Nursing home visitation during COVID is a difficult question

Sep. 18--The Lake Cumberland District Health Department (LCDHD) addressed questions about long-term care facilities and their policies, as well as reiterating their stance when it comes to complaints about businesses being noncompliant during its weekly question and answer session held Wednesday.

LCDHD Director Shawn Crabtree responded to a question concerning current nursing home restrictions, and, since there are no foreseeable changes in the COVID crisis, whether those restrictions should be reevaluated.

The questioner stated that the loneliness and depression that some elderly people in long-term care facilities are facing should factor into the decision to allow visitors.

Crabtree began by explaining the current rules concerning longterm care facilities. Places are allowed to admit visitors as long as they have not had a positive case within the facility for a certain amount of time, 28 days for nursing homes, 14 days for skilled care facilities.

He added that the administrators of those facilities have the discretion of preventing outside visits outside of those guidelines in an attempt to keep the virus from finding its way in.

He said he understood the concern from family, calling it the "most tragic double-edged sword." He understands that socializing is important to the health of the patient, or the family may be missing precious time with a family member who may not have long to live, but he also pointed out there have been several nursing home outbreaks that have caused health problems and even deaths for many others.

"This is a really tough one, and I don't have an answer," he said. "I think you've just got to try to talk with the nursing home administration, and if they're in the time frame where visitation could be allowed, just try to work with them to work something out."

Responding to another question about long-term facilities, such as nursing homes and jails, one person asked what is the percentage of people in those facilities who are negative when tested.

Crabtree said that was something the health department doesn't know.

"That's just not something we keep up with," he said, adding that it's because they don't need that information when responding to positive cases.

Switching from long-term facilities to questions of public figures, Crabtree talked about how he heard a "disturbing" complaint about an unnamed person "in a significant position" in one of the district's counties -- Crabtree did not say which -- who was a positive COVID case and decided to go out to a public place.

The complaint said the person felt it was okay to do so as long as they were standing a few feet away from everyone and wearing a mask.

Crabtree reminded the public that the social distancing and face covering guidelines are for prevention only.

"Once you have it, six feet and a mask -- that's no good for you. You're a positive case. You're to be isolated and separated from the public, period," Crabtree said.

"...Either that was just open defiance, or a sever misunderstanding of the difference between prevention guidance vs. post-exposure restrictions."

He said that if someone who is COVID-positive is in public and sneezes or coughs, they are actively infecting others.

One question came from someone discussing recent comments from Governor Andy Beshear that it was time for health departments to issue citations for non compliance.

Environmental Director Stuart Spillman said that the number of complaints within the district have been going down. In fact, they have been getting more complaints from other states sent to them on accident than legitimate local complaints, he said.

He then reminded the public that LCDHD is only concerned with businesses that the health department permits and inspects normally -- such as restaurants and grocery stores.

"We don't inspect and permit hardware stores," Spillman said. "We don't inspect and permit parts houses for car parts. We don't inspect and permit factories."

And, even in the cases of those businesses they do enforce regulations on, the health department would prefer to educate rather than issue citations, Crabtree added.

"Our goal is not to punish a business. Our goal is to just get compliance," Crabtree said.

Spillman said they have not issued any fines to any district businesses.

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