Hugging, longer visits allowed at Indiana long-term care facilities

by: Corinne Moore

INDIANAPOLIS (WANE) — Indiana long-term care facilities will now be required to allow up to two-hour visits for all residents, at all times with a few exceptions, Indiana Health Commissioner Dr. Kristina Box announced on Wednesday. This announcement comes after the Centers for Medicare and Medicaid Services (CMS) announced new guidelines.

Indoor visits should be allowed at all time for all residents, except for circumstances that would be considered a high risk of COVID-19 transmission, the CSM said. These high risk scenarios include:

• A resident is unvaccinated if the nursing home’s COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated.
• A resident has a confirmed COVID-19 infection, whether vaccinated or unvaccinated. until they have met the criteria to discontinue Transmission-Based Precautions.
• Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.

“These visits can occur in single occupancy rooms but are still discouraged in double occupancy rooms,” Dr. Box said. “Physical touch such as hugging is permitted for residents who are fully vaccinated, provided that the residents wear a well-fitted mask and preform hand hygiene before and after physical contact.”

Dr. Box added that facilities must allow up to two hours for visits unless unique circumstances make that impossible. These circumstances need to be discussed with the state’s regulatory division in advance.

Outdoor visits should be held whenever possible, the CMS website said. Facilities are encouraged to create accessible and safe outdoor spaces for visitation. However, Dr. Box said that “outdoor visitation will no longer be automatically suspended in the event of an outbreak.”

The CMS recently announced new guidelines for visitations in long-term care facilities. The guidelines that should be adhered to at all times include:

• Face covering or masks (covering mouth and nose)
• Hand hygiene (use of alcohol-based hand rub is preferred
• Social distancing at least six feet between persons
• Cleaning and disinfecting high-frequency touched surfaces in the facility often, and designated visitation areas after each visit

“These changes represent a vast improvement to the quality of life for our most vulnerable Hoosiers,” Dr. Box said. “And we know that many families will be extremely happy to reconnect with their loved ones.”

More recommendations and directions for facilities will be released in the near future.

To read the full guidelines recommended by CMS, click here.

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Hugging, longer visits allowed at Indiana long-term care facilities

COVID-19: NJ Long-Term Care Residents Who Go Home For Holidays Might Not Get Right Back In

by Jerry DeMarco 

New Jersey Health Commissioner Judith Persichilli Photo Credit: NJSP

New Jersey's health commissioner urged families not to take residents out of long-term care facilities for the holidays -- and warned that they might not get right back in if they do – as the number of COVID-19 cases statewide continue to spike.

Guidelines issued by Health Commissioner Judith Persichilli include a mandatory 14-day quarantine for any long-term care resident, either in their own room or in an observation room, once they return to the facility after a family visit.

For that reason, Persichilli urged the facilities to create a “reservation list,” as well as a waiting list, based on the number of residents who can be quarantined at a time.

 

Administrators were also told to tell families that residents who leave without a reservation or while on a waiting list “may not be guaranteed readmittance to the facility at the end of their visit.”

“We remain concerned about the number of outbreaks we are seeing in long-term care,” Persichilli said, “so we need to be especially vigilant to protect this population.

“Small family gatherings are a significant driver of increasing cases, and bringing your loved ones home could put them at risk,” she added.

Residents of these facilities “are being treated for conditions that make them particularly vulnerable to suffering the most serious complications of COVID-19 infection, including death,” the commissioner wrote in a letter to facility administrators across the state.

“To protect the health of this vulnerable population,” she “strongly recommended” that families not take residents out of the facilities for “holiday celebration events or gatherings.”

Instead, Persichilli recommended “visitation outdoors or possibly indoors in facilities that meet the requirements for indoor visitation.

Long-term care facilities also should “plan to accommodate increased virtual communications for residents,” she said.

The facilities “need to develop a plan for holiday visits and gatherings” that estimate the number of residents who can be placed into a 14-day quarantine from Nov. 25 through Dec. 31, the commissioner added in her “guidance” letter.

They should also “create a reservation process tied to the number of individuals the facility can quarantine on their return,” she wrote. “A waiting list should be created once the reservation list is full.

“However, residents and families should be informed that residents who leave without a reservation or while on a waiting list may not be guaranteed readmittance to the facility at the end of their visit.

“Residents and families must certify that they will follow masking, social distancing and hand hygiene practices, and that they will notify the facility if anyone who attended the holiday gathering tests positive for COVID-19 or exhibits symptoms of COVID-19 within 14 days of the resident’s visit/stay outside the facility,” Persichilli added.

A link to the entire guidance letter is below.

CLICK HERE for: NJ Long-Term Care Holiday Visiting Guidelines

 

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COVID-19: NJ Long-Term Care Residents Who Go Home For Holidays Might Not Get Right Back In

Minnesota Eases Visits To Long-Term Care Facility Residents

MINNEAPOLIS (AP) — Minnesota health officials rolled back rules Monday that prevented many families from visiting their loved ones in nursing homes and assisted-living facilities because of the coronavirus pandemic.

The new guidelines from the Minnesota Department of Health allow indoor visitations at most senior homes that have not had new infections in the preceding two weeks and when the infection rate in the surrounding county is no more than 10%. The state still recommends that long-term care facilities limit how many visitors a resident can have at once and the duration of indoor visits.

The new guidance significantly eased the restrictions that had been in place since March, when nursing homes and assisted-living complexes locked down and barred family visits in an attempt to protect vulnerable residents, the Star Tribune reported. Advocates for residents and their families have been clamoring for relief, noting that many elderly residents have suffered anxiety, depression and physical decline because of the social isolation.

