Visits to Texas nursing homes hit snag
Some facilities in limbo over qualifying under new rules
Late Thursday afternoon, a state agency announced a change that many advocates and family members of nursing home residents had hoped for: Visitors would again be allowed at some nursing homes and assisted living facilities.
By Friday morning, however, that news became slightly tempered. Visits would not start right away. The actual rules outlined in the state’s news release had not yet been published for nursing home providers to see — much less ensure they could follow.
It remained unclear, too, how many nursing homes would even qualify. Under the rules described in the Texas Health and Human Services Commission’s news release, the visits at nursing homes, mostly outdoors, would be allowed only at facilities where no residents were currently infected with COVID-19 and where no staff member had tested positive in the previous two weeks.
Data published by the state on coronavirus cases in individual facilities is two weeks behind and only goes back to July 13, but the most recent information shows that had these rules been in effect on July 23, at least 550 of the state’s 1,223 licensed nursing facilities — or 45 percent — would have been disqualified.
And that doesn’t account for a third rule, which is that staff must be tested weekly. (While testing devices are being sent to nursing homes by the federal government, not all facilities in the state
have received them.)
So while industry and resident advocates praised the news as a step forward, they hoped for more clarity on how they could again open their doors to visitors nearly five months after the state banned them. The rules for nursing homes were published late Friday, but it still left nursing home operators in a bit of limbo.
“While yesterday’s announcement was a great step forward, unfortunately without the guidelines and additional detail, it’s making it difficult for facilities to respond to families who are reaching out right now wanting to come see their loved ones,” said Kevin Warren, president and CEO of the Texas Health Care Association, which advocates for nursing homes.
Any visitation is better than no visitation, said Patty Ducayet, the state’s long-term care ombudsman, who has repeatedly heard from family members that virtual visits fall short in meeting the needs of older residents and others who require a higher level of care. But she said the general outline of the rules as of midday Friday raised concerns.
Among her questions: What happens if a facility meets the requirements but still refuses to allow visits or cannot provide weekly testing? Will personal protective equipment be given for visitors? Will visitation ever be
allowed at facilities with active COVID-19 cases? (She believes it should.)
Still, she said, “This is something, and something is better than nothing.”
The state banned nursing home visitors in mid-March to protect a vulnerable population from COVID-19 spread, but advocates increasingly called for finding a safe way to allow families to visit, pointing out that the isolation had come at a sometimes severe cost to residents’ mental and physical health.
In the Texas HHSC news release, state Rep. James Frank, chairman of the House committee on human services, called the change a “critical first step” and state Sen. Lois Kolkhorst, chairwoman of the Senate committee on health and human services, described it as “a move in the right direction for some of our most fragile Texans.”
Kelli Weldon, a spokeswoman for Texas HHSC, wrote in an email that the agency was posting the rules as quickly as possible and that they took effect upon publication. She said that facilities meeting the requirements did not have to allow visitation if they chose not to.
The nursing home rules published by the end of Friday explained that facilities first had to submit a form showing they met requirements. The added stipulations for visits included that they be scheduled in advance, that residents wear a face mask if possible and that social distancing be maintained.
At assisted living facilities — which have not seen the same staggering case and death totals as nursing homes — it appeared that the rules would be slightly looser, without the requirement for weekly staff testing and with an additional option for visits to take place indoors with a plexiglass barrier.
Diana Martinez, president and CEO of the Texas Assisted Living
Association, said the news provided a welcome first step toward visitation for family members worried their relatives in nursing homes were suffering mentally and physically.
“It gives people incentive and hope,” Martinez said, “which is what everybody needs right now.”