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Long-term care facilities weighing how to safely allow visitors

Costs of molecular and antigen rapid testing can be an expensive investment for long-term care facilities

JACKSONVILLE, Fla. – Nursing homes and assisted living facilities have been closed to visitors for months since Florida Gov. Ron Desantis issued an executive order in March.

On Tuesday, Desantis announced he was considering ways to allow visitors to go inside long-term care facilities again to be with their loved ones, despite more than 1,400 facilities reporting cases of the coronavirus.

“We’ve got to figure out a way to not only protect folks from the virus but also address some of the serious emotional damage that has been done by our countermeasures to the virus,” DeSantis said Tuesday during a roundtable discussion at ElderSource in Jacksonville.

Danielle Kessenger hasn’t seen her mother in 150 days. Kessenger said her family has settled for going to her mother’s window at the Jacksonville assisted-living facility where she is staying.

“I can see that she’s sad, and sometimes she cries, and sometimes we cry together,” said Kessenger. “We would bring my grandson, who has just turned 2 at the end of May, and she just wants to hear him and hug him and touch him.”

DeSantis discussed potential policies that would allow some visits, particularly he talked about family members who have COVID-19 antibodies being able to visit relatives.

“Any family member who has COVID-19 antibodies should be allowed to go visit the facilities,” the governor said. “If you test positive for that, we know that confirms a certain level of immunity.”

In a news release Friday, experts with the Food and Drug Administration warned against people interpreting positive antibody results as having immunity to the coronavirus.

“There are many unknowns about the presence of SARS-CoV-2 antibodies may tell us about potential immunity,” the release reads.

Brian Lee, executive director of Families for Better Care and former state long-term care ombudsman for the Florida Department of Elder Affairs, believes the testing needed to screen visitors is molecular rapid testing, not antigen rapid testing.

“If Florida Gov. DeSantis would allow for nursing homes to tap into, we have said this before, to tap into these nursing home fines to acquire the molecular rapid testing machines, get the kits for them put at the door — that would ensure a good safety measure,” Lee said. “It is not infallible, but it’s a whole lot better than what he’s wanting to use.”

Megan Kennedy — vice president of operations at Starling Living, a company that runs five long-term care facilities in Florida — said the company has prepared since March for how to safely allow for visitors to come back into the facility.

“Our residents that are not cognitively impaired understand the why. That everyone’s goal is to protect the vulnerable population, but those that have cognitive impairments definitely have struggled more so,” Kennedy said. “We are glad to hear there’s dialogue about potentially the end being near.”

She went on to say: “I think PPE — using the masks, gowns and gloves — will not be going away even when we allow visitation. I do also feel we will be screening, taking temperatures, asking those travel-related questions about how they are feeling, cough, etc. We will continue that. I do think some consideration will be given to an essential caregiver per family perhaps, perhaps a number of visits per resident per day, point-of-care screening. We have had some conversation with our providers, as recently as this week, with test results as quick as 15 minutes.”

The costs of molecular and antigen rapid testing can be an expensive investment for long-term care facilities.

“We’ve seen some costs coming through from our providers, and it’s definitely expensive, but it is an expense that would be worth bearing to provide family support for our residents again. We value the relationship between the families, the residents and us as a community, and it’s critical that we find a way to reintroduce visitation,” said Kennedy.

Kessenger said she’s at least glad her mother is mentally able to understand why things have changed and why they can’t be together.

“There’s nothing for her to do. There are no activities right now. They dine alone in their rooms. It’s not a way to live,” said Kessenger.


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