It’s the little things that worry Jennifer Yamada.
Someone needs to massage her mother’s feet to help with the chronic pain that’s plagued her for years. At 79, Arleen Yamada’s mind “waxes and wanes” through periods of alertness. Lately, she’s been lucid, and her daughter has been missing it.
Earlier this month, Jennifer Yamada drove to Westminster Point Pleasant, her mother’s nursing home in Bradenton, and was told she couldn’t go inside. A staff member had tested positive for COVID-19.
“If my mom has to be locked down, it should be in a facility like that. I can’t say enough good things about them,” said Yamada, 48, from Sarasota. “But nobody could give me an estimation of how long this is going to last. After what happened last year, I’m just trying to brace myself.”
Some long-term care facilities in Tampa Bay are limiting visitation as the state’s overall coronavirus case numbers rise — tripling in the past two weeks to an average of 10,000 new cases daily.
It’s impossible to tell how many of those are in long-term care facilities. The state stopped sharing numbers by facility in May. But the Tampa Bay Times received a handful of tips in the past week from staffers and family members about new cases in local homes.
And while most Florida nursing home residents are vaccinated, only 44 percent of nursing home staff members were vaccinated as of July 11, according to the latest federal report, a rate that lags every state but Louisiana.
Westminster Point Pleasant confirmed last week it has seen an increase in new cases, but said they all were asymptomatic.
“Ninety-five percent of residents have been vaccinated, but we have seen instances where some have tested positive after receiving a vaccine,” said executive director Amy Bowen. The facility did not respond to questions about the number of recent cases or the staff vaccination rate.
Most nursing homes in the state pause indoor visitations in a unit when a resident or staffer tests positive, according to Kristen Knapp, communications director at the Florida Health Care Association, which represents more than 80 percent of Florida nursing homes.
Knapp said her organization is seeing an uptick in facilities reporting new cases in recent weeks, though the number at each is low compared to when the pandemic began — usually fewer than 10 residents or staff — and most are unvaccinated.
Some long-term care homes are allowing only vaccinated visitors in common areas, according to Nick Van Der Linden, spokesperson for LeadingAge Florida, an industry group representing about 500 facilities. In other facilities where residents are unvaccinated, some are allowing visitation only through a closed window or plexiglass barrier until positivity rates subside, Knapp said.
“It really depends on the market and what the positivity rate is in that area,” Knapp said.
The state has encouraged long-term care facilities to abide by federal Centers for Medicaid and Medicare visitation guidelines. (Florida eliminated its visitation guidance in March.)
Outdoor visits should remain available at all facilities, under the federal guidance, unless a resident has a health condition — such as a COVID-19 infection — that hinders their ability to do so safely.
Facilities also should allow indoor visits, regardless of a resident’s vaccination status, unless there is a high risk of COVID-19 transmission, according to the guidance. If a staff member or resident tests positive, for example, the home is encouraged to suspend visitation, at least in that area of the facility, and to begin testing. If fewer than 70 percent of residents in a facility are fully vaccinated and cases in the county are spiking, the home should limit indoor visits.
There’s one exception.
Compassionate-care visits, which permit a loved one to provide comfort to a long-term care resident who is suffering or near death, should be allowed “regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate or an outbreak.”
Two weeks after Westminster limited visitations, Yamada was able to take her mother out for lunch.
“But that was a total nightmare,” she said. “Everybody was on a different page, even though I thought I had it cleared with the administrator. Some said it was not allowed, some said it was.”
And facilities may interpret visitation guidelines differently.
“You have facilities that may be right across the street from each other, that are identical, that are doing visitation completely different,” said Mary Daniel, 58, who advocates for families of those in long-term care.
Daniel said her husband’s facility has active COVID-19 cases, but she has been able to visit as a compassionate caregiver.
The current COVID-19 surge in the United States is expected to peak in October, according to public health researchers, but outbreaks at long-term care facilities are likely to continue throughout the summer.
Health care providers and advocates have begun asking facilities to require staff vaccinations, and Florida lawmakers have asked the state to share data on facility outbreaks and vaccination rates.