AARP State Director Kathleen Connell sent the following letter to Governor Gina Raimondo on Monday, March 23.
Dear Governor Raimondo,
AARP Rhode Island, on behalf of our 132,000+ members and all older Rhode Islanders, is writing regarding your directive through the Rhode Island Department of Health on preventing transmission of COVID-19 in facilities providing long-term services and supports (LTSS).
We deeply understand your focus on protecting the health and safety of our state’s nursing home residents, which is paramount. We are, however, very concerned that neither current state guidance, nor current guidance from the Centers for Medicare & Medicaid Services (CMS), truly enable nursing home residents and their families to virtually visit and communicate during this public health emergency.
Requiring nursing home residents to go weeks or even months without any visits from loved ones is extremely serious, and the state guidance should reflect this by requiring nursing homes to prioritize virtual visits and caregiver communications.
In March, the state advised via the RI Department of Health website that “nursing home administrators have been directed to not allow any visitors (unless they are essential to the care of a resident).” There is no mention of how nursing homes might facilitate virtual visitation in lieu of in-person visitation. We also note that the CMS guidance contains a similar restriction on visitation and only advises that facilities “should consider” offering “alternative means of communication for people who would otherwise visit, such as virtual communications (phone, video-communication, etc.).” People living in nursing homes have the right under federal law to receive visitors, “subject to reasonable clinical and safety restrictions and the resident's right to deny or withdraw consent at any time.” The law also requires that nursing homes “must provide services to attain or maintain the highest practicable physical, mental, and psychosocial well-being of each resident.”
During this stressful and difficult time when in-person visitation is very restricted, we strongly recommend that the state of Rhode Island immediately modify its guidance to require nursing homes to offer and facilitate reasonable and practicable alternative means of communication for individuals who would otherwise visit, such as virtual communications. Virtual visits can be essential to the emotional, mental, physical, and social well-being of nursing home residents. For some residents, these virtual visits may be the difference between life and death.
Given the widespread adoption of video-chat options (from FaceTime to Skype to Zoom and so on), AARP Rhode Island believes these virtual visitations must include the ability to communicate on video, not only for the emotional well-being of the resident, but also so family caregivers can ensure their loved ones are being well cared for. If funding is needed to ensure video-chat options, we encourage the provision of such funding and consideration of how such communications could be part of tele-health.
In addition, during these times of great uncertainty for families, we believe nursing homes should be required to provide proactive communications to the primary caregiver(s) of nursing home residents regarding their physical and emotional health and more general updates or information for families. We urge the state to modify its guidance to reflect that nursing homes must also create additional or increase listserv communications; assign staff as primary contact for families; and offer a phone hotline for family members to get information about their loved one’s care.
We appreciate the State of Rhode Island’s efforts to ensure the health and safety of nursing home residents and LTSS recipients and understand the challenges LTSS facilities are facing. At the same time, it is essential for residents and families to be able to communicate and visit virtually, especially during this public health emergency. Thank you for your prompt attention to this issue of great importance to our state’s nursing home residents and their families. If you have questions, please contact me at 965-5324 or John DiTomasso at 349-7437.
State Director, AARP Rhode Island