Nursing Home Care in the Age of COVID-19

Use these links to jump to different sections:

• Visitor Bans During the COVID-19 Pandemic
• Infection Control Decisions  
• Legal Concerns as Long-Term Care Setttings Locked Down

With all the other challenges facing aging Americans, a deadly new one was added this year: the highly contagious coronavirus, especially risky for older adults.

Visitor Bans During the COVID-19 Pandemic

When visitors were banned at Florida assisted living facilities because of COVID-19, family members panicked. Would their elderly loved ones become lonely? Would they catch a COVID-19 infection from others? 

But Jill Ginsberg, an elder law attorney at Ginsberg Shulman in Fort Lauderdale, believes it was the right thing to do.

“You had some lawyers of the mindset that this was terrible,” she says. “But it was a smart move. You don’t want to go in there and get these people sick.”

In normal circumstances, nursing home residents generally have the right to have visitors, communicate with others, and leave the facility, says Ginsberg. Only residents in memory care units are restricted.

Infection Control Decisions  

But that changed after COVID-19 outbreak in a Washington state nursing home, ultimately resulting in 37 COVID-19 deaths. Many U.S. nursing homes began voluntarily limiting visitors. The Centers for Medicare & Medicaid Services issued nationwide rules restricting visitors and canceling group activities and communal meals as a way to prevent the spread of COVID-19. 

On March 15, Gov. Ron DeSantis ordered the lockdown on Florida long-term care facilities. At the time of publication, it was unknown when that ban would be lifted.

Legal Concerns as Long-Term Care Setttings Locked Down

No surprise that the order caused a host of other legal issues, such as the handling of documents naming health care surrogates and power of attorneys, as well as living wills containing do-not-resuscitate orders.

By law, notaries and witnesses must see clients in person, or a guardian may represent the client, but a judge must rule on that. When the courts closed, judges were forced to make emergency rulings via Zoom meetings. As for signing, “it’s been resolved somewhat,” Ginsberg says. “The new protocol for doing this is what we’re calling parking lot document execution. Notaries, witnesses and clients drive in, they stay in their car with the windows open, and the lawyers sit at a table—everyone wearing gloves and masks—and documents get passed and signed. They are put in a room for a day or two, then they get scanned and sent out.”

Ginsberg doesn’t expect a flurry of suits against nursing facilities over visitation restrictions, since the governor ordered them for infection prevention. She’s also not expecting them to be sued over shortages of PPE like masks and gloves. Everyone is taking their safety cues from federal agencies including the CDC, Ginsberg says.

“The nursing homes are all being extremely careful,” she says. “Most are trying to make do the best they can.”