Hawaii senior care facilities are preparing for a coronavirus outbreak in Hawaii, spurred on by the nursing home deaths in states like Washington.
The U.S. Centers for Disease Control and Prevention says older adults and those with pre-existing medical conditions are the most vulnerable for contracting the disease. So facilities that care for the elderly are at increased risk for seeing major outbreaks.
What's not clear is whether all elderly care facilities are abiding by best practices 24 hours a day, and unlicensed nursing homes may not have infectious disease controls in place to help keep the virus from spreading.
CDC has provided guidelines to nursing homes aimed at preventing the transmission of COVID-19 from person-to-person.
Barring visits by anyone who is sick, preventing staff with respiratory infections from going into work and providing personal protective equipment like face masks and gowns outside residents' rooms are among the strategies facilities should be following.
In Hawaii, senior care facilities are beginning to take extra steps in screening people who visit loved ones.
John McDermott, the state’s long-term care ombudsman with the state Executive Office on Aging, has been visiting care homes in recent days.
"One that I had gone to on Thursday asked everyone to sign in. They asked you three questions: have you been to one of these countries in the last 14 days? Have you had contact with anybody who's been to one of those countries in the last 14 days? And do I have a fever?
"That was all self-reporting. They gave you a little stidker so you're wandering through the building, everybody knows you went through the screening," he said.
Three days later, he said, the facility had increased its screening and began taking forehead temperatures of visitors.
Licensed senior care facilities in Hawaii must have infectious disease control plans in place that are approved by the state Office of Health Care Assurance.
"For infection control, the facility would need to identify for us how they would prevent the spread of infection, keeping things clean, keeping sanitized those common use [areas] or anything that might otherwise be shared with other people," said Keith Riley, chief of the office.
"So things need to be clean and infection-free to the fullest extent possible or reasonable."
Only state licensed senior residential facilities must have approved infectious disease plans. That’s why it’s important for families to only choose licensed care facilities for their relatives, Riley said.
The office has no plans to mandate any additional preventative measures to cope with the coronavirus, but the facilities do have to follow any directives from the CDC.
As the coronavirus has spread, at least one agency that matches seniors with licensed providers has seen an increase in the number of families looking for elderly care.
"We're seeing a lot of people trying to set up care right now. I think before everybody is trying to make sure that they have adequate supplies and adequate care in place. So we are, you know, right now setting up a lot of caregivers," said Nicole Coglietta, CEO of Care Sift.
Care Sift has changed its practices in the wake of the coronavirus outbreak, she said.
The company now limits tours of facilities to only one or two family members, and it has reduced the number of tours it schedules to decrease exposure and risk for any infections.
While dealing with only licensed facilities provides a measure of assurance for families seeking quality care, McDermott questioned if care facilities are doing all they can to prepare for the virus.
He's not certain, for example, if night shift staffers are taking the same precautions as those taken during the day. He also said facility staff need to enforce the screening requirements, such as ensuring all visitors are properly checked.
There are now two confirmed cases of the coronavirus in the state. One, a man in his 90s, was in serious condition at Kaiser Permanente's Moanalua hospital. The other is in stable condition and quarantined at home under supervision by the health department.