DPH announces new COVID-19 guidelines allowing visitation at long-term care facilities

by: Alex Ceneviva, Kent Pierce

HARTFORD, Conn. (WTNH)– Governor Ned Lamont and the Department of Public Health have released new COVID-19 guidelines for visitation at long-term care facilities.

The newly issued directive, which is from the Centers for Medicare & Medicaid Services (CMS) and the Connecticut Department of Public Health (DPH) Acting Commissioner Deidre S. Gifford MD MPH, rescinds the previously issued orders that limited visitation at those long-term care facilities, which included nursing homes.

Those orders were issued to protect the residents from the COVID-19 pandemic, but as of Monday, the new guidelines mean that long-term care facilities in the state are permitted to resume indoor visitation effective immediately, provided that certain conditions are met.

Those conditions, according to the DPH, include “that there has been no new onset of COVID-19 cases in the last 14 days and the facility is not currently conducting outbreak testing. Indoor visitation will be suspended if there is a positive COVID case among staff or residents.”

Facilities and visitors also must adhere to the following conditions:

• Screening for all who enter the facility;
• Hand hygiene recommendations;
• Personal protection equipment as applicable;
• Social distancing requirements;
• Instructional signage throughout the facility;
• Cleaning and disinfecting high frequency touched surfaces in the facility;
• Effective cohorting of residents as applicable;
• Visitors should be able to adhere to the core principles and staff should provide monitoring for those who may have difficulty adhering to core principles;
• Facilities should limit the number of visitors per patient at one time and limit the total number of visitors in the facility one at a time (based on the size of the building and physical space).
• Facilities should consider scheduling visits for a specified length of time to help ensure all patients are able to receive visitors; and
• Facilities should limit movement in the facility. For example, visitors should not walk around different halls of the facility. Rather, they should go directly to the patient’s room or designated visitation area.

Governor Lamont released the following statement on the new guidelines:

“Making the decision to limit in-person visits at nursing homes is one of the hardest things I’ve had to do as governor, but amid the outbreak of this pandemic that is impacting the lives of so many people in our senior population, I knew it was the right thing to do. Each facility is strongly urged to develop a visitation plan and strictly adhere to it to the greatest extent possible so that we can keep this virus from spreading and impacting our most vulnerable patients.”

Governor Ned Lamont

Acting DPH Commissioner Gifford also released a statement:

“With this new guidance from the federal government, indoor visitation is now allowed in nursing homes under specific conditions. I urge nursing homes to work closely with family members to arrange for the type of visitation that is most appropriate for each resident’s physical, mental and psychosocial wellbeing. There will be protocols in place to make sure the visitation is as safe as possible, including personal protective equipment to limit the spread of COVID-19 among our most vulnerable population.”

Acting DPH Commissioner Deidre S. Gifford, MD MPH

You can read the full release on the new guidelines from the DPH below:

https://www.wtnh.com/wp-content/uploads/sites/100/2020/09/CIACAlternativeCompetitionSeasonandFallFootballActivitiesGuidance-Media.pdf

 

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DPH announces new COVID-19 guidelines allowing visitation at long-term care facilities

People in long term care ‘dying of isolation,’ Georgia group tells governor

Georgia Caregivers for Compromise

Photo of Betty

Kristian Hugo can’t hide her love for her “granny,” Betty, who is in a long-term care facility in St. Marys.

“Words can’t do it justice,” Hugo said. “She’s always been a caregiver. She’s always taken of, even as a little girl, she would go take care of the elderly.”

Click to Watch Video

Hugo is frustrated and worried since the pandemic has locked her and others out of the facilities where their loved ones live.

“It’s hard when you’re hearing, you know, the talks of theme parks opening and sports and schools,” she said. “Where are we talking about our homes that, you know, our loved ones have been in for five months in isolation?”

Hugo and Maxine Williams, her aunt, are both with Georgia Caregivers for Compromise. Williams is the administrator. A letter the group wrote to Gov. Brian Kemp reads in part:

”Our loved ones are dying of isolation and loneliness and it has to stop. While we appreciate the efforts to save them from the virus, there comes a point when the effects of isolation are more deadly than the risk of contracting COVID-19.”

