New York Eases Rules for Nursing Home Visitors, But Only Those With COVID Tests

It’s been more than six months since Beverly Noody sat down in person with her 94-year-old mother, who lives on the memory ward of a nursing facility near Noody’s home in Oakfield, New York. 

So Noody was thrilled when she learned that state health officials are relaxing certain rules for visitation, cutting in half the time a facility needs to go without a new coronavirus infection among residents and staff from 28 days to 14 days. Noody immediately scheduled an outdoor visit for Friday, the day after New York’s new guidance goes into effect.

But her excitement faded when she learned that the state had added a testing requirement for visitors. Those hoping to see loved ones in person will need to present a negative coronavirus test taken within a week of their visit.

Noody had to reschedule her long-awaited reunion. She will need to drive 40 minutes to the nearest testing site and expects she’ll need to wait five to seven days to get her results back. “These COVID tests are awful. I’m so frustrated right now,” she says.

Frustration with new visitation guidelines is not unique to the Empire State. Now six months out from the nursing home visitor shutdown ordered by the federal Centers for Medicare & Medicaid Services in mid-March, more than 40 states have developed a patchwork of nursing home visitor policies. These policies can vary widely, at times conflicting from one county to the next. Florida officials recently unveiled their own visitation guidelines that were criticized for not going far enough to make testing mandatory for visitors and staffers entering long-term care facilities.

“There’s too many inconsistencies,” says Andrea Goldy, who works with New York’s chapter of Caregivers for Compromise, an advocacy group seeking safe but expanded visiting guidelines for nursing home residents and their families.

More homes can open, but more hurdles for visitors

More than 216,000 nursing home residents have contracted the coronavirus, according to the latest CMS data. More than 53,000 residents have died. No state has endured more nursing home coronavirus deaths than New York, with more than 4,500 reported.

Perhaps as a result, New York was not among the first states to release guidelines for allowing visitors into nursing homes. More than 40 states across the country have either developed or implemented such guidelines, but it wasn’t until July that New York issued its policy. Supervised outdoor visits were allowed to take place at facilities that decided to reopen and that adhered to a strict series of guidelines. One of those requirements was that each facility go 28 days without a new coronavirus case.

The guidelines were designed to keep residents safe, but frustration mounted as few facilities were able to accept visitors. Shortly after the state implemented its 28-day threshold, the New York State Health Facilities Association completed a survey indicating 77% of the state’s long-term care facilities would be unable to reopen because they couldn’t meet the new requirements.

Goldy, whose mother lives in a facility in Amherst, New York, says she was only allowed to start scheduling outdoor visits two weeks ago. She’s visited her 87-year-old mother three times, but she’s disappointed that she wasn’t able to see her in person earlier, anticipating that outdoor visits will need to stop as it gets closer to winter.

“It’s cold. We’re in upstate New York," Goldy says. "Our temperature is going down pretty rapidly now. It’s really not going to be feasible much longer to do outdoor visitation.”

Now that New York has reduced its new infection threshold to 14 days, state officials believe more facilities will be able to accept visitors. In a statement published on Tuesday, New York Department of Health Commissioner Howard Zucker estimated 500 of the state’s 613 nursing homes would now be able to welcome visitors.

But requiring proof of a negative coronavirus test will make that more difficult. Health experts contend that rigorous, rapid testing is among the safest ways to reintroduce visitors to nursing homes. And new CMS visitation guidelines published on Thursday encourage but do not require nursing homes to test visitors.  But in much of the country, rapid tests are difficult to come by.

“Around our area here, it sometimes takes more than seven days to get your test results back. So you need to make an appointment to see your loved one, but you might not have your results yet,” she says.

Taking a page from other states

Goldy has been in touch with advocates for nursing home residents in other states and is pushing New York officials to carve out a visitation exception for essential caregivers. These people are deemed integral to a resident’s well being and are allowed more regular access into facilities. Florida, Indiana and Minnesota are among the handful of states to recognize essential caregivers.

Goldy says she appreciates exemptions that already exist for compassionate care visits, which include end-of-life situations and allow those loved ones to meet with residents indoors. But she’s discouraged there aren’t more visitation options in communities with particularly low rates of coronavirus spread.

“I don’t want to see my mom two days before she passes away,” she says. “I want to spend quality time with my mom — not through a window, not through a phone.”