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Skeptical reactions as indoor nursing home visits to resume Oct. 12

As one family accuses Gov. Mike DeWine of "appeasing a lot of negative publicity," long-term care ombudsman John Saulitis said, “There’s an importance to do it, and I think the facilities that are truly committed to person-centered care and quality of life will figure out a way to do it."
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Ursel McElroy, director of the Ohio Department of Aging, speaks on the state's plan to reopen Ohio nursing homes to indoor visitors during a Thursday briefing on the state's coronavirus response on Thursday, Sept. 24, 2020.

CEDARVILLE — Ohio now has a plan to allow relatives of nursing home residents back into those facilities to visit, but those relatives, who for months said they’ve felt cut off from meaningful contact, doubt whether local nursing homes will be able to follow through.

Ursel McElroy, director of the Ohio Department of Aging, announced Ohio nursing homes will be allowed to reopen for indoor visitation beginning Oct. 12, nearly seven months after those facilities were closed to residents' loved ones due to the COVID-19 pandemic.

"We've been waiting for this day," McElroy said during a Thursday briefing on the state's coronavirus response, while cautioning the reopening "does not signal that we can be less cautious.

"What it means is that each of us needs to be even more vigilant in practicing the basic yet critical practices: wash your hands; wear a mask; keep your distance; limit your visiting time; but most of all, stay home if you feel you've been exposed or are becoming ill."

Simultaneously, Jeffrey Davis, director of the Ohio Department of Developmental Disabilities, said indoor visitation at intermediate care facilities for those with developmental disabilities is set to resume Monday, Sept. 28.

State interim health Director Lance Himes issued an order to that effect later Thursday.

"We also understand ... that human contact is so very important and so essential," Davis said.

McElroy on Thursday summarized the litany of precautions nursing homes should take before offering indoor visits. But relatives who’ve been advocating locally for more personal time with their loved ones inside nursing homes said they feel the incoming guidance won’t help much — and there may be few local facilities able to comply with it.

“I don’t see that happening in most cases in this area. It’s not a reflection on [the nursing homes] — it’s just a matter of fact,” said Susan Penwell.

Though outdoor visits were allowed starting July 20 under amended state orders, the facility housing Penwell’s 85-year-old mother required it to have no new coronavirus cases for at least two weeks before allowing outdoor visitation. It never reached that point, she said.

“I’m gonna guess a good majority of [nursing homes] in our area have not been COVID-free for two weeks,” she said. “To me, it was just [Gov. Mike DeWine] appeasing a lot of negative publicity.”

Penwell, who ultimately checked her mother out of her nursing home and claimed the facility’s personal care declined over the course of the pandemic, doubts whether nursing homes will be able to handle the extra workload: ushering residents — who are often immobile — to their visitation area; supervising the visit; sanitizing the visitation area; then cycling in another resident.

“The restrictions are unrealistic. … They have to have adequate staff, which we know they don’t,” Penwell said. “He’s actually put more burden on them.”

Under the state’s new guidance for indoor visitation, McElroy said facilities will be expected to determine their level of readiness to offer indoor visitation, and consider:

  • The level of coronavirus transmission in their communities and inside their facilities
  • Whether they have adequate staffing to care for residents will conducting safe visits
  • Their access to PPE and testing, and whether they're otherwise compliant with state virus testing guidelines
  • Whether their community has enough hospital capacity to accommodate a new outbreak of COVID-19

At the minimum, McElroy indoor visitors will be required to be screened before entering and must wear masks provided by the nursing home. Those visitors will also be logged.

Only two visitors will be allowed at once. Visits must be scheduled in advance, may last no longer than 30 minutes and must take place in a designated visitation area.

Though new Centers for Medicare and Medicaid Services guidance on indoor visitation issued Sept. 17 allows for visitation in residents’ rooms, state health departments which regulate nursing homes may enact stricter policies, said John Saulitis, director of Direction Home of Eastern Ohio’s ombudsman program, which advocates for long-term care residents and their families.

Renee Ciotti, who drives an hour from Salem to her 92-year-old mother’s Streetsboro assisted living facility — and is only allowed to visit for 20 minutes — said Thursday’s announcement makes little difference for her.