“We are really looking to make sure that we do everything that we can to have the residents and families be able to connect with one another,” said Lindsey Krueger, director of the department’s Office of Health Facility Complaints.

But officials cautioned that rising community spread of the virus could still prevent many senior homes from opening their doors. Nearly 250 long-term care facilities have had at least one positive case of COVID-19 in the last two weeks, meaning they generally will remain barred to indoor visits. Two counties, Martin and Redwood, have infection rates of greater than 10%, so visitations in those counties will remain restricted under the new guidelines.

The department reported nearly 1,200 newly confirmed infections Monday after a weekend where confirmed case counts rose by nearly 3,000. Hospitalizations in the state are approaching record levels for the pandemic.

The department on Monday also reported 14 new cases among people who attended recent political rallies in Minnesota.

Kris Ehresmann, the department’s infectious disease director, said the number of confirmed cases linked with President Donald Trump’s outdoor rally in Bemidji on Sept. 18 had risen to 16, up from nine as of Friday, including four people who attended a protest. Three cases have been reported among people who attended Trump’s outdoor rally in Duluth on Sept. 30. Three people tested positive after attending a rally Sept. 24 with Vice President Mike Pence in a Minneapolis-St. Paul International airport hotel ballroom, including one who was among the Duluth rally cases. Two individual cases have been reported among people who attended Joe Biden campaign events in Duluth on Sept. 16 and Brooklyn Park on Sept. 22.

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Minnesota Eases Visits To Long-Term Care Facility Residents

Senior Investors Are the Focus of New “Principal Consideration” in FINRA Sanctions

On April 10, 2017, the Financial Industry Regulatory Authority’s (FINRA) National Adjudicatory Council (NAC) introduced new Sanction Guidelines (Guidelines) which allow the NAC and FINRA staff to take into consideration the vulnerability of customers in determining appropriate sanction levels.1 The last update to the Guidelines occurred approximately two years ago, and included changes related to unsuitable recommendations and misrepresentations.2 Last month’s changes to the Guidelines provide for the first time a “principal consideration that analyzes whether a respondent has exercised undue influence over a customer.”3 Now listed as a specific factor for adjudicators and FINRA staff4 to consider in determining appropriate sanctions is “[w]hether the respondent exercised undue influence over the customer.”5

I. New Guidelines Codify Past Practices and Apply Immediately

Prior to the new “principal consideration,” FINRA has historically acknowledged the vulnerability of customers in certain decisions.6 However, including customer vulnerability and a respondent’s undue influence over a vulnerable customer when analyzing sanctions has never been specified.

This new “principal consideration” applies to all FINRA cases immediately, unlike the recent senior investor-related rulemakings (new FINRA Rule 2165 (Financial Exploitation of Specified Adults) and amended FINRA Rule 4512 (Customer Account Information)), which are not effective until February 2018. The NAC and applicable FINRA staff can immediately take the new “undue influence” factor into consideration when adjudicating, prosecuting or negotiating disciplinary actions.

II. New FINRA Rule 2165 and “Undue Influence”

Neither FINRA Rules nor By-Laws define the term “undue influence.”7 Definitions in new FINRA Rule 2165 may help the industry to understand what it means for a respondent to “exercise undue influence” over a customer. The concept of undue influence arises in Rule 2165’s “financial exploitation” definition as “an act or omission . . . to . . . obtain control, through deception, intimidation or undue influence, over the Specified Adult’s8 money, assets or property.”9

It is possible that the NAC or FINRA staff may look to whether a senior investor was deceived or intimidated by the respondent, or whether the respondent exercised an inappropriate level of “control” over an investor given that investor’s mental capacity or the availability of a designated family member or friend. Presumably any influence over a customer’s decisions would only be considered “undue” if there was some level of deceit, self-dealing or other bad intent. However, this conclusion is not clear from the Guidelines.

III. Expect Continued Scrutiny of Firm Interaction with Senior and Vulnerable Investors

The senior-centric update to the Sanction Guidelines should come as no surprise. Over the past two years, FINRA has significantly increased its focus on senior investors, first with a joint report with the U.S. Securities and Exchange Commission in early 2015,10 followed closely by the launch of its Securities Helpline for Seniors,11 the topic’s rising prominence in the latest examination priorities letters,12 and most recently with the adoption of new FINRA Rule 2165.13 This scrutiny is expected to increase, with a focus on related sales practice examinations and subsequent enforcement actions.

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Senior Investors Are the Focus of New “Principal Consideration” in FINRA Sanctions

New model act from national organization hopes to end financial exploitation of seniors

NASHVILLE, Tenn. (WVLT) -- Tennessee hopes new guidelines from a national organization can help in preventing the financial exploitation of people 65 and older, or people who have an increased risk for diminished capacity or other cognitive impairments.

The Tennessee Department of Commerce & Insurance's (TDCI) Securities Division hopes the state legislature will pass a new model act from the North American Securities Administrators Association (NASAA).

The “Act to Protect Vulnerable Adults from Financial Exploitation” is a set of guidelines that NASAA hopes will “tackle a wide range of challenges confronting senior investors, regulators and securities industry professionals.”

In order for the model act to work in Tennessee, the state legislature will have to adopt the guidelines as law.

The act would help address several points of concern, like requiring records from brokers or advisers to provide records that could show suspected or attempted fraud and gives the brokers or advisers immunity for withholding disbursements if they suspect exploitation may be happening.

If enacted, the model act would only apply to people 65 or older and individuals who qualify for protection under a state adult protective services statute.

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New model act from national organization hopes to end financial exploitation of seniors