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Long Term Care Facilities And The Toll Of COVID-19

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>>BOB ZALTSBERG: This is Noon Edition on WFIU. I'm Bob Zaltsberg from the WFIU WTIU newsroom along with co-host Sara Wittmeyer, the news bureau chief of WFIU and WTIU. We're recording the show remotely today to avoid the risk of spreading infection. And today we're going to be talking about nursing homes and elder care during the pandemic. We have four guests with us. Joining us by phone, we have Lynn Clough who's the State Ombudsman for long term care, Melissa Roemer who's care management team leader at area 10. Lou Ann Blake is the Heritage House facility administrator. That's a facility in Greensburg Indiana. And Sarah Waddle is the AARP state director. You can send us your questions or your comments at News at Indiana Public Media dot org and you can also follow us on Twitter at noon edition. So thank you all for being here with us today. And I wanted to start with Lynn, I believe Lynn Clough and talk about how your job has changed as the state ombudsman during this pandemic. 

>>LYNN CLOUGH: Well first of all I'd like to thank you for having me on your show. I really appreciate that, being able to talk for the long term care ombudsman program. Our job has changed a little bit. Most people don't know exactly what the long term care ombudsman program is. We are a group of ombudsmen. We advocate for residents of licensed long term care facilities such as nursing homes licensed assisted living facilities and other licensed residential care facilities. Our ombudsmen are trained to assist residents with complaints and resolve problems. And we are resident directed, meaning that we act only upon permission of the residents or their authorized representative. If the resident is not able to give us permission. And finally all ombudsman programs services are free. And information is kept confidential. As far as how our program is changed during the pandemic, we began hearing - getting phone calls. That's how most people get in touch with us, residents and family members and their residents representatives. Ombudsmen contact information is posted in every facility. And we talk about resident rights. That's one of the ombudsman's - the first rules of being an ombudsman is talking to long term care residents, that they still have rights. They had rights before they moved into a facility and they still continue to have those rights. But like I was saying our calls started to change a little bit when visitation was began to be restricted due to COVID. And we were getting calls from very frustrated family members who were not being able to see their loved ones. And over time now we're hearing - we were very excited because the Department of Health has come out with new guidelines. We're starting today - effective today for essential family caregivers being back in our facilities and outdoor visitation. So our role has changed somewhat. I do want people to know that we are still available. Ombudsmen have been restricted from being in facilities as well as family members. So that has been difficult because ombudsmen are used to being seen in facilities and are very regular visitors in facilities. But we are still continuing our advocacy. We are able to be reached via phone. We've done zoomed meetings, conference calls. We're still available to all residents. 

>>BOB ZALTSBERG: So Melissa Roemer you're the care management team leader for area 10. So covid 19 has had a major effect on a lot of people I'm sure that you deal with on a regular basis. So can you talk about about what's going on with area 10 and the folks that your clients? 

>>MELISSA ROEMER: Yes. And thank you for having us on the call today. Things have definitely changed. Area 10 agency on aging is one of four community partners that goes out and has direct contact with the elderly and the disabled and especially during covid nineteen those individuals are the most vulnerable at this time for this virus. We have a lot of different programs that area 10 does throughout the community. We have our care managers that go out and meet with individuals in their own homes. We do in-person assessments. We base all of the care that we provide for individuals as far as in-home services like caregivers coming in to help with daily activities. We base all of that on person-centered planning. So it's been challenging especially with this demographic to be able to communicate over the telephone in order to try to get a full picture of what's going on with that person and how best to implement services to support their needs. We have our rural transit. We have wonderful drivers that are still able to go out and provide transportation for the community. We've implemented barriers as well as deep cleaning of all of the buses regularly throughout the day in between shifts. We have received wonderful outpouring support from Monroe and Owen counties and donations volunteers offering to help. We have our retired senior volunteer program where a bunch of retired seniors come and volunteer to assist with other individuals in the communities. And one of the things that's been really wonderful is they've been making friendly calls to people that may be in those facilities that Lynn spoke about and having difficulty trying to - sorry cut out there - having difficulty trying to make sure that they're maintaining social relationships in this time when we're supposed to be social distancing. So they can call and talk with people, brighten their spirits let them know that they do have support. We've even seen hand sewn masks be delivered for our volunteers and employees. We've had our main office closed to the public and have been staggered you know shared space to continue social distancing. There's been a lot of changes, some challenges but very impressed with the way that our community has responded. 