“We’re going to be 6 feet away from her in a room that’s not her room,” and her mother would rather have her help get her living space in order, she said.

Ciotti’s mother’s facility hasn’t reported any cases of COVID-19, but since she last spoke with Mahoning Matters, the facility halted visitation, as Portage County entered the level 3 “red” alert phase under the Ohio Public Health Advisory System map. It reverted to orange this week.

“It’s better than nothing, I suppose,” Ciotti resigned. “There’s no way they can make it personal, where you have privacy? We just want privacy with her. That’s what’s hard, when you have no privacy … alone time.”

Neither Penwell nor Ciotti expect any local facility will be ready for visitors come Oct. 12. Neither of their mothers’ long-term care facilities had plans in place by the time outdoor visitation resumed, they said.

But Saulitis said the move toward indoor visitation shouldn’t come as a surprise to Ohio’s nursing homes — it’s been slowly coming for months.

“There’s an importance to do it, and I think the facilities that are truly committed to person-centered care and quality of life will figure out a way to do it,” he said.

The state expects facilities not to restrict indoor visitation without "a reasonable or safety cause," McElroy said.

Saulitis said relatives who encounter issues with scheduling visitations at area long-term care facilities should contact the ombudsman office.

McElroy said when indoor visitation resumes Oct. 12, an online dashboard will be released on the federal coronavirus site, with information visitors need to know, like the status of outdoor visitation at a particular facility; the maximum number of visitors allowed; and contact information.

Other news

• According to the latest figures Thursday from the Ohio Department of Health, the state is reporting 147,744 confirmed or suspected cases of the coronavirus. There have been 3,030 confirmed or suspected cases in Mahoning County; 1,876 in Trumbull County; and 1,924 in Columbiana County.

• Statewide, there have been 4,715 confirmed or suspected COVID-19 deaths, including 281 in Mahoning County; 132 in Trumbull; and 80 in Columbiana. Mahoning County's 281 reported COVID-19 deaths on Thursday was fifth among Ohio's 88 counties; Cuyahoga County had the most with 656.

Columbiana County this week was upgraded to the level 2 "orange" alert phase under the Ohio Public Health Advisory System map, as it now meets two of the state's seven risk indicators for coronavirus transmission: more than 50 percent of its new weekly cases in the past two weeks were reported outside congregate settings; and the county noted a consecutive, five-day trend of increasing ER visits for a COVID-like illness or diagnosis between Sept. 11 and Sept. 16.

Mahoning and Trumbull counties this week both remained in the map's level 1 "yellow" alert phase. In both counties, more than 50 percent of the new cases reported in each of the last three weeks were reported outside congregate settings.

• In nearby counties: Stark, 2,817 cases and 170 deaths; Portage, 1,116 cases and 66 deaths; and Ashtabula, 655 cases and 48 deaths.

• According to the Pennsylvania Department of Health on Thursday, there are 153,397 COVID-19 cases in the state which have led to 8,079 deaths. The state said the recovery rate is 81 percent. There have been 710 confirmed or suspected cases in Mercer County and 16 deaths; 509 cases in Lawrence County and 23 deaths.

Mahoning County Public Health has scheduled nine flu shot clinics in October throughout the county. The Centers for Disease Control and Prevention recommends everyone 6 months of age and older get a flu vaccine every season.

• The Ohio House on Wednesday passed House Bill 614, legislation that allocates $650 million in federal CARES Act relief funds for local governments. The bill now heads to the governor. Mahoning County will receive $8.2 million; Trumbull County will receive $7.1 million; and Columbiana County will receive $3.6 million.

• About 870,000 workers filed new unemployment claims last week, a slight increase from the week prior though the overall unemployment rate continues its slow decline. According to U.S. Department of Labor data released today, the seasonally adjusted unemployment rate was 8.6 percent for the week ending Sept. 12, with 12.58 million workers filing continued claims for benefits.

• In Ohio, 17,435 workers filed initial jobless claims last week, according to the Ohio Department of Job and Family Services.

Justin Dennis

About the Author: Justin Dennis

Justin Dennis has been on the beat since 2011, covering crime, courts and public education. Dennis grew up in Poland and Salem and studied journalism and communications at Cleveland State University and University of Pittsburgh.
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