Should you pull a family member out of a nursing home right now?

With coronavirus outbreaks in some facilities, it can be a tempting option for families. But advocates say several factors must be weighed.
Sunstar employees walk gurneys into a wing of St. Mark Village nursing home Monday in Palm Harbor. Several residents were transported from St. Mark Village Monday to local hospitals.
Sunstar employees walk gurneys into a wing of St. Mark Village nursing home Monday in Palm Harbor. Several residents were transported from St. Mark Village Monday to local hospitals. [ CHRIS URSO | Times ]
Published April 21, 2020|Updated April 21, 2020

Across the country, elder-care facilities have become hotbeds of spread for the coronavirus.

News of the outbreaks has prompted families to consider removing their loved ones to keep them safe. But advocates and legal experts warn that those decisions should be made carefully.

While the law allows families to take such a step, it’s not always the safest option for an elderly relative who may require special care, they say.

“Are they putting their relative at risk if they take them home? Also what happens if you can’t bring them back? Not a lot of people are capable of caring for a family member who lives in one of these types of skilled facilities," said Adam Levine, an adjunct professor at Stetson University College of Law in Gulfport.

“It’s hard to know which is the safer option for them,” he said.

The state ordered most long-term care facilities in Florida to shutter on March 15, banning visitors and instituting precautions like temperature-taking for all staff members.

Related: 5 things to know about hitting the COVID-19 peak

The order also discourages residents from leaving, but it doesn’t give facilities the power to prevent it, said Jessica West, a health care attorney with the Shumaker, Loop and Kendrick law firm in Tampa.

Every case is different, she said.

Families should consult the patient’s doctor “to understand if they can meet the needs of their relative for medication, mobility, nutrition and transportation,” West said. "Once that person is home, they need to assess what kind of risk of exposure they will be at from others coming in and out of the home.”

Despite the state order, outbreaks have occurred in some areas of Florida, including Pinellas County.

Four patients at Freedom Square Seminole Pavilion Rehabilitation center have died and more than 75 residents and staff members have tested positive for the virus since early last week. A second nursing home, St. Mark Village in Palm Harbor, had 13 residents and eight staff members test positive for the novel coronavirus this week.

In addition to health considerations, families should consider the financial implications of moving a loved one out of a nursing home, advocates say.

Many patients, for example, are on Medicaid, which limits the number of days a facility can hold open a bed should the person need to return.

“If a patient goes to a hospital from an assisted-living facility, Medicaid will pay for up to eight days to hold their bed at that facility," West said. "Sometimes a patient’s family can hold it longer, for up to 15 additional days, but it can be very expensive.”

April Hill, an elder law attorney at Hill Law Group in St. Petersburg, said one of her clients was removed from a nursing home by their family and then tried to return, but the nursing home wouldn’t take them for fear of exposure.

How facilities react to a family-initiated move can vary, said Levine, the Stetson professor.

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“They can go to the courts and ask to get a guardian in place if they think the patient may be in danger," he said. "But I don’t know who is going to go through that kind of effort in a climate like this.”

West said some facilities are requiring patients to be tested before they can return. “That’s something to keep in mind if you want to bring a family member home for a temporary period,” she said.

Related: Fourth coronavirus death tied to Seminole nursing home

Families should make sure they understand their contract with a nursing home or assisted-living facility, she said.

Whether or not families decide on making a move, it’s important to keep in close contact with their loved one, advocates said.

While some rules have changed for skilled-care facilities under the executive order, patients and family members still have the right to talk to one another. FaceTime or Skype have become a popular option for family to keep in touch, said Heather Samuels, a board certified elder law attorney out of Palm Beach County.

“The most important right that you can keep up that they can’t take away from you is the right to communicate,” she said, “to the extent that you can call the facility and say I want to see my loved one.”

Samuels also said it’s important for people to get paperwork together. Families who have already filled out advance directives are able to get medical records and information more easily, but those who didn’t can still fill out releases.

And when it comes to learning information from nursing homes about the coronavirus, the best thing to do is call and ask about their loved one and testing protocols, Samuels said.

West agreed, adding: “I would recommend getting all communication down in writing, say in an email, instead of verbal communication.”

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