>>BOB ZALTSBERG: Yeah. Thank you Melissa. So Sarah Waddle, I'm sure that life has changed for you too with the AARP. So what are some of the unique steps that the state AARP has taken to try to serve your population? 

>>SARAH WADDLE: Sure. Hi Bob. Thanks for asking. I'm here to be part of today's conversation. You know life has changed for us and AARP as well. As you may know we are a nonprofit nonpartisan membership organization here in Indiana. We represent about eight hundred and twenty thousand members and their families. And it's really about working to empower people to choose how they live as they age. So taking that purpose in and looking what's happening with covid in our long term care facilities it has caused us to become pretty hyper focused on this issue. Obviously you know we have some other priorities but this is really taken front and center, working at both a state level and federal level, looking at policy recommendations and making sure that our facilities, the workers and our facilities and our residents and our families are being served the best they can be during this time. There isn't a playbook for this. So it's it's a little bit fast and furious and trying to get all this figured out. But I think you know AARP has always up to the challenge. 

>>BOB ZALTSBERG: Right. So I know that we've had a lot of questions about nursing homes and about this population and I'm going to ask a few of them now. I mean one of them is a pretty basic question. But I hope that maybe Lynn could start with this, answer it. It says a majority of - this is from Barbara. A majority of residents in these long term care facilities don't go out much. How or who is infecting them and what kind of follow up is being done? 

>>LYNN CLOUGH: I'm not sure I understand the question. Could you repeat it Bob? 

>>BOB ZALTSBERG: Yeah. Well I think the question is basically if you know that nursing homes have been areas where there've been a lot of infection. At least that's - I'm stating I guess a very broad statement but since a lot of the folks who do live in the nursing home just that's what this question says don't go out much is being brought in by family members, by workers. Do we know in those areas where there have been hotspots? 

>>LYNN CLOUGH: OK. All right. Thank you. I think you know many residents don't go out of long term care facilities. However you know sometimes residents become ill. And they are transferred to the hospital. Some residents have dialysis three times a week and need to go out. Dialysis is not provided in most nursing facilities. So they go to a dialysis center. So some residents are are being transported in and out of the facilities. I know that facilities are taking great care to protect those residents from transportation and getting them out of the building into where they're going in and coming back in. But you know there's always that we don't know exactly you know how covid is being transferred. But we also know that as careful as staff is and in using handwashing techniques and PPE personal protective equipment or PPE correctly - and you know they've all been trained on it. And I know they use it. But you know sometimes things happen. We also have staff going in and out of - you know they go home at night. And I'm sure you know they're very careful they take all precautions but they go back in the next day. So again it can happen. I think the visitation restrictions helped with that. You know having as few people in and out of the facilities as possible has hopefully reduced the number of covid positive cases and facilities. 

>>BOB ZALTSBERG: If I could ask you to expand a little bit on the rules that changed today. I was trying to ask Lou Anne but we lost her. We're hoping that we can get her back. But if you could talk a little bit about about what is available now or what what is possible now for people who are going to be trying to visit their loved ones in nursing homes. 