The organization is asking the state for:

• A point of contact within the administration so they can make “informed decisions based on facts, not hopeful speculation”
• A plan for reopening facilities “in a safe, smart, step-by-step way”
• The implementation of an essential family caregiver designation program “that’s currently being implemented in Minnesota and Indiana”

Hugo says she misses the little things, like just “being there” for her granny. But she says speaking out is what she can do for her and others.

“They need us and they don’t have the voice,” Hugo said. “They don’t have the voice to tell everyone that they need us to be there and some of them, the ones with Alzheimer’s or they have dementia or are mentally incapacitated, they cannot look through a window at their loved one. They just don’t understand. It isn’t enough. They need their touch, and they need to hear their voice.”

The group is asking for Kemp to announce a plan by Aug. 3, but so far, the the group says it hasn’t received feedback from the governor.

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People in long term care ‘dying of isolation,’ Georgia group tells governor

CMS Issues Updated Guidelines, Clarifications on Nursing Home Visitations as States Reopen

By Alex Spanko

The Centers for Medicare & Medicaid Services (CMS) on Wednesday released an updated set of frequently asked questions designed to encourage safe visitation of residents in nursing homes.

While the federal government has largely left the decision to reopen nursing facilities up to the states, CMS emphasized that it supports safe visitation efforts — while also clarifying that aspects of the original ban, issued in March, may not be as strict as some facilities have interpreted.

“We are all aware of the emotional toll that the visitation restrictions and limitations have placed on not only nursing home residents but their families and loved ones,” Evan Shulman, director of CMS’s nursing home division, said on a Wednesday call with industry stakeholders. “Since we first issued the first memo on visitation back in March, though, we have learned a lot more — and anything we can do to bring residents closer to their loved ones we want to be able to do. However, we also want to make sure it can be done safely.”

For instance, CMS took pains to note that the “compassionate care” exemption to the ban on non-essential visitors does not only apply to end-of-life situations.

“For a resident who was living with their family before recently being admitted to a nursing home, the change in their environment and sudden lack of family can be a traumatic experience. Allowing a visit from a family member in this situation would be consistent with the intent of the term ‘compassionate care situations,'” CMS observed. “Similarly, allowing someone to visit a resident whose friend or family member recently passed away, would also be consistent with the intent of these situations.”

That said, CMS warned that such visits should not be conducted on a routine basis, and left the final decision up to local officials.

“CMS cannot define each situation that may constitute a compassionate care situation,” the FAQ reads. “We encourage facilities to consult with state leadership, families, and ombudsman, to help determine if a visit should be conducted for compassionate care.”

CMS signaled its approval of outdoor visits, which many states have adopted as part of their reopening plans, and also suggested that operators can develop indoor “safe spaces” with see-through walls or other means of visual contact without touching or air contamination.

The agency also emphasized that rules regarding ombudsmen’s interactions with residents have not been suspended during the pandemic; under the Social Security Act, operators must grant state long-term care ombudsmen “immediate access” to nursing home residents upon request.

While facilities can prevent in-person ombudsman visits due to infection-control issues, operators must provide telephone or electronic access for ombudsmen, CMS advised.

“Since ombudsmen are critical resources for residents and their families, nursing homes should facilitate their in-person access as soon as is practicable,” the agency noted.

CMS issued a blueprint for reopening nursing homes back in May, with universal testing of residents a prerequisite for even starting the process.

States still retain the final say on when to grant nursing homes the blanket ability to begin receiving visitors, and individual facilities may remain on lockdown if conditions in the community or specific building are deemed unsafe.

In general, CMS only recommends reopening properties to the public when a state or region enters phase three of its multi-step protocol, with no new COVID-19 cases in the nursing home for 28 days — along with sufficient staff, personal protective equipment (PPE), access to testing, and capacity at area referral hospitals.

The new FAQ also emphasizes that group activities can occur with the proper precautions.

“Facilities may be able to offer a variety of activities while also taking the necessary precautions,” the document reads. “For example, book clubs, crafts, movies, and Bingo are all activities that can be facilitated with alterations to adhere to the guidelines for preventing transmission.”

