As it did for most health care institutions, the COVID-19 pandemic altered operations of nursing homes and senior living facilities, including the suspension of routine inspections meant to improve and maintain the safety of patients and residents.
In March 2020, the Centers for Medicare & Medicaid Services suspended nonemergency state survey inspections, allowing inspectors to prioritize the most serious health and safety threats, like infection diseases and abuse. The suspension was lifted by August, but the state did not resume federally-mandated surveys until March 2021.
"Nursing homes have to get surveyed every 10 to 15 months, and they don't tell you when," said Mark Erwin, administrator at Cherokee County Nursing & Rehabilitation Center Inc. "It's a requirement that CMS did waive during COVID. The state of Oklahoma started surveying all nursing homes again about a month ago."
During the time when the Oklahoma State Department of Health was not conducting on-site surveys, it did complete more than 1,000 COVID-19 surveys. Erwin said his facility had a state surveyor visit three times, and despite receiving no deficiencies in the reports, he said the home was in "survival mode."
"I had 14 people die from COVID and I had 70 people catch COVID, so we were just trying to survive the chaos of it, not to mention all the staff that got it," he said. "What's happened, though, is a lot of people have left the field. It's just been too much for them, emotionally and physically. Staffing has become an issue everywhere."
While the time between routine surveys may extend over a year, assisted living homes could see an inspector visit sooner, if someone files a complaint. Survey based on complaints that related to an immediate jeopardy situation - when noncompliance has caused or is likely to cause serious injury, harm, impairment or death to a resident - continued, though.
The Cherokee County Nursing Center was not cited for any deficiencies related to a complaint, nor was Go Ye Village, where Executive Director Steve Thomas said state employees visited numerous times to check on the community and whether the staff was following protocols.
"Oklahomans should be proud of the way in which the state looks out for our senior adults," Thomas said.
Go Ye Village does not accept Medicare or Medicaid, so it doesn't operate under CMS. It does receive the same routine surveys from the state health department, and received COVID-focused surveys over the course of the past year.
"We did very well. We passed all of them, with no infractions noted," said Thomas.
Meanwhile, things are starting to change at area senior living facilities. At Go Ye Village, visitation has resumed, and the dining room was reopened last week.
"We still require masks to be worn, unless you're seated and dining in the dining room," said Thomas. "We've opened up our games and things along that line. So we're pretty close to being back to normal. That's because the vaccinations have been a tremendous impetus to allow us to do that."
Visitation has also resumed at the Cherokee County Nursing Center. Visitors are screened and have their temperatures taken, but don't have to be vaccinated against COVID-19. The federal government encourages outside visitation, but the center also allows visitors indoors. There are a few caveats to it, however.
"If a person is in a private room, then their family can pass the screening and go to the private room and visit," said Erwin. "If the residents have a roommate, we have to bring the resident up front to meet them in a family room, or a conference room, or an outside visit. It's a little bit strange, but people are able to visit, and it's made all the difference in their psyche. It's been amazing how much happier people are."
There are still come core principles the federal government wants the center to continue following, too. Adhering to a 6-foot social distance between people continues, and they still ask residents to wear face coverings. There's not as much isolation for new residents, though.
"So if I got a new resident who came in, if they have both vaccinations they don't have to be isolated anymore," Erwin said. "That's one of the biggest differences that've occurred through vaccinations. That bugs people, too, when they get here and have to be isolated for 14 days."
Check it out
All surveys of long-term care facilities in Oklahoma can be found at surveys.health.ok.gov.