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Families want answers as Cuomo loosens nursing home visitation restrictions

Buffalo News - 2/20/2021

Feb. 20—Gov. Andrew M. Cuomo's announcement Friday to allow broader visitation at the state's 613 nursing homes spurred relief and questions from families who wonder what the visits will look like.

They also expressed frustration over the untold number of residents who died from loneliness since March 13 when Cuomo enacted an initial visitation ban to try and halt the spread of the deadly Covid-19 virus.

"Just because he announced this, I want to know how long will it be before he lets us in. I'm so frustrated," said Michelle Layer, whose 91-year-old father lives at Harris Hill Nursing Facility in Lancaster. "I have had both of my Covid vaccination shots and I should be allowed in as a caretaker."

Ray King's children have not had an in-person visit with their father inside the nursing home since March, said Ryan King, a son.

Layer and others have been urging the state for months to loosen its restrictions on nursing home visits.

Nursing homes on Monday will receive state Health Department guidance on how to allow the visits, which will be based on federal guidelines, Cuomo said.

One of the requirements will be that visitors take a rapid Covid-19 test, provided at no charge by the state, before being allowed to enter a facility, the governor said.

Layer said she calls her father, Ray King, every day and asks how he is doing.

"He is in a 10-foot by 10-foot room. I ask him how his day is every day and he says, 'It's the same day every day.' " Layer said. "He is lonely."

Months after enacting the visitation ban, the Health Department in mid-July allowed non-contact visits if a nursing home had not had a Covid-19 case for 28 days.

On Sept. 17, the wait period was reduced to 14 days.

In November when a large swath of Buffalo and Erie County suburbs were placed in an "orange zone," as Covid infections soared, the limited visits were halted in that zone.

At his Friday Covid-19 briefing, Cuomo offered some insight into why he is now taking a different approach to nursing home visits. He said 73% of the state's approximately 86,490 nursing home residents have been vaccinated. That percentage, he said, represents the highest among any of the vaccination-eligible subgroups in the state.

But there may also be another factor at play in Cuomo's decision. The governor has faced intense criticism from state lawmakers in recent weeks for failing to present an accurate accounting of how many nursing home residents have died from the coronavirus.

His administration did not include nursing home residents who contracted the virus and were then transferred to hospitals and other facilities where they died. Also, Cuomo's policy early on that allowed hospitalized individuals with the virus to be admitted to nursing homes drew criticism and was later rescinded.

State Attorney General Letitia James late last month issued a report that estimated the Health Department had underreported nursing home Covid deaths by about 50%.

Since then, Health Department officials have released more complete numbers on deaths that include residents who died after being transferred to other health facility settings.

As of Feb. 4, there were 6,139 confirmed Covid-19 deaths of nursing home residents in nursing homes, 4,067 confirmed Covid-19 deaths of nursing home residents at hospitals and other sites, and 2,957 presumed Covid-19 deaths of nursing home residents at nursing homes. Those numbers total 13,163.

"One of the most devastating aspects of this virus has been how it separated families from their loved ones, making an already difficult situation even harder to bear," Cuomo said. "Thanks to the dedication of New Yorkers, we're now at a point where we can begin to resume nursing home visitations under strict guidelines to protect the health and safety of residents."

Ken Rogers, chair of the board of directors at the Weinberg Campus, which includes the Rosa Coplon nursing home in Amherst, welcomed the change.

"Obviously it is exciting for our residents and it is exciting for all of us who are charged with their care and responsible to their families," he said.

Too late for some

However, the upcoming change has come too late for many families of nursing home residents who have died since March. Yet these relatives said they were happy for families who will be reunited.

"Unfortunately, it is too late for our family and many families who have lost their loved ones due to the isolation," said Kristen Squillace, whose 91-year old father Sam LoVullo died Jan. 22 at Terrace View Long Term Care in Buffalo, after a gradual decline in health since the pandemic hit.

"We've been advocating for this since March 13 when they closed the door. I have reached out to the state multiple times over the year and they have finally listened," she said.

Squillace said it is important for the state and nursing homes to move quickly "because family members need to resume acting as a voice, advocate and reason for living" for their loved ones.

"Right before my dad passed, we did get in and I told him I would continue to advocate until the doors would open," the daughter said. "My dad is smiling because he knows we fought for him and all the others."

Carol Schmeidler, whose 91-year-old mother Deborah Schmeidler died on Nov. 28 at Beechwood Nursing Home in Getzville, wanted to know how the visits will be structured.

"Will it be these 6-feet-apart visits or will there be contact?" she asked. "We were able to do exactly one outside visit with my mother last July at least 6 feet apart and separated by a snow fence."

She said contact visits "are necessary to provide meaningful physical and emotional support for both the residents and the family members."

Safety concerns

Raising concerns over the plans for increased visitation and use of rapid testing was Dr. Bruce R. Troen, chief of the division of geriatric and palliative medicine at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo.

"The ideal target for rapid testing is individuals who are exhibiting symptoms. For those who are asymptomatic and may be infected, rapid testing is less precise with both false negatives and false positives," he said.

The preferred screening for the virus is the "PCR test," which is much more sensitive than the "rapid antigen test," he said. But it often takes several days to get results from the more reliable test, Troen said.

To ensure the safety of the approximately 27% of nursing home residents who have not received the vaccination, the geriatrician recommended visitors wear personal protective equipment.

"The best way to minimize risk would be to have appropriate personal protective equipment with medical grade three-ply masks along with hand sanitation. That is still the most important thing," he said.

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