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CMS Issues Updated Guidelines, Clarifications on Nursing Home Visitations as States Reopen

Isolated during the pandemic, seniors are dying of loneliness and their families are demanding help

By Christopher Magan

Minnesota’s efforts to protect its most vulnerable residents during the coronavirus pandemic is also having an unintended consequence — the isolation is killing some of them.

“Families are literally watching as their loved ones die of loneliness,” said Kristine Sundberg, executive director of Elder Voice Family Advocates. “We know full well, isolation has a significant impact on both physical and mental well-being.”

Sundberg and other advocates for seniors and vulnerable adults say the recent guidance the state Department of Health released for window and outdoor visits doesn’t go far enough. After more than three months in isolation, long-term care residents desperately need contact with their loved ones, they said.

“So many of our families are just desperate to see their people, especially those with memory issues,” Sundburg said. “We are seeing serious impacts. We need to figure this out. We need to help families get together.”

Three Minnesotans, all in their 90s, who died in early June had “social isolation” listed as a cause of death or contributing factor on their death certificates. Only one of them had tested positive for COVID-19, but all three lived in long-term care facilities that have been ordered to restrict outside visitors to protect residents from the coronavirus.

Stella D. Fadden, 99, and Chester E. Peske, 98, both died June 2 at Copperfield Hill – The Lodge in Robbinsdale. Both were struggling with Alzheimer’s and while only Peske tested positive for COVID-19, the coronavirus was also suspected as a contributing factor in Fadden’s death.

The third fatality, Forest D. Lehman, 90, died June 4 at Ecumen Prairie Hill in St. Peter. Lehman also struggled with Alzheimer’s disease and while he was not suspected to have the coronavirus, “failure to thrive” due to isolation because of COVID-19 restrictions was listed as the chief cause of death.

Family members of the three who died due to social isolation were unable to be reached at press time.

Ashley Fjelstad, who oversees licensing and compliance for Copperfield Hill, said as soon as they learned isolation was listed as a cause of death for two of their residents, they were “very concerned” and immediately contacted Allison Fiedler, the certified practical nurse who certified the residents’ death certificates.

Fjelstad learned that Fiedler determined isolation played a role in the residents’ deaths because they had lost interest in eating and slept constantly after having their routines disturbed during the pandemic.

“We already knew a change in routine is tough, especially for people with dementia,” Fjelstad said, noting that residents still had regular contact with staff, but their interactions with family and other residents was curtailed. “Their daily routine is what was upended, more so than any type of complete isolation.”

State officials said listing “social isolation” as a cause or contributing factor in someone’s death was unusual. They noted that the Centers for Disease Control and Prevention did not recognize social isolation as a cause of death in its vital statistics manual.

Health officials said a search of Minnesota death records did not find other references to social isolation as a cause of death.

“We absolutely know social isolation and emotional disconnectedness is a major health concern in its own right,” said Jan Malcolm, state health commissioner. “The separation that has happened for residents of long-term care facilities and their loved ones is one of the most heartbreaking things about the epidemic.”

Malcolm noted that the state Department of Health recently announced guidelines for visiting long-term care residents at their windows and outside. Window visits became common for some during the pandemic and outdoor visits are the latest step state officials have taken to address seniors in isolation.

Malcolm acknowledged that those types of visits may not be enough for long-term care residents and their families. But health officials warn that further contact comes with inherent risks and they want to do it as safely as possible.

“It is a tricky balance to strike,” Malcolm said.

Dustin Lee, president of Prairie Senior Cottages, agrees it is a tough balance, but he says it can be done. Prairie Senior Cottages has seven locations across rural Minnesota and caters to seniors needing dementia care.

“I do think opening up to visitors will open up exposure,” Lee said, but he added that the risks need to be balanced against the benefits for residents.

Prairie Senior Cottages sites have worked hard to avoid exposing residents to the coronavirus. But Lee says the separation of families is causing trauma for both seniors and their loved ones.

“Untreated trauma leads to long-term health consequences,” he said. “We have to find some kind of balance.”

In addition to window and outdoor visits outlined by the state Department of Health, operators of long-term care facilities and advocates for residents are trying to figure out safe ways for families to visit.

