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COVID-19

Feds say nursing homes ‘should allow’ indoor visits, but residents in Washington, Idaho will have to wait

Marty Shape, left, talks to his mother, Judy Shape, right, on the phone as they look at each other through her window, Monday, March 9, 2020, at the Life Care Center in Kirkland, Wash., near Seattle. Long-term care facilities were shut down soon after, but after new federal guidance was issued Wednesday, they are expected to open back up.  (Ted S. Warren)

The federal government opened the door Wednesday for visitors, vaccinated or not, to enter nursing homes to see family and friends. It’s been a year since nursing homes began to lock down to protect residents from COVID-19.

But residents of Washington and Idaho long-term care facilities will have to wait before they can welcome outsiders.

John Ficker, executive director of the Tumwater-based Adult Family Home Council, said he was among a large group of state officials and stakeholders that convened as soon as it could Thursday to work on charting a path toward reopening state facilities.

“People cleared their calendars and worked on this all day,” Ficker said.

The opportunity to seek looser restrictions comes as a result of widespread distribution of the COVID-19 vaccine in such facilities. More than 52,000 people in care homes across Washington have been vaccinated, according to the Centers for Disease Control and Prevention.

“That’s the vast majority of residents,” said Chris Wright, a spokesman for the Washington state Department of Social and Health Services.

An increasingly inoculated population has coincided with a sharp decline in the number of active cases. In January, the state saw a peak, with outbreaks in nearly 600 of the state’s approximately 3,300 facilities, Wright said. As of Thursday, that number was down to 166. Despite the improvement, such facilities had accounted for 49% of all deaths from COVID-19 in Washington as of Monday.

Nursing homes in Washington have been on guard against the virus since February 2020 when the nation’s first major COVID-19 outbreak struck a facility in Kirkland.

Soon after, such facilities were locked down.

While Gov. Jay Inslee implemented a four-phase plan, separate from the state’s recovery plan, to ease those restrictions in early August, little progress has been made.

In September, Spokane facilities moved to Phase 2, but that represented only a slight practical change.

In Phase 1, indoor visits were allowed only for end-of-life care while two masked and socially distanced outdoor visits were allowed twice each day. The only difference in Phase 2 was an allowance for a single “essential support person” to come inside, only if the visit can’t be done outdoors.

Phase 3 would let visitors come inside, although outdoor visits would remain the preferred way.

That model is similar to what’s contained in the recommendations from the Centers for Medicare and Medicaid Services.

Those adjusted guidelines state facilities “should allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission.” But they also say “outdoor visitation is preferred even when the resident and visitor are fully vaccinated against COVID-19.”

Wright said the state health department got to work “immediately” to implement new guidelines and ease the “devastating” effect of “prolonged social isolation on residents.”

Zachary Clark, a public information officer with the Idaho Department of Health & Welfare, said officials have also begun “working on revisions” to existing state guidance for long-term care facilities in light of the new federal recommendations.

The urgency of allowing the residents, staff and families of the state’s nursing homes, adult family homes and assisted-living facilities to reconnect inside, Ficker said, is hard to overstate.

“I don’t even know that I can begin to measure what that’s going to mean to those families,” Ficker said. “I think there’s a lot of excitement.”

But that excitement has to be tempered with the practical work of aligning the latest federal guidance with the nuances of the state’s situation.

Because the restrictions were done by the governor’s proclamation, Flicker said, “We have to give him something new to proclaim.”

Part of the complication, according to Ficker, is the federal guidance is only applicable to nursing homes and not to other long-term care facilities.

He said his “personal hope is that we are able to get guidance drafted today and over to the governor’s office as soon as tomorrow.”

Once plans for each facility type are “adjusted to ease restrictions,” Wright, the DSHS spokesman, said the governor will have to approve them and issue a new proclamation.

Ficker said an official proclamation could come next week.

“Some of this is going to require the facilities to have a policy about how we manage visitation,” Ficker said. “Because while we want to open up again, we want to do it in a way that’s responsible.”