While Nebraska Gov. Pete Ricketts announced long-term care facilities can start phasing in to open, the opening will not be instantaneous.
Ricketts said in his June 15 press conference that the short-term solution of people not visiting long-term care facilities has kept the number of coronavirus cases down, but recognized the impact on the mental health of the vulnerable.
"The governor said we had to make our plans and have it completed by June 22, so people think they can visit their loved ones that day. No," Crowell Home Executive Director Jaclyn Svendgard said. "All nursing homes in Nebraska are currently on Phase 1. Visitors aren't allowed in the building until Phase 3."
Phase 1 is the most restrictive, where virtually no visitors are allowed. Phase 2 is an initial relaxing of restrictions, and in Phase 3, all residents should have the ability for limited visitation.
The Department of Health and Human Services (DHHS) and Centers for Medicare and Medicaid Services (CMS) released a 12-page phasing guidance to facilities as they prepare for opening to visitors.
Key criteria prior to changing phases include adequate staffing, case status in the community or facility, ability for proper testing, access to adequate personal protective equipment for staff, local hospital capacity, access to adequate cleaning and disinfecting supplies and no one in isolation or quarantine due to COVID-19.
"If the facility is successful and all criteria has been met after the 28 days, the facility may move forward with the next phase," Svendgard said.
Carter Place, which did not return a message seeking comment, experienced an outbreak of COVID-19 in March. Three Rivers Public Health Department linked 19 cases of COVID-19 to Carter Place, which included both staff and residents. One resident died.
The facility was temporarily closed in late March and 23 residents were moved to CHI Health Midlands in Papillion.
Carter Place reopened April 15 following full cleaning and remediation of the facility, continued training on COVID-19 best practices and procedures for staff, conducting a voluntary Infection Control Assessment and Promotion Program review and a walkthrough of the facility.
Carter Place was cleared by ICAP and the Nebraska Department of Health and Human Services to allow residents to return.
The closure of facilities to visitors has been hard on residents and staff alike.
"I know how difficult it is for the residents, and there is nothing I'm looking forward to more than for them being together," Good Shepherd Lutheran Community Administrator Sharon Colling said. "The separation of the residents and their families has been the most difficult thing I have ever endured in my career."
Colling said she hopes researchers find a vaccine in the next year, so the residents can have more freedom and autonomy.
"Most are choosing to stay in their rooms," she said. "Unlike pre-COVID, we (will) have visits by appointment and only in designated areas, with residents and staff still wearing masks. We are really excited and cannot wait."
Families and staff will be notified as soon as plans are approved by the state, Colling said.
"We will send out letters to the families and a blast email and hold a meeting with the residents and staff," she said.
Residents at Good Shepherd have interacted with families at the door or spoken through the glass in their three seasons porch.
"We have several iPads so a lot of families visit that way and we take the iPads to the residents," Colling said.
Autumn Pointe residents in Fort Calhoun also have had some interaction with family, though it isn't the same.
Jenna Morris, executive director, said they have submitted their plan to their corporate offices and will submit it to the state.
"We are going to give each resident time to be with their family member weekly, a short visit to start," Morris said. "It will mean so much. Our main objective is to get families back together."
Morris said the facility has allowed window visits, parades in the parking lot and entertainment in the facility by staff — line dancing, pop-up happy hours and hallway bingo, for example.
"They are itching to go somewhere," she said. "We will have to see the numbers go down for a considerable amount of time and are trying to keep everyone patient."