That would likely include separate spaces inside long-term care facilities where families and residents could spend time together. State officials have yet to offer any guidance on how such visits may occur.

Without that kind of contact, advocates fear more residents will die of loneliness.

“They need to listen to families. … This is literally killing people,” Sundburg said.

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Isolated during the pandemic, seniors are dying of loneliness and their families are demanding help

Is Elder Abuse the Real Nursing-Home Crisis?

by Andrew Moran

Long-term care facilities are now ground zero in the fight against the Coronavirus pandemic. As health authorities focus on containing the highly infectious respiratory illness, the public is learning of another outbreak that has been festering inside these nursing homes for years: elder abuse. It is estimated that more than five million seniors are abused in some form every year at these establishments. The latest clip of a suspect viciously assaulting a defenseless senior may have been the catalyst to trigger public outcry and demand some type of intervention.

Westwood Nursing Center

President Donald Trump recently reacted to a shocking viral video that showed a 20-year-old male suspect beating an elderly patient at the Westwood Rehabilitation Nursing Center in Detroit, MI. The culprit had been diagnosed with the Coronavirus and was transferred from Ann Arbor hospital to the facility. The individual was arrested, and a lot is still unknown as to why or how he was moved to Westwood. The 75-year-old victim is recovering in Sinai-Grace Hospital, and his family accused the center of “dropping the ball.” A police investigation into the incident is ongoing, and the nursing home is performing an independent probe to find out what happened.

But it has sparked a broader conversation on a system that Diane Menio, the Executive Director of the Center for Advocacy for the Rights and Interests of the Elderly (CARIE), calls “fragile.” With COVID-19 igniting a lot of panic and creating plenty of confusion throughout the health care sector, the industry might be ill-equipped to endure the public health crisis, potentially increasing abuse or neglect.

The State of Nursing Homes

Lori Smetanka, the Executive Director of the Consumer Voice, an advocacy group for quality long-term care, says the abuse of elders is tragic, and it often goes underreported.

“Families place their loved ones in long-term care facilities with the expectation that they will be safe and well cared for,” Smetanka said in an interview with Liberty Nation.

Although figures from the Adult Protective Services (APS) show that there has been an increase in the number of reported abuses, experts say many seniors are unable or unwilling to report their cases. Of the reported instances, the data have highlighted staggering findings about the state of nursing homes. One study from the National Center for Victims of Crime found that as many as 10% of self-reported elder abuse is physical, 60% is verbal, and 14% is neglect.

All 50 states have implemented anti-elder-abuse laws, but a Government Accountability Office (GAO) report discovered that state regulators had missed signs of abuse. A two-year congressional investigation also uncovered that about one-third of nursing homes were cited for violations that had the potential to inflict harm on residents.

What is going on? Diane Menio explains that you cannot point to one specific cause of the myriad of systemic challenges facing nursing homes today, which range from inadequate training to insufficient compensation for staff. While funding could enter the conversation, she does not believe it is the primary factor.

She tells Liberty Nation:

“There are so many systemic issues with long-term care. First of all, the training requirements are not sufficient. Certainly, some people may go above and beyond what their requirement is. They also might be compassionate, caring people who would never consider abusing someone. But then the fact that you’re paying people low salaries, you’re not providing the adequate training limits your pool of people to hire. What does that do? It can cause some of these problems.”

“We need to do better,” Manio said.

It might be an objective difficult to achieve during the outbreak because of a new problem that could limit accountability and transparency in the short-term: Nobody is allowed inside. The CARIE representative warns that regulators have not been permitted inside, although these restrictions have eased in multiple states in recent weeks.

“It is a time when you could imagine people are vulnerable, staff are stressed, and management may not be able to oversee things as well as they might otherwise. Regulators aren’t there, advocates aren’t there, families aren’t there,” she noted, adding that families are the best people to be there.

For those shocked by the state of the industry, it could be easy to think that this situation is only prevalent in the U.S. Elder abuse and dilapidated conditions inside these places are global problems.

