With most long-term care residents vaccinated against COVID-19 and infection rates plunging, facilities across Pennsylvania on Monday began opening their doors wider than they’ve done in more than a year.
At Messiah Village near Harrisburg, visitors began arriving in the morning, with no time limits on visits.
“We are really excited to welcome families back. It’s been a long time. The residents and the families really need this connection,” said Katie Andreano, the communications manager at Messiah Lifeways, which has about 250 residents in its skilled nursing and personal care units.
For most long-term care residents, the coming days will mark their first opportunity for close contact with family or friends since Pennsylvania facilities were locked down by the state’s order a little more than a year ago.
Even with the lockdown, COVID-19 took its greatest toll among long-term care residents. In Pennsylvania, more than half of the state’s nearly 25,000 COVID-19 deaths involved long-term care residents.
Yet even with that, many family members and experts feared isolation from the lockdown posed a grave danger of its own, contributing to depression, mental and physical decline and loss of will to live among some long-term care residents.
“She’s 92. How many years does she have left? And she’s been robbed of one of them,” said Cindy Sheaffer, whose mother lives in an assisted living facility in Cumberland County.
Sheaffer on Friday attended a rally at the state Capitol held by a group called Pennsylvania Caregivers for Compromise, whose catchphrase has been “because isolation kills too.” The group for months had pushed for Gov. Tom Wolf and state officials to find ways to expand visitation.
Sheaffer described more than a year without consistent, meaningful visits with her mother.
Her mother’s facility was among the many which for a while allowed “window visits,” where the visitor remained outside a window or similar barrier. Sheaffer said her mother couldn’t grasp why her loved one wasn’t in the room, making the visits stressful.
Later, the facility allowed distanced, restricted indoor visits. But those proved temporary, as Pennsylvania’s second wave of COVID-19 infections last fall triggered another tight lockdown that continued until Monday.
A sea change began in the middle of last week when federal officials recommended a dramatic easing of restrictions, essentially advising facilities to allow unrestricted visits except in certain high-risk situations.
The new advice is largely driven by high levels of vaccination at most long-term care facilities and a dramatic drop off in infections within them, with the drop attributed to the vaccines. In Pennsylvania, all skilled nursing residents who want vaccine have been vaccinated, and the state expects vaccination at assisted living and personal care facilities to soon reach that level.
On Friday, the Wolf administration said it “strongly encourages” Pennsylvania facilities to adopt the federal advice, noting visitation is critical to residents’ physical and mental health and “there is no substitute for physical contact, such as the warm embrace between a resident and their loved one.”
The state’s announcement further said, “if the resident is fully vaccinated, they can choose to have close contact, including touch, with their visitor while wearing a well-fitting mask. Regardless, visitors should physically distance from other residents and staff in the facility.”
In essence, Pennsylvania is recommending that facilities “allow responsible indoor visitation at all times for all residents,” regardless of whether the resident or the visitor is vaccinated against COVID-19.
Exceptions would involve unvaccinated residents in a situation where the county’s COVID-19 test positivity rate is greater than 10% and fewer than 70% of the facility’s residers are vaccinated, or when the resident has COVID-19 or is in quarantine.
Still, it remains up to individual facilities to decide how much to expand visitation. On Monday, there was fear some facilities would continue strict policies.
“It’s strongly suggested, but there’s not anything to say they must do it. There are a lot of ‘shoulds’. I just wish it was a lot more enforceable,” said Diane Menio, executive director of the Center for Advocacy for the Rights and Interest of the Elderly.
Menio said on Monday afternoon she heard of a facility that will limit visits to 15 minutes. “We are still concerned about facilities that will not open it up in a way that helps a lot of people,” she said.
Zach Shambaugh, CEO of the Pennsylvania Health Care Association, which represents for-profit long-term care providers, called the new recommendations “welcome news.”
He noted that, because of the recommendations, there will be strong public pressure on facilities to expand visitation, and he expects most if not all will do so within a few weeks. He noted that some had long planned for expanded visitation and were ready to adopt them on Monday, while others will need time to put in place protections and policies to protect their residents from COVID-19, which remains a threat.
At Messiah Village, for example, visitors are being asked to sign up online for approximate time slots, although Andreano said that’s only to help anticipate and manage volume.
There’s no time limit on visits and people can visit every day, but not more than two visitors per resident per visit. Visitors must pass a screening for COVID-19 symptoms, wear a face mask and keep at least six feet away from residents other than their loved ones.
Shambaugh said that, by expanding visitation, facilities take on a risk of being sued as the result of residents coming down with COVID-19. He said his organization continues to push for facilities to be made exempt from lawsuits stemming from COVID-19 infections as long as they followed government recommendations.
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