Arizona is close to reopening nursing homes to visitors after restricting nearly all in-person visits since mid-March in an effort to control the spread of COVID-19.
A state Task Force on Long-Term Care, established by Gov. Doug Ducey, approved recommended guidelines Tuesday that set up two main ways for visits to resume.
One way is a phased approach, based on where an Arizona county falls in terms of COVID-19 transmission.
The other approach would allow indoor visits in any county as long as visitors tested negative for COVID-19 within 48 hours of the visit. Visitors would be required to wear face masks and observe social distancing. They also would have to sign a document, saying they had isolated themselves between the time they were tested and their visit.
The recommended guidelines, which could be announced by the Arizona Department of Health Services later this week, are a ray of hope for family members who for months have only been able to talk with loved ones by telephone or video chat.
While many families say they understand the restrictions are necessary to keep their relatives safe, the months of separation have been tough on residents and their families.
Diane Drazinski, a school teacher, has an 86-year-old mother who resides in independent living in Phoenix and an 81-year-old father who lives in a memory-care unit in Scottsdale.
She is able to see her mother because she is a designated caregiver but hasn’t seen her father for five weeks, since he entered the long-term care facility. She looks forward to in-person visits with her father again, though she is also apprehensive.
“I have probably missed out on the last few weeks where he will remember who I am,” she said.
The governor formed the task force in late July made up of long-term care providers, families and lawmakers, to develop guidelines for the safe return of visitors. Task force members on Tuesday acknowledged the draft guidelines were far from perfect, but said they represent a start toward resuming in-person visits.
A chief concern is whether a 48-hour turnaround time for testing results is realistic. If labs are unable to meet the narrow window, many prospective visitors could be disappointed.
Joseph LaRue, CEO of Sun Health and a task force member, said while turn-around times on testing have gotten better, results are still running 48 to 72 hours. He asked the state to consider prioritizing testing so prospective visitors can get results quickly.
The cautious approach to resuming visitation comes as long-term care facilities around the country and in Arizona have been hard hit by COVID-19.
The communal setting of nursing homes — where residents often share rooms and are cared for by the same staff — puts residents at higher risk of contracting the virus than the general population. Many patients are over 65 and have chronic medical conditions, making them vulnerable to complications if they become infected.
In Maricopa County alone, long-term care residents account for 33% of the county’s total COVID-19 deaths. More than 3,500 residents and 2,000 staffers have been infected and more than 930 residents have died.
Around the country, states are in various stages of reopening long-term care facilities to visitors. Many states are taking a phased approach, first allowing outdoor visits with social distancing; then indoor visits will be allowed provided visitors can prove they are free of COVID-19.
The draft guidelines for Arizona allow nursing homes to reopen to visitors in stages, depending on transmission of the virus in the county. Counties are classified as having “substantial,” “moderate” or “minimal” community spread with visitor restrictions gradually easing as there are fewer cases and fewer positive tests.
Most of Arizona’s 15 counties are still experiencing “substantial” community spread, though task force members were told Tuesday that a half-dozen counties where most of the state’s population lives, including Maricopa and Pima, may move to the “moderate” category by Thursday.
Nursing homes in the “moderate” category would be allowed to have outdoor visitation, under the draft guidelines, while indoor visits would be permitted if visitors can prove they are COVID-free within 48 hours of the visit.
To some task force members, the visitor restrictions by county makes little sense because visitors could easily travel from counties with substantial COVID-19 spread.
It “doesn’t seem like that’s appropriate for the safety for everyone in that facility,” said Rep. Joanne Osborne,R-Phoenix.
Once the state approves the guidelines, the task force plans to reconvene in about three weeks to see where improvements need to be made.
The state Department of Health Services referred questions about the guidelines and how soon they could be implemented to the Governor’s Office.
Patrick Ptak, a spokesman for Ducey, said the governor appreciates the task force’s work.
“Arizona is committed to protecting our seniors and most vulnerable during this pandemic, and finding a safe way to make sure they can remain in contact with their loved ones,” he said in a statement. “There’s more work to do, and we will continue to work with the stakeholders on a plan that puts Arizonans’ health and safety first.”
Arizona AARP announced support for the recommendations on Tuesday.
State Director Dana Kennedy said the governor and his staff moved quickly to develop a plan so the task force could provide meaningful input to safely reunite families with loved ones.
Kennedy, who also served on the task force, said the guidelines provide a balance between public health, peace of mind for families and the safety of all individuals involved.