Long-Term Care Ombudsman program adjusts to pandemic

Like other states, Delaware’s Long-Term Care Ombudsman program works to resolve problems related to the health, safety, welfare and rights of individuals who live in long-term care facilities.

The list includes nursing homes, board and care and assisted living facilities, and other residential care communities. It can even be people living in their own homes.

In normal times, Jill McCoy’s job overseeing Delaware’s ombudsman program provides an inside track to those places.

Jill McCoy

“One of the things that we do is we go into the facilities,” said Ms. McCoy, who has overseen the ombudsman program for about 2½ years. “We talk to residents. We talk to family members and we talk to the staff. Our role is to advocate for residents’ rights, to educate family members and facility staff about residents’ rights and good practices and making sure that residents have timely access to ombudsman services. We provide technical support to the development of resident and family councils inside of the facilities.”

COVID-19 has shut those doors, and Ms. McCoy and the state’s ombudsman staff are on the outside looking in.

“What the impact has been is we can’t go into the facilities. So we are relying primarily on facilities to contact us if there is an issue or a concern,” said Ms. McCoy. “Facilities have been really good about being the first point of contact. They will reach out to their ombudsman. Family members will reach out. But at this particular point it’s very difficult for most of the residents to reach out to us.”

Nursing homes have been at the forefront of the COVID-19 impact in Delaware. Through April 25, 74 of the 120 Delawareans who died related to the virus were residents of long-term care facilities in the state.

But Ms. McCoy said Friday she hasn’t heard from any families about those deaths.

“The Ombudsman staff has not been contacted by any families about the deaths of residents due to COVID-19. One family called about a planned discharge,” she said. “When we get concerns from the facilities, such as the lack of testing kits, we recommend they bring up the issue with the Division of Public Health’s State Health Operations Center, which holds twice-weekly calls that include facilities’ representatives.”

The facilities can also email their concerns to dph_pac@delaware.gov or contact the DPH call center at 1 (866) 408-1899 ext 2, Ms. McCoy said.

The First State’s ombudsman program works in conjunction with the Division of Delaware Healthcare Quality through the Department of Health & Social Services.

“They are our surveying entity if there are problems, issues or concerns. They can go in — and they still have the ability to go in. It needs to be around infection control or immediate jeopardy. So if we were to get any type of complaint or concern about abuse, severe neglect, financial exploitation we would reach out to them,” said Ms. McCoy. “And in all honesty, they handle those issues anyway, not just during COVID-19.”

Ms. McCoy added that she has been in contact with Division of Healthcare Quality Director Yrene Waldron, as well as Cheryl Heiks, executive director of the Delaware Healthcare Facilities Association, of which most of Delaware’s nursing homes are members.

Given the continuation of Delaware’s State of Emergency, which placed restrictions on nursing homes in March to prohibit visitors and increased them last week to require further actions to prevent the spread of COVID-19, efforts are being made to create virtual contact with residents.

“We’re reaching out via phone or email. We’re trying to set up the ability to either Facetime or talk with residents on the phone, so that we can keep contact with the residents,” said Ms. McCoy. “It is very different at this time. We’re trying to figure out ways to be creative and be supportive of family members, residents and staff. We recently reached out to the facilities to see if we could find a way to do some Facetime or Zoom with residents.”

In an April 21 email to facilities, Ms. McCoy requested direct contact information “because some of our residents are younger — they have cellphones — so that we could contact them directly. We also asked for the resident’s representative information so we could reach out to family members. And we’ve done that with facilities, too. We’re here to help. We understand that they are having a very difficult time as well.”

On a bi-weekly basis, Ms. McCoy is part of the state health operations call with facilities, hospitals, nursing homes and assisted living facilities.

“I am on the call and I am able to hear what their immediate concerns are. And I guess it would be no surprise that testing and personal protective equipment and staffing are all concerns for most of the facilities in Delaware,” said Ms. McCoy.

Just over a month into the pandemic emergency, Ms. McCoy said the caseload has basically returned to normal, noting report data spanning March 13 through April 22.

“Right now, our caseload count has gone down and the number of activities that we do related to advocacy and education have also gone down,” said Ms. McCoy. “Initially the complaints were about visitation. Family members were incredibly upset that they could not visit their loved one. We were upset that we couldn’t visit either. It was a huge rush. Those calls have almost completely stopped. I think now that we are a little over a month into no visitation, people understand the implications of COVID-19, especially on a vulnerable staff (and persons) with underlying health conditions.

“The number of calls we are getting now are more normal type calls for what we would get if we weren’t in a COVID-19 situation.

“I am just trying to keep my finger on what’s going on in the facilities and making sure that we are not forgetting the residents. One of the most important things that I think people forget is this is the resident’s home. And this environment for them has changed drastically,” said Ms. McCoy.

“We have reached out to facilities and asked, ‘What are you doing now that you’ve got social distancing?’ And the facilities have gotten creative. They are doing hallway Bingo, where they are going over the PA system. They are trying to engage the residents.”

In addition to Ms. McCoy, Delaware’s ombudsman program includes two long-term-care staffers in New Castle County, one covering Kent and lower New Castle County, and another in Sussex County.

“We have volunteers in our program, too, but of course the volunteers can’t go in at this time either,” said Ms. McCoy. “So, they are concerned as well, and have the same concerns that we do. We’re not in there. We’re not able to be the resident’s voice. But hopefully this too shall pass. We just don’t know when.”

Helpful Coronavirus links

Delaware Division of Health Coronavirus Page
CDC: About the Coronavirus Disease 2019
CDC: What to do if You Are Sick
Johns Hopkins Coronavirus Resource Center
AP News Coronavirus Coverage
Reopening Delaware: Resources for Businesses
Delaware Phase 2 guidance

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