Within days, Georgians could be visiting their loved ones in nursing homes across the state, easing one of the most painful restrictions brought on by the year-long COVID-19 pandemic.
The Biden administration on Thursday said that with nursing homes’ vaccination rates increasing and new infections plummeting, most should reopen to visitors — with limits.
Nursing home advocates said new rules would be conditional on the state relaxing its own emergency bans on nursing home visitation, and a spokeswoman for Gov. Brian Kemp, Mallory Blount, said the governor intends to do that, clearing the way.
After that, the Department of Public Health is expected to lay out rules and procedures, nursing home officials say. The homes would then take a couple of days to acquire more masks and ramp up.
“We’re very glad,” said Ginny Helms, president of LeadingAge Georgia, which lobbies the Legislature on behalf of nonprofit organizations that provide housing and other services to the elderly.
“We felt like...the residents had been suffering from isolation which led to both physical and emotional hardships,” she said. “And families were very concerned because they couldn’t lay their eyes on loved ones. Right now everyone is very excited.”
“It’s huge,” said Tony Marshall, an advocate for Georgia nursing homes.
The visits should take place regardless of the vaccination status of a resident or visitor, if the nursing homes meet several conditions. Not all do.
First, for indoor visits, a nursing home would have to have 70% or more of its residents vaccinated. Most do, as vaccination acceptance has been very high among patients. Advocates say one of the primary reasons for that is that residents understood vaccination was key to getting their visitors back.
Second, for a facility to qualify for indoor visits, the surrounding community could not be among the most uncontrolled COVID-19 hotspots. The rules only relax for nursing homes in counties where less than 10% of COVID-19 tests come back positive. As of March 8, positivity rates were too high in 15 of Georgia’s 159 counties, Marshall said.
In addition, there would be several exceptions for residents who were in quarantine, or residents of nursing homes with outbreaks. If one person in a home tests positive, all visitation would have to be suspended until facility-wide testing assures there is no outbreak.
Among other caveats, there are recommendations. For example, while indoor visits are allowed, the guidance encourages a preference for meeting outdoors.
Added risks
Nursing homes have seen some of the earliest and most devastating outbreaks of the pandemic, and their elderly residents are more vulnerable to severe disease and death from the coronavirus than just about anyone. Implementing the lockdowns in many cases stemmed deaths and undoubtedly saved lives.
On the other side of that is the toll that isolation has taken on the senior residents, both emotional and physical. The accelerated deterioration of many patients with diseases such as Alzheimer’s is well documented.
In addition, families and friends play an important role in advocating for residents, seeing in person how they’re being cared for and speaking up or reporting to authorities if necessary.
Dr. Carlos Del Rio, a professor of infectious diseases at Emory University, is torn over the new guidance.
Residents need to see their loved ones, he said. But the guidance is clear that residents who are not vaccinated should also receive visitors in most cases, and that raises a host of concerns about enabling possible spread of the virus.
He is also concerned that unvaccinated family members could bring in disease to staff who are not vaccinated. While the majority of nursing home residents took the vaccine, nursing home staff were often reluctant and their vaccination rates are quite low.
Del Rio hopes frequent testing will be a part of the plan in order to catch potential outbreaks. He also hopes that rules will not just encourage, but require, distancing and masks for any meeting where someone is not vaccinated.
And if both the resident and the visitor have refused to be vaccinated? Del Rio paused and sighed. “The problem is you’re putting others at risk,” he said referring to the possibility for new outbreaks.
Collision course
The guidance does not affect hospitals, assisted living facilities or other senior care settings or health facilities.
But it would put the state’s nursing homes on a collision course with a proposed state law that would prohibit nursing homes and hospitals from limiting visits and has other provisions contradicting the federal guidance. The legislation, House Bill 290, proposed by Rep. Ed Setzler, R-Acworth, passed the House on Monday and is awaiting consideration in the Senate.
Even if a facility were having an outbreak, the Georgia bill would not restrict visitation. That puts the bill in direct conflict with the new federal guidance.
Nursing homes would be caught in between the two, and home would likely be forced to follow the federal guidance. Their advocates are anxious about that. “These types of things need to be driven by CMS (the U.S. Centers for Medicare and Medicaid Services),” said Helms.
Meanwhile, patients’ families are waiting to see their loved ones.
Lori Ballington of Woodstock is hoping to soon hug her mother-in-law, who lives in a memory care facility in Atlanta.
”Just to be able to touch her and give her the comfort she deserves,” said Ballington, who started to cry.
“I am not gong to jump up and down until I am in her room — and then I will excited,” she said.
Staff reporter Helena Oliviero contributed to this article.
Visitation guidelines
Indoor visits at nursing homes shouldn’t take place in these situations, federal government guidelines say:
• If less than 70% of residents are fully vaccinated or the county COVID-19 positivity rate is greater than 10%.
• If a resident to be visited has a confirmed COVID-19 infection and still may be contagious
• If a resident to be visited is in quarantine, whether vaccinated or unvaccinated
• If a new case of COVID-19 among residents or staff is identified, until at least one round of facility-wide testing is completed.
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