Fears of COVID-19 infections in nursing homes may be subsiding as more facilities employ the trifecta of increased staffing, surveillance testing and vaccinations.
Christine Tardiff, chief operations officer and vice president of Clinical Services at Elder Services of the Merrimack Valley and North Shore, says just a year ago, the agency had to field through the heightened fears from families who were reluctant to place their loved ones in a nursing home.
“At the beginning of the pandemic — when things spiked in March and May — we absolutely saw an increased concern [from families],” said Tardiff. “We were definitely finding and hearing that families did not want their loved ones placed in a nursing home.
“This is certainly not the case today, it’s certainly leveled out,” she said.
Tardiff says, due in part to the systems in place at many facilities and the state’s vaccine rollout, families on the North Shore are more likely to consider nursing homes for their loved ones.
“[The fear] hasn’t gone away, but it’s not anywhere near where it is now,” she said. “There’s a huge vaccination effort and much more attention to look at reporting and compliance with COVID protocols.
The stats
Massachusetts has fared lower than the national average of nursing home resident cases and deaths. However, cases within nursing facilities have increased nearly 300% between November and December 2020, marked in part by the holiday season.
In December 2020, nearly 6 in every 100 Massachusetts nursing home residents contracted COVID-19, according to AARP’s COVID-19 nursing home dashboard data. Per the Massachusetts COVID-19 dashboard, the average age for coronavirus hospitalizations is 70 years old, which is also the median age of a nursing home resident.
Congregate care settings, including nursing homes, have been a hotbed for COVID infections due in part to spotty testing of staff and residents, and inconsistent contact tracing and isolation measures to keep the virus from spreading early in the pandemic.
“There’s much more control [now],” said Tardiff. “We have learned so much. Safety has always been at the forefront but you don’t know what you don’t know.”
In August 2020, a weekly survey of state-licensed nursing homes and long-term care facilities, conducted by the state’s Executive Office of Health and Human Services, found four nursing homes across the North Shore were “out of compliance” with the state’s testing requirements. Massachusetts requires at least 90% of staff members are tested regularly and test results be reported to the state.
Halcyon House in Methuen was among those listed in state documents as non-compliant. But Lisa Ardizzone, owner and administrator of Halcyon House, says testing is administered by a third party and at that time, results were taking longer than expected to return.
“It’s unprecedented and was completely overwhelming,” said Ardizzone. “We have to wait for the weekly test results to come in to get the records in. Now it takes nearly a week to get the results. It’s just a part of life now."
Effective infection control requires test results to be obtained in less than 24 hours. In August and September 2020, less than a quarter of nursing facilities across the nation had a turnaround time of less than a day, an analysis published in the Journal of American Medical Association found. A majority of facilities reported that test turnaround time was three days or longer.
Halcyon House, a women’s home, continues to test its 11 residents weekly. The home has also implemented and maintained a no indoor visitor policy despite state guidelines that have opened and expanded indoor capacity of other facilities.
“We’re all still very connected, and are still with their family as best they can,” said Ardizzone. “We are their family.”
On the North Shore
The latest survey found all North Shore long-term care facilities are now in compliance with the state's testing requirements. Less nursing homes are also reporting supply and staffing shortages today compared to previous months, according to AARP.
“While we have made significant progress and have seen cases and deaths decline since the peak of the pandemic, we recognize the painful toll the virus has taken on residents and staff of long-term care facilities,” a spokesperson for the state’s Executive Office of Health and Human Services said in a written statement. “Looking ahead, the changes to Department of Public Health and MassHealth regulations will improve standards of care and resident quality of life through adequate spacing in resident rooms, improved staffing levels, and payment structures that incentivize high quality care for all residents.”
While COVID rates continue to decline across the state, elders still remain at highest risk of dying from the disease.
David Lennon, executive director Alliance Health at Devereux in Marblehead, says staffing levels remain a concern at the nursing facility. Lennon says COVID-19 has impacted their operations, and he continues to worry about his staff or residents contracting the virus.
“It has been difficult,” said Lennon. “It has been particularly hard with staffing.”
Elder Services of the Merrimack Valley and North Shore provides care plans and resources for elders considering various living options, including nursing home care. Tardiff said many facilities have used the lessons learned in the early months to make it a much more safer environment.
“Nursing homes really took the brunt of a lot of the negative outcomes,” she said.
Ardizzone agreed, adding that Halcyon House is a family-owned and operated home with not a lot of turnover in residents or staff. The small number of residents and staff also differentiates it from larger long-term care facilities, which have been the center of major outbreaks.
“There is a negative connotation with nursing homes, but part of my job is to talk to families and discuss their decision,” said Ardizzone. “Families can rest their heads on their pillows at night knowing they are OK.”
To ease concerns, Tardiff says nursing homes should be transparent in their safety protocols and procedures. Families, too, should look beyond what nursing homes endured in the early months of the pandemic and inquire on what they are doing today, she said.
“Ask the questions directly to the facilities you’re considering — what are you going to do to keep my loved one safe?” she said.
Ardizzone says Halcyon House plans to remain vigilant in their safety policy until there is significant data that the vaccines work to lessen COVID infections and spread.
“There are people who may not get it, or think it’s just a cough — but elderly can die from what others find to be mild,” said Ardizzone. “Don’t let up so that we can maintain the gains."
Lara Salahi is an assistant professor of journalism at Endicott College. Sarah Wolak, Maria Wilson, Kaley Brown, Barrett Hodgson, and David Leonardi contributed to this report. This article was written with the support of a journalism fellowship from The Gerontological Society of America, The Journalists Network on Generations and the Silver Century Foundation.
Comments