A banner hanging near the main entrance of Acadia Center for Nursing and Rehabilitation in Riverhead proclaims, “Dear Visitors…WELCOME BACK! We missed you!” Though the banner remains up, visitation has been shut down — just five days after it was reinstated for the first time since mid-March.
Acadia was finally able to open its doors to visitors last Wednesday after 28 days had passed without a positive COVID test among staff and residents. Then late yesterday, a support staff member’s test came back positive. Now, New York State rules have cut off visiting for another 28 days — at least. It could be longer if other staff members test positive going forward.
Nursing homes are struggling to meet state-imposed requirements for reinstating visitation that nursing home operators, their statewide advocacy organization and residents’ family members say are nearly impossible to meet.
Nursing home visitation can resume as long as a facility is COVID-free for 28
days. Most facilities have not been able to meet that standard, according to a statewide organization representing several hundred nursing homes and assisted living facilities in New York.
And facilities that have been able to meet the standard often have to shut down visitation again for 28 days after a staffer tests positive — just as what happened at Acadia.
The children of Acadia resident Bertha Kulesa were relieved and excited to finally be able to visit with their 96-year-old mother once visiting was reinstated last week.
“One of my brothers and I got to see her last Wednesday,” her daughter Pat Kurpetski of Calverton said.
Kulesa has lived at Acadia since Dec. 7. Her family visited every day until the governor ended nursing home visitation in mid-March when the coronavirus pandemic hit New York. Since then, until last week, they were able to have three “window visits.” FaceTime on an iPad and even phone calls weren’t realistic option, Kurpetski said, because her mother has both impaired eyesight and hearing.
Kurpetski believes isolation has hurt her mother’s mental and emotional state. “She can’t read or watch TV. Even when you’re talking to he in person, you have to be face to face and speak slowly,” she said. Visiting with masks from six feet away made communication difficult even in person.
“I don’t think she fully grasps why we can’t visit her,” Kurpetski said.
Kulesa was “sharp as a tack” when she entered the nursing home, said close family friend Kathy Berezny of Riverhead. “She’s lonely. She’s isolated,” Berezny said. “Isolation is killing these residents.” Berezny is hopping mad and spends a lot of time calling elected officials demanding they do something — from town hall to Hauppauge to Albany and Washington. So far, nothing has changed, she said.
Isolation — despite efforts to connect residents and family via FaceTime, Skype and telephone — has been hard on nursing home residents everywhere.
“If my mom is any indication, mental health issues from isolation are huge. It’s heartbreaking,” said Riverhead resident Patricia Snyder, whose mother is a resident at San Simeon by the Sound in Greenport.
San Simeon also reinstated visitation last week. While its residents remained COVID-free throughout the pandemic, staff members testing positive prevented the Greenport facility from opening sooner.
Snyder was able to visit her mother on Friday for the first time since March. “COVID has been pretty rough on the residents,” she said.
“It’s been a source of ongoing frustration for the residents, their families, and the facility’s staff — all of whom would like to see our residents and their families reconnected,” said Vince Liaguno, administrator at the Hamptons Center for Rehabilitation and Nursing in Southampton.
“With 200 residents and 250 staff members, the likelihood of there being no positives for a sustained period of 28 days is slim to none, especially with the wider community opening back up and people getting out and about more,” Liaguno said. It’s like “trying to hit a moving target,” he said.
Visitation at Westhampton Care Center has been temporarily suspended until Sept. 25, according to a message on its website. The administrator there could not be reached for details.
The New York State Health Facilities Association/New York State Center for Assisted Living is calling on the state to change the policy from 28 to 14 days.
“It has been since early March of this year that a majority of our residents have been unable to receive visitors in person as a consequence of the COVID-19 pandemic,” NYSHFA|NYSCAL president Stephen Hanse wrote in a letter to the governor Friday.
“Moving from a 28-day restriction to a 14-day policy is essential for the health and well being of our residents and their families and loved ones,” Hanse wrote to Cuomo.
Kurpetski said the 28-day rule “doesn’t make sense.”
“I can’t understand what the point is to stop visitation for a month if one of their staff tests positive,” she said.
NYSHFA|NYSCA is also urging the state to adopt new COVID-19 testing requirements issued on Aug. 26 by the federal Centers for Medicare and Medicaid Services for staff testing. The state requires all staff to be tested once a week.
CMS’s new testing requirements are based on the positive rate of the virus in the county where a facility is located. The new CMS rule requires testing once a month for facilities in counties with less than a 5% infection rate, once a week for facilities in counties with a positivity rate between 5% and 10%, and twice a week for facilities in counties with a positivity rate of over 10%.
“The CMS approach of county-based positivity rate testing will pinpoint testing in communities where it is needed most while continuing to safeguard the health and safety of skilled nursing and assisted living residents and staff,” Hanse wrote in his letter to the governor.
The cost of the testing is “unsustainable,” Hanse said.
Health insurers are refusing to pay for the state’s staff testing requirement which costs providers approximately $100 per test, he said.
The “unreimbursed testing costs are in addition to ever-increasing staff and PPE costs providers are struggling to keep up with in the face of record low occupancy rates throughout the state,” Hanse wrote.
According to data released yesterday by the N.Y. State Department of Health, more than one-quarter (6,639) of the state’s 25,328 COVID-19 fatalities were among nursing home and assisted living facility residents.
The state health department has come under sharp criticism for its March 25 directive requiring nursing homes to admit COVID-positive patients discharged from hospitals.
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