Visitation rights

Department of Health regulations, the care center and worried family members

By ANNEMARIE SCHUETZ
Posted 4/14/21

MONTICELLO, NY — Cat Scott wants to visit her mother. Lou Setren wants to visit his mother, too. 

Bert Kohn, the administrator at the Care Center at Sunset Lake, says his hands are tied …

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Visitation rights

Department of Health regulations, the care center and worried family members

Posted

MONTICELLO, NY — Cat Scott wants to visit her mother. Lou Setren wants to visit his mother, too. 

Bert Kohn, the administrator at the Care Center at Sunset Lake, says his hands are tied by the state’s confusing new regulations.

The subject came up at the April 8 health and family services committee meeting.

A few weeks ago, Gov. Andrew Cuomo and New York State Department of Health Commissioner Howard Zucker issued new rules allowing visitors into nursing homes. It adheres to CDC guidelines and “permits visitation at all times and for all residents with limited exceptions for unvaccinated residents in areas of high community spread and lower resident vaccination rates, residents with confirmed COVID-19 infection or those in isolation or quarantine,” an accompanying statement says.

It replaces the previous rules that required a facility to be COVID-19 free for two weeks. Vaccines are cited as one reason for the new, looser regulations.

This is good news for residents and their families.

Visiting is important. As a reporter with many years of various experience with long-term health facilities, I can attest that it’s not just because you love a nursing home resident and miss them, or that not seeing loved ones is harmful to the resident. Visitors know the person they’re visiting, so they are better able to catch changes in behavior that signal illness or other problems. They are another set of eyes to check for bedsores or an easily missed injury. Visitors can also watch for the issues that arise when there are too few staff to meet the needs of residents. 

But protecting residents is also important. 

According to the Kaiser Family Foundation, investigations are just beginning into nursing home deaths during the pandemic. Their long-term care tracker says that 31 percent of total deaths from COVID-19 were in long-term care facilities, but that figure is being constantly revised as new data emerges.

It’s a tough needle to thread, and the new guidelines are not helping. 

Nursing homes are expected to maintain “infection prevention practices” and to protect residents.

“I’ve been an administrator for 25 years,” Kohn said, “and I’ve never read such confusing guidelines... This really takes the cake.” He said he has to close for 14 days after a positive test in the facility. “It’s in the best interests of the residents to see their families, but my hands are tied.” 

Lack of staff may be complicating the situation. Earlier in his report, Kohn said that “staffing in the building remains a tremendous challenge.” They need RNs, LPNs and CNAs. 

More staff would probably ease visiting. When legislator Luis Alvarez talked about how he wouldn’t be able to see his wife when he was late for a visit at the care center (she has since left), Kohn said that visits are “very, very staff consuming.” Residents have to be escorted, visits supervised, if necessary, then residents are escorted back. “The staff wants the family to visit,” he said at one point. Everyone wants visits. But “my hands are tied.” 

Another factor could be lower vaccination rates among staff, a subject that came up during the meeting. Forty-nine staff have had two doses, nine have had one. 

Kohn couldn’t say how many employees had not received shots yet. He said that some had expressed the belief that because they had already had COVID-19, they were safe; others were worried about the vaccine. “We tell them, ‘it’s in your best interest.’ Should New York require it? I don’t know,” he said. 

Another problem is that the new regulations allow visiting to be suspended because of “limited exceptions.” (See sidebar for details.) 

Say there’s been an outbreak in the facility, and “outbreak” can mean one person, staff or resident, who tests positive. Then the nursing home closes to visitors until further testing shows how far the disease has spread. One person in one area? Visitation can start up again. More people, or someone, like a staff member, who goes everywhere in the building? Visitation is suspended until the facility “meets the criteria to discontinue outbreak testing.” 

“There’s been a positive employee test almost every week since September,” said Cat Scott in public comment. “It’s not enough to say, ‘What can we do?’”

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