>>LYNN CLOUGH: Well we are very excited about this. And the ombudsman program is very happy to have been a part of this and working with the family and social services administration in Indiana and the Department of Health. The outdoor family visitation guidelines were released on June 3rd. And what it means is - I mean there still are restrictions. But up to this point of family members have been reduced to using phones. And I've heard so many stories of facilities staff who have used their own personal phones to help residents talk with family members. And you know many of many residents are older adults who aren't always used to tech technology and may need a little help with using cell phones or iPads or any other kind of technology. And like I said I heard some great stories of the staff who have really helped with that communication. Other family members have been doing window visiting. But that's not the same as being able to actually see your loved one you know sitting across from you. The outdoor visitation, while it does still have some restrictions, you know family members you know we're asking them I think to limit to two or three visitors. There must be a sign up sheet at the facility. Visitors need to be checked by facility staff to make sure that they don't have symptoms of covid or they don't have a temperature and setting up an outdoor area you know particularly because it's starting to get hot out. It's going to be hot every day, a shaded area hopefully where people can sit while maintaining physical distancing still wearing masks. But at least they have that opportunity now to actually see their loved one. And their loved one can see them. Touching is not encouraged. You know I know that personally for me I'm distancing - physically distancing from my grandchildren. But that's really hard. I want to hug them. And I know that's difficult for residents and their family members. The other thing that we're very excited about is the essential family caregivers in long term care facilities. Those guidelines just came out last week and went into effect today in order to give facilities time enough to prepare. And what this is - so many residents had prior to covid they had a family member who was in the facility with them providing essential care every day or at least several times a week maybe helping them bathe or feeding them helping them eat, just providing companionship. And this applies to family members or even personal private caregivers, a partner who comes in. This - these guidelines like I said start today. And we know that that's such a critical role because it gives the family member a chance to be with that - their loved one. Now they are allowed to come in. They can schedule an amount of time with the facility and provide that care and the support similar to what they were giving before covid. So we're hoping that this will help calm some of their - family members fears and give them some comfort and then actually able to see their loved one again. 

>>BOB ZALTSBERG: OK. I want to ask Melissa and Sarah you know one of them has any any follow up to that in terms of the populations that you work with. 

>>MELISSA ROEMER: Sure this is Melissa Roamer with Area 10. I think it's important for you know different restrictions to be put in place to protect this endangered population. And it's - you know it's a scary time. We're still learning more and more about the virus. And you know there's been some studies showing that people are not expressing any symptoms. And so someone who thinks they're fine could potentially spread the disease. So that's why it's just so important to maintain social distancing frequently wash hands wear face masks do anything you can to protect others as well as yourself. We've been able to disburse some personal protective equipment to our employees and volunteers. If we drop off a delivery we knock on the door immediately step back at least six feet in order to make sure the person is able to get the items that we delivered. So I think it's very important to stay vigilant during this time. 

>>BOB ZALTSBERG: Right. Okay. I want to give our ways to get all of us again. If you want to send us a question or comment news at Indiana Public Media dot org. Or you can follow us on Twitter at noon edition you can contact us there. Sarah. 

>>SARAH WADDLE: Yeah. I think when I was listening I think Melissa used the word militant. And I think that's going to be super important during this time where we start to open these facilities back up under some specific guidelines. And I just - you know I hope that facilities all feel like they have appropriate staffing and appropriate protective equipment on hand to be able to manage these outdoor visitations. And I hope that you know the State Department of Health is really paying attention to see what happens during this time so that they are aware of if this is working or you know maybe we need to rethink some things. So I think we need to be paying close attention to this. And I know facilities across the state do marvelous work. And I'm sure that you know folks are going to be really happy to see their loved ones. 

>>BOB ZALTSBERG: OK. 

>>SARA WITTMEYER: We got a comment that probably Lynn I'll have you react to you first. This is from Mike. He says the Indiana numbers from covid 19 positive tests and deaths don't match those available from federal sources which we've reported here. But the last report said that the state reports were a significant undercount. And then he goes on to say locally he has a friend at a nursing home where there was a significant outbreak. The numbers reported for the state and then from monroe county don't reflect the numbers that the facility is reporting. So he's talking basically about all this confusion between the numbers. So maybe Lynn if you can just kind of address that and if you can explain it all, just sort of the confusion and the different numbers. Can you talk to that? 

