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Long-term care’s lonely lockdown extends to Sept. 5


As Florida’s governor focuses on reopening schools, he has also quietly extended the ban on visitors to long-term care centers until Sept. 5.

The lockdown means visits from friends and family continue to be banned, and residents are not allowed to take field trips outside of the facility.

“The new ruling is disappointing, but after what we’ve been through, we support that decision,” said Don Wright, chairman of the board of the Senior Resource Association and owner of Rosewood Manor, a 50-bed assisted living facility that exploded with more than 20 cases of COVID-19 after results of mass testing never made it back to the care home.

“There is no doubt: These people are vulnerable,” Wright said.

The move to extend the long-term care lockdown came with Gov. Ron DeSantis’ order last Tuesday continuing the state of emergency in Florida for another 60 days.

While all the talk lately has been of young people getting COVID-19, case numbers have been rapidly rising statewide in senior care facilities, up 70 percent in just two weeks.

With the same urgency DeSantis now speaks of getting kids out of isolation and into classrooms, he spoke in May of concerns about depression in the elderly, unable to see their friends and relatives. In terms of vulnerability to COVID-19, though, those in senior care are at the opposite end of the spectrum from schoolkids, much more likely to suffer serious harm if infected.

At the same time, if the reopening of schools backfires and triggers a further increase in cases, those numbers would start to roll in just when the state of emergency order – including its stay on long-term care visitation – is set to expire.

In that case, a rising infection rate would leave the governor hard-pressed to ease nursing home restrictions, since federal guidelines for reopening long-term care facilities include a decline in cases in the surrounding community.

Wright said the staff at Rosewood tries to keep residents active while social distancing. But the field trips to town are no longer allowed. “It’s heartbreaking,” he said. “A simple trip to Wal-Mart or a ‘mystery ride’ in the bus are off limits since March. Families are not allowed in, and this affects both the residents and the families.”

As of Monday, Rosewood Manor’s May 28 mass testing results had still not been received, Wright says. A second mass testing conducted June 19 revealed the 20 positive residents and five staff members, and Wright is convinced those May 28 results, had they not been lost, could have stopped the spread of COVID-19 by revealing asymptomatic carriers.

“I guess we’ll never know how our situation was back then [in late May],” Wright said. “For that I am disappointed.”

Wright said three of the four residents who died with COVID-19 at Rosewood were asymptomatic; all had pre-existing conditions. “Only one of the four showed virus symptoms. That’s the scary part.”

Rosewood Manor relocated all its positive patients to other facilities which were better equipped to isolate and care for them. Since then, some of those residents have tested negative and if they test negative again, they can come home to Rosewood.

“Family members are notified as soon as we get these results and they can’t wait for their loved ones to return. We can’t either,” Wright said. 

In mid-May, DeSantis began agitating to reopen long-term care facilities to families. He said the ban on visitors, which he had enacted March 9, had likely prevented thousands of cases of COVID-19, but had come at a “psychological and social cost” that people weren’t discussing. “We’ve got to figure out a way to give some folks hope and be able to see their families.”

CMS guidelines issued around that time spelled out the way. Along with considering the spread of COVID-19 in the community, the individual facilities should have a 28-day reprieve of any COVID-19 cases. They should also have adequate staffing; have a lab lined up with availability for weekly testing of both residents and staff; have adequate supplies of disinfectants and PPE; and have beds available in the local hospitals and ICUs.

Last week, DeSantis gave up on trying to reopen nursing homes and assisted living facilities this summer, extending the no-visitors rule that effectively limits the social lives of 160,000 Floridians to their caregivers and fellow residents.

A recently added chart posted on the state’s Health Department website tracks current cases in senior care centers going back through early March. The numbers are not cumulative, meaning people who get well, or people who pass away, don’t show up in the figure.

The chart shows that on June 25, 1,465 long-term care residents in Florida were currently fighting the virus. Five days later, the total would break the record set in mid-May for the highest daily count in long-term care since the pandemic began.

And the climb continued. By July 8, there were 2,489 positives out of the 142,000 people living in long-term care. That’s a rise of more than 1,000 cases in just two weeks, and a 70 percent increase in a high-risk population.

At last check Monday, the state added another 500 to that total. As for staff, 5,417 were positive out of close to 200,000 people who work in senior care centers.

Last week in Indian River County’s 25 facilities, there were seven current COVID-19 positive residents along with 29 staff.

Thirty-eight more positive residents had transferred out of their facilities, including 19 residents of Rosewood Manor.

At least nine long-term care residents with COVID-19 have died in the county, five at HarborChase and four at Rosewood Manor.

While the figures add up to a severe public health calamity, each case, to say nothing of each death, greatly adds to the anxiety already suffered by many long-term care residents. That in turn adds stress to the lives of staff members already dealing with clients’ emotional well-being, and weighing their own risks against the paltry pay many are earning as nursing aides, cooks or janitors.

As for facility administrators, the already challenging workload has doubled, at least. Wright describes the effort Rosewood administrator Zoe Morejon has made “with a giant heart [in taking] this situation on her back.

“She worked endless hours, dealing with AHCA and the Department of Health while being in constant contact with families, checking daily on the residents that were forced to move out.”

All the while, Wright said, Morejon’s assistant administrator has been out with the virus. “We had some very tearful conversations together,” Wright said.

“Most folks that come in here are here for a reason. Many, especially in the memory care area, have conditions that are hard to live with without any virus,” Wright said. “Our job is to keep them active, fed, clean and living with dignity. That’s our passion and we love the rewards that come with it. In normal times, I can walk in any one of our communities and tell when someone has passed. You can see the sadness on our staff’s faces. They love these people.”

Often, the local numbers don’t reflect the corporate pressures bearing down on administrators as branches of the same chain face COVID-19 deaths even when the Indian River County facility does not.

Seven Palm Garden nursing homes around the state show a combined 20 deaths on the state’s chart of COVID-19 deaths in long-term care. Five Consulate nursing homes have a combined 15 deaths. Two Willowbrooke Court nursing homes have 10 deaths between them.

Four Solaris facilities in Florida show 23 combined deaths, including Solaris Charlotte Harbor with 18 deaths. Five Brookdale centers in the state have a total of 22 deaths.

Vero-based Harbor Retirement Associates was the first in Vero to have COVID-19 deaths, with its HarborChase of Vero’s five deaths in April. In addition, there were six deaths at HarborChase of Tamarac, and one at HarborChase of Palm Beach Garden.