SHERIDAN — Until the rate of community spread of COVID-19 in Sheridan County drops, seniors living in local assisted living facilities will not be able to have indoor visitors even as temperatures drop this winter.
“There has been discussion about indoor visitation, however the last I’ve heard, that is dependent on your community’s positivity rate,” said Tanya Murner, executive director of Westview Health Care Center.
As of Friday morning, Sheridan County had a total of 358 lab confirmed positive cases, for an increase of 22 cases over the previous 24 hours. The total number of tests in the county sat at 12,332 as of Friday afternoon, and Sheridan County has had four COVID-19 related deaths.
Among adults, the risk for severe illness from COVID-19 increases with age, with older adults at highest risk, according to the Centers for Disease Control and Prevention. Across the nation, nursing homes have been severely impacted by COVID-19, with outbreaks causing high rates of infection, morbidity and mortality. The vulnerable nature of the nursing home population, combined with the inherent risks of congregate living in a health care setting, have required aggressive efforts to limit COVID-19 exposure and to prevent the spread of COVID-19 within nursing homes, according to the Center for Medicare and Medicaid Services.
According to a Sept. 17 report by the CMS, a “low” rate of community COVID-19 activity is 5%, a “medium” rate is 5-10% and a “high” rate is anything higher than 10%. Facilities across the nation have been directed to use Medicaid’s “activity rates” to determine if and when to allow indoor visitation. If activity is low, visitation can occur if visitors wear masks, visit on a limited basis and only if there has been no new onset of COVID-19 cases in the facility within 14 days, among other guidelines. However, if the community activity is considered high, or above 10%, CMS recommends visitation only occur in compassionate care situations.
“We are all doing OK. It is difficult, but we are doing outdoor visitation,” Murner said. “There are still limits on that, so it is a little bit difficult. We do have to keep the 6-foot distance, and the visits have to be supervised. The length of the time, there are all sorts of limitations that are in place because of that.
“I’m hoping that our positivity rate will go down so that we can move to indoor visits, because that is so important to all of our residents. They miss their families,” she continued.
Michelle Craig, administrator at Green House Living for Sheridan, said that her staff schedules two “visit” days a week for outdoor visits, which are regulated. Visitors must wear personal protective equipment, maintain social distancing and staff must be present.
“But we do our best to keep it open. We try to be flexible with our time to permit people to come in, while also allowing people to see their loved ones,” Craig said, adding that each cottage is equipped for Zoom visits and telephone calls.
Westview has the technology for virtual visits as well, and both facilities offer “window visits” where family members can stop by the facility and wave from outdoors.
“That can be hard, when they are trying to talk to each other through a window but we do have cordless phones,” Craig said. “We do have people with dementia and there are challenges getting them to remember what is going on during the visitation.”
Murner said that if a resident does not live near a window, staff will take them to a main area to see their family outside. Life inside the facility is easing up just a bit, she said, and the state is starting to let communal dining and activities take place.
“You still have to have that 6 feet distance, and if residents are going to be close, they need to wear masks,” Murner said. “That can be difficult, with those residents who are more confused or don’t understand, or are on oxygen.”
Often during the fall and winter holidays, community members visit local assisted living facilities to show off Halloween costumes, to hand out cards or to sing Christmas carols. Unless the community positivity rate goes down, the holidays will likely be different this year.
“I do know that the higher our community spread, and the higher the positivity rates, the less likely the nursing homes are going to be able to get back to some sort or normalcy,” Murner said. “I get asked by the residents all the time, they want to go back to the way it was. I absolutely do too.”
Murner said Westview would happily accept cards from the community, or window decorations. When it snows, she suggested bringing a group to build a snowman in front of the facility.
“Right now, they look out the window and they see animals but it is going to get colder and they are not going to see the birds and the turkeys and the deer,” she said. “Anyone interested can drop off cards or pictures and we would be happy to distribute them, or they can call our activities department and talk to our activities director about scheduling so we can have an idea when your group might want to come up.”
Tammy Yelton-Boone, executive director of Elmcroft of Sugarland Ridge, said residents who live at Sugarland Ridge would also love to receive cards or letters this fall and winter. Craig suggested word puzzle books or book donations, or any solo activities that would keep residents’ minds active.
“In the beginning, there were people who came out and they put hearts on the windows … that has kind of fizzled out a little bit,” Murner said. “Anything would still be very much appreciated by our residents and our staff as well. Sometimes it can be a bit challenging, but our staff has done a wonderful job.”
Craig urged the public to help decrease community activity, explaining that that would be the best morale booster her residents.
“My words to the public would be to take the recommendations of face masks and good hygiene seriously, because the Centers for Medicare and Medicaid Services has passed a rule about permitting indoor visitation, but now we can’t (allow it) because of how high the county positivity rate is here,” Craig said. “If we can get that down, we can have families visit in a limited capacity.”