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Are Nursing Homes Being Held Accountable During The Coronavirus Outbreak? Industry Representatives Say Yes, While Family Advocates Worry That's Not The Case

A young woman sits at the bedside of an elderly woman. The young woman holds the elderly woman's hand.
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The Agency for Healthcare Administration regulates Florida’s nursing homes and assisted-living facilities. On May 12, the agency reported conducting more than 1,400 onsite visits to these facilities since the pandemic began.

The state is requiring nursing homes and assisted-living facilities to bar visitors from entering to prevent COVID-19 from spreading. Family advocates say that cuts out some of the key people who hold these facilities accountable. However, industry representatives argue, residents have more eyes on them now than ever as state teams enter facilities to help stop the spread of the coronavirus.

Lori Danello Roberts' mother lives in a Tallahassee assisted-living facility. The state rule blocking visitors from entering means Roberts has had to find new ways to communicate with her mother—like FaceTime.

"When we had to go to FaceTime, there was really no communication. We could sit and watch her, but she would just look at the people around her. She didn't understand it," Roberts says.

Recently, the facility has allowed visitors to stand outside a resident's window and look in. So Roberts and her father did that.

"She saw my father for the first time and just kept eyes on him and wouldn't let them off, and then she reached out and touched the window, and he touched the window, and it was really beautiful, of course, my eyes filled with tears," Roberts says.

Roberts says these window visits are making all the difference in the world, and she's excited for the next time she can see her mother this way. However, not all families have that option. Brian Lee, with Families For Better Care, says he's heard concerns from many people with relatives in nursing homes and assisted-living facilities.

"Families are having a difficult time getting ahold of someone at the facility to ask about their loved one, and when they do, they're not hearing back from either the caregivers, the nurses, or whoever—the supervisors they need to talk to about their loved ones' care. They're not getting that communication back, and it's very difficult for people to get answers." Lee says.

Scott Gwartney is an attorney who handles nursing home litigation. He says people have called him about facility staff not wearing masks.

"I talked to somebody today who I think by FaceTime, or some similar app had contacted their loved one in a long-term care facility, and they were alarmed to see that there was no face mask on the employee who was there with their loved one," Gwartney says.

Lee says another concern is the people who typically hold these facilities accountable are also banned from entering—again to protect residents from the spread of the coronavirus.

"The framework for all of that accountability has just pretty much disappeared since the COVID outbreak," Lee says.

The people who used to check up on residents like voluntary ombudsman can't go inside nursing homes. Instead, they are doing their checks over the phone. The Agency for Healthcare Administration (AHCA), regulates Florida's nursing homes and assisted-living facilities. Agency Secretary Mary Mayhew says oversight for these places is still happening.

"When we are in a facility, we are not looking just at infection control we are looking broadly at [the] quality of care. Concerns around pressure ulcers, concerns around falls, appropriate nutrition, all of that is front and center in our review of these facilities," Mayhew says.

AHCA now requires all nursing homes and assisted-living facilities to allow Florida Department of Health officials and representatives inside to work on preventing and controlling COVID-19. That includes testing of all staff for the virus. On May 12, the agency reported conducting more than 1,400 onsite visits since the pandemic began.

"So we've had a lot of exposure, and through that, we evaluate any concerns around adherence to infection control standards," Mayhew says.

Donna Fudge is an attorney that has represented long-term care providers. She says now residents are getting full on nursing assessments every shift because of COVID-19.

"The reality is that because our care teams are so devoted and dedicated to doing their best to try and spot the presence of COVID impacting the residents, they're giving extra eyes and extra attention and extra assessment and extra compassion quite frankly." Fudge says.

For Roberts, who is looking forward to her next window visit with her mother, she says what's keeping her family going is knowing the staff members are doing their best.

"Everybody loves her. The staff, I mean the kitchen people know my mom. The people that clean up know my mom. Everybody knows my mom, they know her nuances, they know everything about her. Every time I walk by, anyone will say, 'oh, I did this with your mom today' or whatever, but she is surrounded by love and care, and it's made a difference in her completely." Roberts says.

Gov. Ron DeSantis says he is hoping to find a safe way for nursing homes and assisted-living facilities to open their doors to visitors. However, he hasn't set a date for when that will happen.