An International Crisis

In Canada, approximately 80% of COVID-19 deaths have been in long-term care (LTC) facilities. The province of Ontario requested assistance from the Canadian Armed Forces (CAF) to help get the pandemic under control. During this time, officials performed an extensive probe into the state of the province’s long-term care homes and published a report that Premier Doug Ford called “gut-wrenching.”

The military discovered numerous examples of residents bullied, drugged, and left for hours and even days in soiled bedding. The overall conditions of the province’s LTC facilities were astonishing, too. One assessment of a nursing home reported “cockroaches and flies present,” the smell of “rotten food” in the hallway, and “multiple old food trays stacked inside the bed table.” The CAF concluded that “respecting the dignity of patients is not always a priority.”

Prime Minister Justin Trudeau described the report as “disturbing.”

“On reading the deeply disturbing report, I had obviously a range of emotions of anger, of sadness, of frustration, of grief. It is extremely troubling, and as I’ve said from the very beginning of this, we need to do a better job of supporting our seniors in long-term care right across the country, through this pandemic and beyond.”

In June 2018, the World Health Organization (WHO) published a report in which it forecast that elder abuse is likely to increase in many nations due to rapidly aging populations. At the same time, WHO states that “too little is known about elder abuse and how to prevent it, particularly in developing countries.”

What are the solutions?

Nurses and Families

A long-term remedy for ensuring the health and safety of society’s most vulnerable people requires both the retirement residence and patients’ families, states Lori Smetanka. Nursing homes must ensure they maintain adequate policies and procedures to protect and prevent residents from abuse, while families can hold everyone accountable and pay attention to their loved ones.

“They need to ensure that they can adequately care for any individual they admit, which includes providing all necessary services, including mental health services. Additionally, having adequate numbers of staff on hand is critical to not only ensuring that each resident’s needs are met, but also as a way of monitoring what’s going on in the facility, including frequently checking in on residents.”
Families can help protect their loved ones by being in regular communication with facility staff, asking questions about the numbers of staff providing care as well as the steps the facility takes to protect residents from abuse. They also should pay attention to their loved one and notice any changes in behavior, physical changes, or unexplained injuries. Raise any concerns with the administration immediately, and contact your long-term care ombudsman program for assistance.”

Indeed, many different types of elder abuse may be hard to notice. Over the years, it has been discovered that senior residents are victims of unwanted sexual attention, psychological abuse (criticizing, humiliating, and yelling), and financial exploitation. There has also been a slight uptick in resident-to-resident abuse, but Manio points out that this is rare due to patients’ physical health.

For families that are not with their loved ones around the clock, how could you detect signs of nursing home abuse? In addition to finding fractures or bruising, some of the other physical indicators could include frequent infections, bedsores, unexplained weight loss, and poor hygiene. There could also be a myriad of non-physical clues, such as emotional outbursts, reclusiveness, changes in mental status, and caregivers not wanting patients to be left alone with others.

The Future of Nursing Homes

Could retirement communities – public and private – experience a complete overhaul on the other side of the lockdown or will their fundamental problems be swept under the rug? Like so many other challenges facing the U.S. and the rest of the world, the Coronavirus has exposed the dire situation occurring in long-term care facilities. Many folks in charge may pay lip service to the issue, but time will tell if they will start taking the problem seriously. Time is, unfortunately, not something too many seniors in these establishments possess.

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Is Elder Abuse the Real Nursing-Home Crisis?

Habersham Medical Center responds to DCH nursing home report

Habersham Home West

Editor’s Note: The following press release was issued by Habersham Medical Center Wednesday in response to a report from the Department of Community Health showing that 47 of its 62 nursing home residents have tested positive for COVID-19. Ten Habersham Home residents have died.

Habersham Home is the licensed, 84-bed skilled nursing facility operated by Habersham Medical Center (HMC). The facility has two locations on HMC’s campus. Habersham Home East is located inside of the hospital, and Habersham Home West is located in a separate building adjacent to the hospital.

As concerns began escalating about the coronavirus pandemic in early March, HMC was one of the first hospitals in Georgia to make swift and decisive decisions to safeguard Habersham Home residents and staff.

