New York nursing homes push for less-stringent requirements

— From Daughters of Sarah Senior Community Facebook page 

Visitors have been restricted from nursing homes in New York since mid-March, so families and friends, as here at the Daughters of Sarah Senior Community, often stand outside and communicate through glass.

ALBANY COUNTY — Mary Chase hasn’t been allowed to visit her 93-year-old mother since March when state restrictions prohibited visitors to nursing homes to limit the spread of the coronavirus.

“I haven’t been able to hold her hand. I haven’t been able to hug her,” said Chase.

Her mother, Helen Rosencrans, has mild dementia, said Chase, and has been a resident of Daughters of Sarah on Washington Avenue Extension in Albany for about a year.

In mid-July, the state opened up nursing homes to visitors for the first time since mid-March, with strict parameters. State guidelines require a nursing home to be free of COVID-19 for 28 days. Only two visitors for each resident may visit at one time, and visitors must have their temperature taken before entering and use a face mask and socially distance themselves while in the nursing home.

Also, no more than 10 percent of the residents of a nursing home may receive visitors at any one time. Nursing homes were each required to develop a plan for visitors and provide it to the state’s health department.

At the time this was announced, Albany County Executive Daniel McCoy said, “If one worker comes back positive, it sets the clock and they can’t open up for 28 days.”

This week, McCoy said not a single nursing home in the county has been able to admit visitors.

On Friday, Stephen Hanse, president and chief executive officer of the New York State Health Facilities Association and the New York State Center for Assisted Living, a statewide association representing over 425 nursing homes and assisted living facilities, delivered a letter to Governor Andrew Cuomo asking that New York conform to federal guidelines issued on Aug. 25.

 A recent survey by the organization showed that 77 percent of providers statewide were unable to open for in-person visits under the state’s 28-day restriction.

The letter to the governor calls for a 14-day, rather than a 28-day, waiting period after a positive COVID-19 test for nursing home staff or residents before visitors are allowed, and it also calls for testing on employees to be targeted rather than requiring all nursing-home workers to be tested once a week.

Under its new rules, the Centers for Medicare & Medicaid Services, known as CMS, is requiring testing once a month for facilities in counties with less than a 5-percent infection rate; once a week for facilities in counties with a positivity rate between 5 percent and 10 percent; and twice a week for facilities in counties with a positivity rate of over 10 percent.

For the past three weeks, New York statewide has had a positivity rate below 1 percent.

New York was ahead of the federal government in setting requirements for nursing-home visits and for testing of staff and residents. After nursing homes across the state suffered many deaths of residents, Cuomo required nursing-home workers to be tested twice weekly for COVID-19. That was later reduced to once a week.

The majority of COVID-19 deaths in Albany County have been of nursing-home residents.

A July 6 report issued by the state’s Department of Health concluded that the primary cause of the spike of COVID-19 cases in nursing homes was due to workers being infected. The report says that one in four nursing-home workers were infected and also that visitors to the nursing homes, before a March 13 executive order forbade visitors, could also have unwittingly spread the disease.

Critics of the report have maintained the cause of many deaths was Cuomo’s initial policy that nursing homes accept COVID-19 patients, an order he reversed on May 10. Cuomo said at the time that he was following directives from the Centers for Disease Control and Prevention.

On Wednesday, the federal Department of Justice sent letters to four Democratic governors — of New York, Pennsylvania, New Jersey, and Michigan — seeking data on whether they violated federal law by ordering public nursing homes to accept recovering COVID-19 patients from hospitals. At the height of the pandemic in New York, there were concerns there wouldn’t be enough hospital beds for patients with severe cases of COVID-19.

Nationwide, over 40 percent of COVID-19 deaths have been of nursing-home residents who make up about 1-percent of the United States population.

The new requirements from CMS are couched in terms of being Donald Trump’s directives. “From the beginning of this pandemic, President Trump has worked tirelessly to protect our vulnerable elderly in nursing homes,” says the government CMS website. “The provisions in today’s rule on nursing homes represent his expectation that CMS pull every available regulatory lever to maximize nursing home residents’ safety and quality of life.”