>>LYNN CLOUGH: I can speak somewhat to that. I know that there has been some discrepancies. The data released from by the federal Centers for Medicare and Medicaid Services CMS, that number was nearly two hundred more than what Indiana reported on the same day. And I think this was as of last week I believe there have been - now this is the number of deaths but over eleven hundred deaths in nursing homes from the corona virus. Dr. Daniel Rasiniac the chief medical officer for the Indiana Family and Social Services Administration I know has said that the Department of Health is currently looking into those differences and trying out trying to figure out how state can get closer to actual numbers. They say that that discrepancy could stem from a difference in how the data have been reported in Indiana. I think there were actually - there have been two different systems, data systems in which the data from facilities have been reported and initially nursing homes used a system called Gateway to report their deaths to the state. But they were told to use a different system after they were told to start reporting the deaths. So I think those two systems may not have talked to each other very well. And so that could be the reason for the discrepancy. I know that the state now plans to transition to a reporting system that more closely aligns with the Centers for Medicare and Medicaid Services or Cms. So we know that certainly there needs to be a step towards correcting the failure to be more transparent in long term care facilities. I think that all of that - that's very essential information that all hoosiers have the right to know certainly. 

>>SARA WITTMEYER: Mike went on to say in his e-mail. He was just commenting on how the state is not releasing any statistics for each facility. Do you know - I mean is that something that other states are doing as well? 

>>LYNN CLOUGH: I do know that other states are releasing their facility level data. Indiana is not doing that at this time. The Ombudsman Program believes very strongly that facilities need to be very open and transparent with their residents and their family members at this time because people need that kind of information in order to make informed choices. I like - I use the example if your mother or your grandmother fell and broke her hip, went to the hospital for hip surgery for the repair and then needed to go to a nursing home for rehab - rehabilitation, you as a family member you would want to do your research. You'd want to know what facility, where you wanted to put your mother. She's going to be there for four to six weeks perhaps for her physical therapy. Where are you going to put her? You want to know that she's going to be in a safe place where they're going to care for her properly certainly. And I think that knowing these numbers would go a long way towards that. You want to know if there have been a lot of covid positive cases in a facility. But to this time Indiana has chosen not to release that information or I don't know that they actually have that information. 

>>BOB ZALTSBERG: Sarah Waddle you've talked about that a little bit. AARP has talked about the trying to get more data available and trying to be more transparent. Is that correct? 

>>SARAH WADDLE: Absolutely. And I couldn't agree with Lynn more. I think it's imperative that we have this data. And I think that there has been an outcry and a response with a lot of good intentions. We have some facilities releasing data on their own. We have some local health departments that are releasing data. We have media outlets that are trying to track it. And then, as we mentioned, the new data that's being released from the Centers for Medicare and Medicaid Services. So we have this like huge patchwork system. And none of it is apples to apples. You know the discrepancies between the CNS data and the state of Indiana - a couple of things we need to keep in mind - one the CNS data is only looking at nursing and skilled nursing facilities whereas the Indiana numbers have been tracking the broad spectrum of long term care facilities including residential and assisted living. Additionally the CNS data only requires a facility to report back to the beginning of May. They are encouraged to report anything that happened prior to that but that data may be missing an entire two months of cases and deaths that occurred. And so there's just a lot of discrepancies. And it can all really easily be cleared up if the state of Indiana would just serve as that clearinghouse and put the data that they have somewhere and put it out there for folks to clear up the confusion and make our communities safer. Thirty two other states are doing it. And there isn't really a reason why Indiana shouldn't be doing the same. 

>>BOB ZALTSBERG: OK. I think we have Lou Ann Blake from the Heritage House facility in Greensburg with us now. So Lou Ann I was trying to ask you earlier about the changes that are coming up with visitation and how that's going to affect your facility. So if you could unmute your your microphone and talk to us. 