Through intense education, screening, monitoring, and infection prevention management, the hospital enacted a series of aggressive measures to limit exposure and transmission of COIVD-19. One of the first policies implemented was a “No Visitors” stance, meaning no outside visitors were permitted on campus to visit patients in the hospital or residents of the nursing home. This stance is still in place until further notice.

Additionally, and in adherence to guidance provided by the American Health Care Association (AHCA), the National Center for Assisted Living (NCAL), the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC), Habersham Home began and continues to screen employees, healthcare providers, vendors, consultants, contractors and others who provide care and services to Habersham Home residents.

Before HMC confirmed its first COVID-19 positive case at Habersham Home, hospital leadership enlisted the National Guard in mid-April to sanitize and disinfect Habersham Home. This is a service the National Guard has offered to over 200 nursing homes in Georgia.

Despite every effort and safeguard put in place, transmissions of the virus began impacting both residents and staff of Habersham Home. Unlike the majority of long term care facilities in Georgia and across the country, as the number of COVID-19 positive cases began escalating, Habersham Medical Center took an aggressively, proactive approach to test every resident and staff member of Habersham Home regardless of symptoms. Habersham Medical Center was one of the first hospitals in the state to take this approach which yields a more accurate impact of COVID-19 and provides an exact number of how many people are actually affected.

HMC enlisted the National Guard to facilitate the testing that was conducted on May 13, 2020. 151 tests were administered. The test results were analyzed by the Georgia Department of Public Health (DPH) and the results concluded that 47 of the 62 residents at Habersham Home tested positive for COVID-19.

More than 50% of the residents were asymptomatic at the time of the testing, meaning they did not show any symptoms of illness. Family members were notified immediately.

Throughout HMC’s response to COVID-19, ten residents who were COVID-19 positive have passed away. While these residents were positive, their deaths cannot be directly attributed to the Coronavirus as several were receiving hospice care. It is important to emphasize that, statistically, the Habersham Home death rate is relatively flat despite the continued threats associated with the Coronavirus.

As a part of the National Guard’s testing efforts, 41 of 89 Habersham Home employees tested positive for COVID-19. Again, over 50% of the employees were asymptomatic. According to guidelines provided by the Georgia Department of Public Health, these employees will quarantine at home for 10 days.

National Guard members disinfect a
public area at a nursing home in
Southwest Georgia.  (photo courtesy
Georgia Army National Guard)

Following the testing conducted by the National Guard, HMC has been working closely with the DPH and, together, have developed a comprehensive response plan which has three key components related to staffing, facility sanitization, and testing.

To ensure Habersham Home is equipped to provide exceptional quality healthcare with the federally mandated staff-to-resident ratio, HMC will access and utilize state provided staffing resources. HMC is also redeploying clinical staff from the hospital to cover shifts at Habersham Home as needed. 

Hospital leadership has also reengaged the National Guard to conduct widespread sanitizing and disinfecting of both Habersham Home East and West. HMC will continue to aggressively and frequently test all residents and staff.

“As the world continues to grapple with the Coronavirus Pandemic, the elderly will continue to be a vulnerable population to this extremely contagious disease,” says Tyler Williams, Habersham Medical Center’s incoming Chief Executive Officer. “However, protecting our residents’ health and safety is our top priority and we will take every possible measure to minimize any potential exposure to the virus.”

“While universal testing of all residents and staff is not being conducted at all long-term care facilities, HMC leadership stands behind this method as it is the most effective known strategy to use to determine the true impact of COVID-19. Having this data will guide the hospital’s response to the COVID-19 crisis,” says Williams.

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Habersham Medical Center responds to DCH nursing home report

Coronavirus In Minnesota: Housley Calls For Transparency On Care Facilities With COVID-19 Cases

MINNEAPOLIS (WCCO) — A Republican state senator is calling for officials to disclose the names and locations of the long-term care facilities in Minnesota where residents or staff have tested positive for COVID-19.

Karin Housley, the chair of the Senate Family Care and Aging Committee, issued a statement Wednesday, urging Gov. Tim Walz and the Minnesota Department of Health to release those details to the public going forward.

