisted-living centers. “Until we know we can contain it, I don’t think we should be having talks about opening,” said Katie Smith Sloan, president of LeadingAge, an association of nonprofit providers of aging services, including nursing homes and assisted-living facilities.
Mark Parkinson, chief executive of the American Health Care Association and National Center for Assisted Living, cited specific benchmarks for reopening safely. Facilities should be able to test every visitor for coronavirus, with near-instant results, he said, or have personal protective equipment for residents, staff and visitors. Widespread rapid testing won’t be available for four to six months, he estimated, while sufficient protective equipment at all facilities is about two to three months away. “That might sound extreme—to wait until then—until you look at the data that shows 20% to 25% of nursing-home residents who catch the virus end up dying,” he said.
Brian Barnes, CEO of Blakeford, a Nashville, Tenn.-based senior-living community, said residents’ relatives began calling him after the state and city announced May reopening dates. “They say: ‘We see other things opening. When can I come and see Mom?’ ” he said.
Mr. Barnes said he will follow state and local guidelines. Nashville has a four-phase reopening plan, spread out over about two months, with each phase lasting about 14 days. The plan advances to the next phase only if the number of coronavirus cases stabilizes or falls. Visits might resume in independent-living settings during the third phase, he said, but likely won’t be allowed in assisted-living and nursing-care areas until the fourth.
Once visitors are allowed, they will be scheduled, likely once a week. “We don’t want to just throw our doors open so all come at once,” he said. “We have done a lot of hard work and don’t want that to go out the window.” Blakeford hasn’t had a single case of coronavirus among its 250 residents in independent living, assisted living and skilled nursing care.
Kevin O’Neil, chief medical officer of North Carolina-based Affinity Living Group, which has 140 communities in six states, will begin a pilot reopening program at a limited number of residential communities, once state and federal authorities lift their ban. He speculated the pilot program could begin in mid-July or early August.
“We won’t do it all at once. Let’s get it right in one, two or three communities, make sure we get the results we want, and replicate it,” he said. Visitors would be screened, answer questionnaires and have their temperatures taken upon arriving. Special rooms would be set aside for visits and disinfected after each visit.
PHOTO: AFFINITY LIVING GROUP
Dwayne Clark, CEO of Aegis Living, is assembling a virus council, including scientists, doctors and psychologists, to update him on vaccines, contagion, and containment and advise him how to safely reopen. Aegis has assisted-living and memory-care communities in Washington, California and Nevada, which are regulated by state authorities. “If the governors say we can open tomorrow, we are probably not going to open tomorrow,” he said.
Things will look different when they do. Mr. Clark is considering building glass booths where residents and visitors can sit and talk in bright and airy surroundings, separated by a 7-foot-high transparent divider. Mr. Clark said he consulted scientists to see if virus droplets could travel over the top of a 7-foot tall divider and was assured they wouldn’t.
He met with a company that makes air-filtering systems to discuss whether its ventilator could kill the coronavirus, and is considering ways to install ultraviolet light inside buildings. “We’re going to do this very slowly,” Mr. Clark said.
Some long-term care providers are concerned about the toll of a lengthy quarantine. “You do start to ask how long it’s reasonable to keep residents from family members. Many are in the last months and years of their lives,” said Melissa Orth, CEO of Legacy Senior Communities, in Plano, Texas, which has independent-living, assisted-living, and memory-care settings.
Legacy is trying to keep families connected through FaceTime and Skype and is planning a Mother’s Day parade, inviting relatives to drive around a big loop on the campus, holding signs.
Ms. McGinn, of San Francisco, says her county is under shelter-in-place orders until June 1 and will then proceed with a four-phase reopening. She wonders if she should bring her parents home. “Ideally, I’d have them isolated with me if this goes on for months,” she said. Her gut says she won’t be able visit them before August. “And,” she added, “that’s being optimistic.”