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

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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. 

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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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Long-term care facilities weighing how to safely allow visitors

Families call for change to visitor restrictions at state assisted living centers

by: Kevin Clark

AUSTIN (KXAN) — Stephanie Kirby remembers vividly the last time she visited her son at the state supported living center in Denton — it was March 12.

“I hugged him, kissed him goodbye, left him on the patio as he was drinking his chocolate milkshake,” she recalled. “Said, ‘See you later.’ And I didn’t see him later.”

As far as caregivers go, Kirby is as dedicated and involved as it gets.

But KXAN’s Investigative team has spoken with many families of residents in state institutions and nursing homes who are concerned for their loved ones’ well-being during the coronavirus pandemic.

Now, stories of isolation and mental deterioration fill a book mailed to Gov. Greg Abbott on Thursday.

The coalition of concerned families make up Texas Caregivers for Compromise, which is calling on the Governor to allow limited family visitation at these facilities, even if it’s just one designated family member.

The Governor’s executive order prohibiting visits also applies to the Denton State Supported Living Center, where Kirby drops off meals for her son at the front gate every Sunday.

She says she’s only been able to see him when he had to go to the hospital, twice this month. One of the trips was following a self-harming incident.

Petre Kirby, 28, has been living at the
 Denton State Supported Living Center
 for more than three years
(Courtesy of Stephanie Kirby)

“He’s lost weight, he looks stressed, he looks anxious,” Kirby said. “A mom can see.”

Petre Kirby is 28 years-old but functions mentally like a three-year old, his mom tells us.

She says Petre is nonverbal and has been known to harm himself.

He’s among the 3,000 or so Texans with intellectual disabilities who live at the state’s 13 state supported living centers. One of the locations is a sprawling, 95-acre campus in Austin.

Kirby has written one letter to Gov. Abbott every day calling for limited visits. Thursday is day 133.

“I said: ‘Let Petre see me in the middle of a wide open field, let him just see that I still exist, that mom hasn’t abandoned him,” she said.

The Associate Commissioner of all state supported living centers emailed Kirby and reiterated the decision was up to the Governor.

“It is my understanding our Regulatory Division has developed some guidelines for review by the Governor’s Office,” the email reads. “I hope we hear something soon.”

But that was a month ago.

“There’s no way anyone could explain to him what happened, and why his mom vanished off the face of the earth and has never returned,” she told us.

Legislators speak up

As our team investigated, we learned of a new letter signed by 55 Texas Senators and Representatives, highlights the concerns about isolation of the most vulnerable Texans who are in state-run institutions.

The letter, sent to Health and Human Services Commissioner Phil Wilson and obtained by KXAN Thursday, asks for an immediate plan to allow limited family visits at assisted living centers.

It predominately refers to residents with memory and mental deficiencies who don’t understand their lockdown status.

“Many cannot understand a virtual visit, and simply look down the hall for their loved one when they hear their voice on an electronic device,” the letter reads.

It adds: “The consequences, as we are sure that you are aware, can be deadly. Hopeless depression and anxiety are quickly leading to failing physical health among these precious and vulnerable people. We have already lost too many to these policies, and more are on the way.”

A spokesperson with Texas Health and Human Services tells us the agency would continue to explore ways to keep families in close contact with each other while the Governor’s order is in effect.

We understand the current policies have been difficult for many parents and guardians, as well as the people we serve, during this pandemic,” she said.

KXAN’s team has also reached out to Gov. Abbott’s office for the last three days, asking about visitation restrictions and when there could be any changes.

As of Thursday evening, KXAN has not heard back.

“COVID is not the only danger to our loved ones,” said Kirby. “There’s the mental damage, the emotional damage, the deterioration.”

“I’m not a visitor. I’m an essential part of his life. I’m his mom.”

KXAN’s Ben Friberg contributed to this report.

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Families call for change to visitor restrictions at state assisted living centers