>>LOU ANN BLAKE: We're working our corporation is working on the policy procedure guidelines to be able to start that. We're cautiously excited about it. We haven't really marketed it yet to our residents until we have our guidelines in place, but I think it'll be a good thing - a positive thing. We've allowed window visits up 'til now and so we're looking forward to the next phase. 

>>BOB ZALTSBERG: Well, how tough has this been on your residents? 

>>LOU ANN BLAKE: Actually I think it has been harder on the families than it have the residents. We've kept them as busy as we can. We've been creative with activities. They think of it as the plague. They'll ask if the plague is still out there. But I think they have really appreciated that we are protecting them. I think they understand that. And we're - we've all been in it together here in our little community and I've been real proud of our staff because they want to protect the residents as well, and just hope we continue to get through it. 

>>BOB ZALTSBERG: Yeah. Can you talk a little bit about those staff members too? I mean, they're - really are on the front lines of trying to keep people safe. So as - you know, what kind of stress is this putting on them? 

>>LOU ANN BLAKE: I think we have our moments when we get weary. We've been able to provide the proper protective equipment for them as far as our isolation supplies. We've done some incentive things for our staff - some morale boosters along the way. But I think they're handling it well. They're, you know, as concerned as anyone is. 

>>BOB ZALTSBERG: OK. If you have questions or comments for us, you can send your questions to news@indianapublicmedia.org or you can follow us on Twitter at @noonedition. We are talking with several people involved with nursing home and long-term care today. We have Lynn Clough, the state ombudsman for long-term care. Melissa Roemer, care management team leader for Area 10. Lou Ann Blake from the Heritage House facility in Greensburg, In.. And Sarah Waddell from AARP - she's the state director. Sara Wittmeyer, do you have a question? 

>>SARA WITTMEYER: I was curious just about - what incentives do nursing homes and care facilities have to release this information? Like, I think maybe it was Sarah who was saying that, you know, some of them are doing this on their own but it seems like, you know, it certainly - it's hard for that not to cast a bad light on the nursing home and for people to think, what are they doing wrong there? So I'm wondering who would be best to do that - I mean, Lyn,, do you want to chime in first? 

>>LYNN CLOUGH: Yeah, this is Lynn and thank you for that question. I think that - as far as an incentive, I think you kind of - you've hit it on the nose if that's the phrase. Not being - I think that being open and transparent with you - that's the best thing. You want to have that open communication. Not having that - you know, trying to hide and - or giving the appearance of trying to hide kind of - that kind of information can cast - I would think could cast a bad light on your facility and no one wants that. If your facility gives good care, you want people to know about it. You want residents to come to your facility. So, you know, the coronavirus doesn't discriminate. It's - it can be anywhere. So if it's in your facility, it's in hospitals, it's in - you know, it is everywhere - it's in schools. So - that aren't in session, but - it's not something that reflects badly on your facility unless you - you know, you admit it and say you're doing something about it. Let your residents and their family members know. Let the - let your communities know what's going on. 

>>BOB ZALTSBERG: I'd like to hear what Lou Ann says about that too, as a healthcare administrator. What about this, you know, that we've been talking some about the transparency and the idea of getting data from long-term care facilities - is it a good idea or not a good idea to release said data? 

>>LOU ANN BLAKE: We've been open as far as reporting to the necessary agencies that we're required to, but we're also doing a - it's called a Call-Em-All site that we put messages out to the families and responsible parties to keep them informed of our numbers at our facility. So I think it's very open - it's good to be open about it. 

>>BOB ZALTSBERG: OK. I want to ask Melissa Roemer from Area 10 - you deal with people who are - well, first of all, I want you to talk a little bit about the range of - the range of different services you have at Area 10 and then I'll follow up with my question that's related to COVID. 