Albany County’s nursing home, Shaker Place, is receiving one of the federal point-of-care testing devices, which McCoy said this week would make test results available within half-an-hour and would save the county about $10,000 on what had been a $16,000 weekly cost for the required state testing.

Facilities that do not comply with the new federal requirements will be cited for non-compliance and may face penalties in excess of $400 per day, or over $8,000 for an instance of noncompliance.


One family’s pain

For Helen Rosencrans’s family, the long wait to visit her in person has been excruciating. Rosencrans, who had been widowed young, raised six children on Johnston Road in Guilderland. Family has always been the center of her life, her daughter said.

Before the pandemic, she received daily visits from her children, grandchildren, and great-grandchildren.

“In the morning, my brother and his wife would be there for an hour or two,” said Chase. “She’d have her hair done and her nails done. She loved that. But not any more.”

Daughters of Sarah had to shut that down, Chase said, along with ending the frequent gatherings for entertainment.

Chase has high praise for the staff at Daughters of Sarah but questions the strict state regulations. Mark Koblenz, chief executive officer of the Daughters of Sarah Senior Community, posts frequent COVID-19 updates, she said.

The most recent one, posted on Aug. 21, says, “We are extremely pleased to note there continue to be no instances of the coronavirus among the residents at either the Nursing & Rehabilitation Center or The Massry Residence.” He reports that no deficiencies were noted in the state’s third infection-control survey.

Koblenz goes on to report that a staff member at the Nursing & Rehabilitation Center, where Rosencrans is housed, has tested positive for the virus and is quarantining.

“The staff member had not been in the building since the end of the first week in August,” Koblenz writes, “at which time they had tested negative for the virus; it was prior to returning to work after a leave of absence that the positive test result occurred. This brings the total of staff members testing positive at the Nursing & Rehabilitation Center, since testing began, to 26.”

“If the staff member never went into the facility,” asks Chase, “why should that count?”

Chase said she has filed a complaint with the state’s Department of Health but has received no response.

The lack of communication with her family is very hard on her mother, said Chase. “Being 93, she’s not understanding Facetiming. She keeps asking, ‘When can I see you?’”

Other than dementia, Chase said, her mother had had no health issues and was not on medication. “Now, they’ve had to put her on an antidepressant. She misses us and we miss her … Even my granddaughter is sad,” Chase said of the 9-year-old.

The family has made visits, arranged ahead with nursing-home staff, so that Rosencrans can wave at them from a window. “But they can’t open the window and she can’t hear well. We hold up signs, saying, ‘We love you.’ She’ll wave. She’s so happy to see us. But it’s just not the same.”

Chase wishes that restrictions would be lifted so that she could see her mother outdoors. “We’d all wear masks and stay 10 feet away. She could see the grandkids running around. She’d love it,” she said.

“I know the elderly are more vulnerable to COVID,” she said, “but inmates are getting visitors.”

Her mother’s personality has not been changed by dementia, Chase said. Staff members frequently tell Chase, “Oh, my God, she’s so sweet.”

Frequently, when Chase calls to check on her mother, staff members will say things like, “We have her at the nursing station.” Chase said, “They’re making her think she has a job to do. They’ll give her things to do to keep her busy, like folding laundry.”

But, said Chase, it’s not the same as seeing family, which is what has kept her going all these years. Perhaps because of her dementia, said Chase, “She doesn’t understand why we left her.”

Chase concluded, “She’s 93. We don’t have much time.”

More Regional News

  • New York State is setting up new sites solely to administer the recently-approved single-shot Johnson & Johnson COVID-19 vaccine, which is just as effective in preventing hospitalization and death as the Moderna and Pfizer vaccines, according to clinical trials, although not as effective in preventing mild cases of the virus.

  • The Albany Alternative Treatment Court will be the first mental health court in the 3rd Judicial District, one of 31 such courts across the state with four more being planned. It was the “missing piece” in a continuum of services Albany County offers to mentally ill residents.

  • The state and federal governments together have opened mass vaccination sites for Black and brown communities, which have disproportionately been hurt by the pandemic. One of those sites is at the Washington Avenue Armory in Albany. Appointments begin on March 3 for residents of these ZIP codes: 12202, 12206, 12207, 12209, and 12210.

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