More than 2,200 Ohio nursing home residents infected with the coronavirus have died since April. Now these facilities are struggling to figure out how to accommodate outdoor visitations as COVID-19 cases and deaths continue to climb. Some say the guidelines they're receiving from local, state and federal agencies are conflicting and confusing.
"Writing with my left hand"
Matthew Pool runs Wayside Farm Nursing and Rehabilitation Center in Peninsula, a 95-bed facility that cares for people with mental illness and behavioral issues. Pool said it’s been an unprecedented four months since closing the facility's doors to visitors in March.
"It was like me writing with my left hand, and I'm right-handed," he said.
Pool said his facility operates a bit differently than most nursing homes because its doors are always locked to keep residents safe.
"So visitation is already a bit different, but we had the sanctions put into place. Everybody is getting screened daily, taking temperatures, and answering the screening questions," he said.
Pool's facility has had no COVID-19 cases among staff or residents.
Some facilities hold off on visitations
In late June, Gov. Mike DeWine announced that the state's nursing homes could begin outdoor visitations with loved ones July 20. But as cases continue to rise, many facilities are waiting. At Wayside, Pool said for now they're limiting visits.
"They can come and chat with their loved ones through a window that we've set up, and they can have privacy and communicate. It's not ideal, but follows the guidelines," he said.
State guidelines say that nursing homes must consider a number of safety standards before allowing visits, including testing all residents and staff. The National Guard has been conducting the testing at facilities statewide.
Pool said his staff was being tested on Friday, and resident testing will begin next month through the Ohio Department of Health.
He said the biggest challenge has been communication.
"It's been very difficult all the agencies and the information that they're sending out that they're all on the same page," he said.
Pool said he receives guidelines from the Centers for Disease Control and Prevention, Centers for Medicare and Medicaid Services, the Ohio Department of Health and Summit County Public Health. Then he has to work to desseminate all the information to staff, residents and family members.
Personal protective equipment
Pool also said a lot has changed since June 29, when Gov. DeWine announced that nursing homes could start outdoor visits. Summit has been at a Level 3 red alert for coronavirus cases. It was dropped to level 2 on Thursday. Still, Pool says the increasing number of cases makes him apprehensive.
"I think it was wishful thinking in trying to get everybody on board of looking towards a goal date, but the cases keep going up but in some counties it's getting very challenging," he said.
Another concern for some facilities is the availability of personal protective equipment (PPE). In a July 21 issue brief from Kaiser Family Foundation, 2,700 nursing homes reported a shortage of PPE.
Pool said this was a challenge early in the pandemic when everyone was rushing to buy hand sanitizer and masks, but he said they've been able to meet the demand.
"It's been challenging, certain products more so than others. You have to get creative. We've had to set up more contracts," he said.
Uncertainty and positivity
Pool said working in the nursing home industry has always had its share of obstacles, dealing with constant staff shortages and employee turnover. He said the pandemic has exacerbated those challenges.
"I think a lot of the unknown is the toughest part for us. Every day when we come in, we don't know what's going to change," he said.
But he said he tries to stay upbeat.
"It's very easy every day to get overwhelmed and scared or worried about what's going to happen. We'll find supplies, and we'll find other things. But I think a positive outlook really helps, especially during this time," he said.
Pool also serves on the Summit County Nursing Home Task Force that was formed before the pandemic to work to improve nursing home conditions. A report with recommendations is due in October.