>>MELISSA ROEMER: Absolutely. Area 10 Agency on Aging offers a range of programs. The one that I supervise is the care management aspect, and we work directly with the Family Social Services Administration Division of Aging to provide an alternative to long term care in a facility and instead providing those services in the community. I think it's very important to have transparency especially for facilities so that individuals can make an informed decision on whether they would like to be in a facility receiving care or if their needs can be met at home with caregivers coming in, services being provided to them in their own home. That should be the individual's decision so that they can make sure that their needs are met. We also have the same requirements for an individual that is authorized to be in a long term care facility or skilled nursing facility. That same level of need is what can make someone eligible to receive Medicaid waiver services in their own home to pay for those caregivers and different services. We have our rural transit that provides transportation for individuals from a rural to an urban setting and vice versa. We do not do urban to urban. We also have our Endwright center which individuals can come and exercise, get involved in different social activities which is very difficult during this time. But our wonderful staff members have been able to move to a virtual platform with Zoom meetings that our participants can join on a Zoom meeting. Of course that comes along with need for access to computers and Internet. We have congregate meal sites where we would have individuals come to share a free hot meal and be able to socialize. We have transformed those into a site where individuals can come and pick up frozen meals that they can take back home with them and heat up as needed. We have our mobile food pantry. We get donations from community members, Hoosier Hills Food Bank and we're able to provide right now three bags of groceries to each person that is on our mobile food pantry route. And those are delivered solely by volunteers. Our rural transit and our retired senior volunteer programs have come up with an innovative way to provide services to people in their home safely during this time. And they are able to run some essential errands such as go to the grocery store, pick up an order and bring it to the person as well as going to the pharmacy, picking up medications and bringing them to the person's home. We work directly with a lot of community providers that staff the caregivers that come into the home to provide nursing and other caregiving activities. And we've seen those caregivers wearing gloves and masks and making sure that they're taking all precautions to try to prevent the spread of this. 

>>BOB ZALTSBERG: I want to ask you first and then I think the rest of our guests can also weigh in on this but I think we often think about older people having at times bouts of isolation if people don't come visit them enough, their families are off doing other things. Then you add COVID on top of that, what have you been finding with the Area 10 clients? Are people able to have enough contact with the outside world, enough contact with others, you know, that human touch human contact? Or is there something that you know you'd like our listeners to know about reaching out. 

>>MELISSA ROEMER: Sure. Our retired senior volunteer program is making friendly calls if anyone is interested in being a volunteer that can call someone or especially anyone in need of just wanting a friendly conversation to kind of pick up their spirits and continue to try to get some social interaction during these times. They can contact Amy Wardlow. She is our program manager with Retired Senior Volunteer Program. Our main number at Area 10 is 812-876-3383. We have a directory that can get people to rural transit, mobile food pantry, RSVP, any of the programs that we provide. We also have individuals that have made cards and different things that we've been able to mail out to participants and try to get in contact that way and for individuals that have access to the Internet and computer we've been able to use some Microsoft teams meetings to get in contact. We have a lot of people in Monroe and Owen County that live with family members and we've received a lot of response that the family really enjoys being able to stay at home, work remotely and be around their family members a little bit more. We've also been working with the caregivers of the people that we serve to make sure that they have necessary support. It's very easy to feel overwhelmed in this time and so just trying to reach out and meet needs as they arise. We have our aging and disability resource center that people can call to get information or referrals for different types of services and subsidies that are available in Monroe and Owen County. So really just trying to do a lot of outreach, stay in regular contact with people and let them know they're not alone. 

>>BOB ZALTSBERG: Sarah Waddle and Lynn what about this isolation issue? 