“As Minnesotans confront a new reality, access to information is critical as we make decisions for ourselves and our loved ones,” she said. “We must make full disclosure the standard in Minnesota, just as they have done in Colorado, Oregon, and other states hit by the coronavirus.”

Currently, the Minnesota Department of Health reports daily on the number of COVID-19 cases in the state by county. However, it does not release information on the precise location of these cases. Health officials say providing those precise details is against the law, as it would violate the Health Insurance Portability and Accountability Act (HIPA).

So far, COVID-19 has killed 17 people in Minnesota, 11 of whom were residents in long-term care facilities, The Star Tribune reports. Additionally, health officials have confirmed that more than 50 residents and staff in long-term care facilities have tested positive for the coronavirus.

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Coronavirus In Minnesota: Housley Calls For Transparency On Care Facilities With COVID-19 Cases

State: Patient advocates in short supply at long-term care facilities

By Daniel Axelrod

New York and the mid-Hudson are critically short of volunteers to help police nursing homes, according to a new report by state Comptroller Thomas DiNapoli’s office.

The region and the state lack both volunteer and full-time paid ombudsmen, according to the comptroller, who defined the mid-Hudson as Orange, Dutchess, Ulster, Sullivan, Greene and Columbia counties.

Among other duties, New York’s ombudsmen identify, investigate and resolve complaints made by or on behalf of the 160,000 residents living in 1,500 long-term care facilities, including those in nursing and adult homes.

DiNapoli’s auditors found that, as of January, only about 600 of the state’s long-term care facilities had an assigned volunteer ombudsman, leaving the remaining 900 to be covered by just 50 paid full-time ombudsmen. That’s about half the minimum number of full-time staff recommended by state guidelines.

Locally, 40 of Orange County’s long-term care facilities were without an ombudsman as of January, while those tallies were three for Sullivan County and five for Ulster County. And the mid-Hudson’s full-time ombudsmen office had three full-time staff members in 2018 or one-and-a-half fewer than the state recommends.

Without ombudsmen, long-term care facilities’ residents and families can still call a state hotline to make complaints.

But, “Volunteers are desperately needed to make sure the elderly are protected and that they do have someone to go to with these complaints” in person, said Mark Johnson, a DiNapoli spokesman.
Part of the problem is that New York’s volunteer ombudsmen total has plummeted in recent years, falling 37 percent to 562 in 2018 from 890 in 2015.

That decline is attributable to several factors, said elder care expert Richard Mollot, who runs the Long Term Care Coalition, a nonprofit advocacy group. The state also subcontracts with his group to handle the mid-Hudson’s ombudsmen program.

In recent years, the state reorganizing and reducing the number of local offices for ombudsmen is partly responsible for the loss of volunteers, who’ve been asked to cover more disparate areas, Mollot said. The move was done to help the state comply with new federal requirements.

The state’s 15 ombudsmen offices, nearly all of which are run by nonprofits subcontracted by the state, also have spent recent years working harder to ensure volunteers are visiting facilities and logging time collecting complaints, Mollot said.

Those accountability, transparency and training requirements have contributed to a loss of volunteers, Mollot added, some of whom were more like “candy-striper” hospital volunteers, who made occasional visits rather than acting as strong advocates for long-term care facilities’ residents.

DiNapoli’s audit also cited the job’s challenges — volunteers being exposed to neglect and abuse — and the lack of pay. The mid-Hudson’s ombudsmen program has been experimenting with a pilot stipend program.

In terms of a lack of full-time staff locally and statewide, Mollot said the state just isn’t funding ombudsmen programs well enough.

“The answer is more paid staff and funding” for regional ombudsmen offices to hire full-timers, while recruiting and training more volunteers, Mollot said. “The ombudsmen are absolutely critical to protecting the elderly in nursing homes and in assisted living.”

Joe Guyt, 55, of Central Valley, who’s part of a class-action lawsuit filed against the Sapphire Nursing Home in Goshen over the March 2018 death of his 84-year-old mother, said he didn’t even know the facility had an ombudsman.

“Clearly, we need someone to better police these facilities,” said Guyt, who also serves on U.S. Rep. Sean Patrick Maloney’s public committee to improve local elder care.

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State: Patient advocates in short supply at long-term care facilities