>>SARAH WADDLE: I'll jump in here. I think this was something that was an issue prior to COVID, you know, making sure that our older adults knew what to do in the instance of social isolation. The AARP Foundation actually has some really good tools including an assessment, it's called Connect2Affect and you can go to the AARP Foundation's website to see more about that. But I will just hone in on the caregiver piece. I think that there are a lot more of our family caregivers that are balancing perhaps a job at home, kids at home and maybe a parent who was going to an adult day service and now they're at home with them. And so I really want those caregivers to step back and make sure that they're doing OK and reaching out if they need those services. And I couldn't recommend anywhere to go first except for Area 10 or whatever area agency on aging covers your area. 

>>BOB ZALTSBERG: Lynn, do you have anything to add? 

>>LYNN CLOUGH: Thank you. I just want to add, you know, I want to thank Melissa for sharing all of Area 10's, all of your resources and Sarah for you know talking about all of the area agencies on aging because they're all good sources of information for caregivers. As far as the impacts of social isolation on older adults and long term care facilities certainly, you know we've talked about that. And you know I think the facilities, their activity directors have done and facilities have done a great job. And I've seen pictures of residents playing hallway bingo and I've seen pictures of them just doing all kinds of activities. They're being very very creative to keep minds and bodies active during this time. But at the same time we've also heard of people who are staying in the rooms and not getting out and that's a problem. I know that I've heard of you know certainly people with dementia forgetting what their loved ones looked like after such a long period of time of not seeing them and that can be heartbreaking. So that's another reason that I'm so very happy that you know the outdoor visitation is starting and the essential family caregivers you know can be starting to go back into facilities. But you know as far as working with people with dementia and memory care units I think this has been particularly difficult for some of them. So you know there are resources available on the ISDH Web site for special care suggestions for people with dementia who may need to have been moved from their normal room because in the beginning when COVID first began in facilities, as facilities tried to you know separate people who had COVID and were symptomatic from those who did not and were not showing symptoms sometimes people with dementia ended up in different rooms and that has caused some issues. So there has been an attempt to make sure that their living environment continues to be as familiar as possible and minimize their changes in daily routine, just things like that, tips like that are so helpful. 

>>BOB ZALTSBERG: Sara? 

>>SARA WITTMEYER: Lynn, can you talk a little bit about how folks, what guidance you're giving them to prepare for a second wave perhaps of the virus and I guess sort of like what lessons have been learned that maybe they would consider in terms of preparing for a second wave. 

>>LYNN CLOUGH: I think that you know I don't know who said it. It was either Sarah or Melissa. But you know continue to be vigilant and just be prepared. I think we've learned a lot of lessons through this. It's something that we've never been through before obviously. It's been an unprecedented time. So we just want to make sure that residents are - long term care residents are kept you know and maintaining their physical health is so important and make sure that they're still moving and their mental health and just keep them going through this time and you know waiting for hopefully a treatment or a vaccine. You know that may be a long time. We just don't know. I think that - I think we're going to be in for a long period of - I think we've entered our new normal for now unfortunately. But I know that Hoosiers are very good at making the best with what they're given. So I know that we're going to come through this. But I do think a surge is possible. I think we're seeing spikes certainly in other states. And you know I just don't know what the future holds. 

>>BOB ZALTSBERG: Lou Ann, do you want to address that? Or is your facility - I know that you've had to make a lot of changes. Now we're starting to open up a little bit and I think the worry is that if the state opens up too much or too fast that there could be another surge. Are you ready for it? 

>>LOU ANN BLAKE: I believe the industry has been altered. Hopefully not for ever but I'm sure there will be some changes ongoing. One thing I wanted to mention that we're doing a lot of in our facility is face time. We've been face timing families frequently and I think that's been helpful to our residents as well as the families to see what the future holds. 

>>BOB ZALTSBERG: Right. How many people do you have at your facility? 

>>LOU ANN BLAKE: Right now we have 50. Since it's down a little bit we're admitting very cautiously. We're at 50 today. 

>>BOB ZALTSBERG: Now we just mentioned the fact that at times if somebody had presented with symptoms of COVID you would have to isolate them in facility. Have you had that kind of - have you had to do that? 

>>LOU ANN BLAKE: Well we haven't had COVID. As far as new admissions missions we isolate them for 14 days once they're admitted just to make sure there's no symptoms. 

>>BOB ZALTSBERG: OK. We had a question come in and I don't know if you can answer it or if somebody else could about contact tracing, you know, if in a facility someone does test positive for COVID, are there ways to find out who all they came in contact with? And how does that work? How does contact tracing work within a facility? 

>>LOU ANN BLAKE: At Heritage House we've not had to do that here. We do not have any positive COVID residents so we have not had to do that fortunately. 

>>BOB ZALTSBERG: OK. Lynn do you know about that? 

>>LYNN CLOUGH: I am not the person to speak to that. I do not know. 

>>BOB ZALTSBERG: OK All right. Well we only have about a minute and a half to go in the program. So I wanted to just give - I'll start with Sarah, Sarah Waddle, is there anything that we've missed that you'd like to add today? 

>>SARAH WADDLE: No I don't think so. I think it's been a great conversation. I just would say you know if folks are experiencing hurdles or speed bumps in terms of relations with their facilities you know, long term care ombudsman is definitely your best friend. AARP would also like to hear from you just so we know and have a good pulse what's going on out there. You can always give us a call at our toll free number 866-448-3618. Or you can catch us online at AARP.org/in And of course on Facebook. 

>>BOB ZALTSBERG: Okay. I'm going to give Lynn the last word. So we only have about 30 seconds. 

>>LYNN CLOUGH: OK. I would just urge everyone to - residents and family members - to stay connected. Make sure you communicate your needs to your facility and raise concerns to your local long term care ombudsman. And I think it's been a great conversation too and I appreciate the time. 

>>BOB ZALTSBERG: All right. Thank you very much. That's Lynn Clough, the state ombudsman for long term care. Also heard from Melissa Roemer, Lou Ann Blake and Sarah Waddle. For my co-host Sara Wittmeyer, for producers Bente Bouthier and John Bailey, engineers Matt Stonecipher and Mike Paskash. I'm Bob Zaltsberg. Thanks for listening.

nursing home

(Seth Tackett, WFIU/WTIU News)

Nursing homes have been on the frontlines of battling the COVID-19 virus.

Facility residents are especially vulnerable to severe symptoms because many of them have underlying health conditions. They live in close proximity to one another, also increasing risk of spreading infection.

The safety of facilities in Indiana is difficult to judge because the state does not require them to publish data. The state does require long-term care facilities to communicate with residents and families daily on the number of COVID-19 cases and deaths, as well as what steps the facility is taking to mitigate the spread.

According to federal figures released last week, Indiana appears to have undercounted COVID-19 deaths. Federal data report 1,141 nursing home deaths in the state. The state's count from the same day was about 200 people fewer.

This discrepancy could be a result of how data were reported, according to Dr. Daniel Rusyniak, chief medical officer for the Indiana Family and Social Services Administration.

As most of Indiana moves into the fourth stage in reopening the economy, the state put out new guidelines for visiting nursing home residents.

The state also announced it would be testing all nursing home staff for COVID-19 over the next month.

Facilities have prohibited visitors since early March, which advocates say takes a toll on residents and their loved ones.

Outdoor visitations will be allowed if a nursing home has no new cases for 14 days, and has adequate PPE.

You can follow us on Twitter @NoonEdition or join us on the air by calling in at 812-855-0811 or toll-free at 1-877-285-9348. You can also send us questions for the show at news@indianapublicmedia.org.

Note-This week of our guests and hosts will participate remotely to avoid risk of spreading infection. Because of this we will not be able to take callers live on-air.

Guests

Lynn Clough, state ombudsman for long term care

Melissa Roemer, care management team leader Area 10

Lou Ann Blake, Heritage House facility administrator

Sarah Waddle, AARP state director

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