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COVID communication is key for Lewis County nursing home

Watertown Daily Times - 2/27/2021

Feb. 27—LOWVILLE — The nursing home that's part of the county-owned Lewis County Health System had people calling, frustrated with their inability to connect with their loved ones and convinced they weren't being told what was "really" going on in the facility.

Those calls aren't happening any more. Transparency fixed it, officials said.

Health system Chief Executive Officer Gerald R. Cayer said the nursing home management team and system administration realized they had to communicate better with the community and family members of residents because of the number of calls and as the frustration of families increased as the county saw its first surge of COVID-19 in early November.

"We were getting questions," he said. "We started seeing residents at the nursing home who were positive, admissions at the hospital who were positive and staff that were positive ... and there was a meaningful concern with regard to the nursing home residents which we all understood."

At that point, Mr. Cayer said families and nursing home residents hadn't seen each other for "six to eight months" and the sadness was tangible every time he was at the nursing home. Family members had been on edge from the beginning of the COVID crisis, he said.

"There was real concern that there was COVID at the nursing home and somehow we weren't sharing it accurately or openly, but we were," Mr. Cayer said. "Communication is an interesting item. For communication to work effectively, the person sharing the message needs to be clear. The person receiving the message needs to understand it.

"If you have those two things occurring, then you have meaningful dialogue in the sense that transparency is there," he added. "It's happening."

As a result, a health system team worked to create a communication tool that would be clear, concise enough to fit key information on one page. That information includes COVID-related statistics about the number of people with the disease whether they be residents, staff or patients, and has evolved to include the number of tests performed and vaccines given.

It also makes clear which people who died of COVID-19 at the hospital were nursing home residents.

But there were some basic challenges from the start in a system with both a residential facility and hospital.

"First thing we had to work through was this notion of, 'Is an individual a hospital or nursing home patient?'" Mr. Cayer said.

As has been made widely known because of controversy surrounding nursing home death numbers released by Gov. Andrew M. Cuomo's office, a nursing home resident who requires hospitalization is officially discharged as a resident and admitted to the hospital as a patient. After being released from a hospital, a patient who wants to return to their nursing home has to be reprocessed as a resident administratively.

"You could put a report out there saying we had no nursing home deaths (even though) we had a death in the hospital," Mr. Cayer said. "Technically correct, however, what people really wanted to understand was how is COVID impacting those that live in a long-term care facility?"

Since the first report was issued Nov. 24, the report is updated daily on the health system's website and shared with the most relevant media outlets.

"As a result we don't get calls anymore," Mr. Cayer said. "That would suggest to me that we found that balance around transparency and information sharing that made sense but also we were able to respect the (Health Insurance Portability and Accountability Act) requirements. I think it works pretty well and we continue to do it."

Mr. Cayer said many lessons have been learned as the pandemic thrashed the state, causing the "book" on how to manage the pandemic to be written as it was being lived.

"In the early days of the pandemic, I thought the executive branch was doing a terrific job ... trying to lead and support as our entire health infrastructure in New York state had to mobilize for something that was not clear cut. In those first few months I thought a lot of good things happened," Mr. Cayer said. "I don't think I'm in any position to judge our elected and appointed leaders because I've been on phone conference calls since the beginning with many people who are, I believe, working hard to do the right thing."

Although the number of COVID-19 positive cases are decreasing across the board in the county, the daily data updates continue.

"By sharing what's happening in real time, I think we're reassuring our community and our workforce that we're managing this thing. That's good news," Mr. Cayer said.

New guidelines for allowing family member visitation in nursing homes recently released by the state Department of Health are giving community members hope, Mr. Cayer said, although the criteria to allow visits are strict: all nursing home residents and staff must be COVID-free for at least two weeks.

Calls haven't increased again despite a pervasive eagerness to visit. People have the information they need to know for themselves if visitation can begin based on guidelines.

As of Friday afternoon's data report, five nursing home staff members tested positive for the disease while two patients are still positive.

Lewis County Health System's "Daily COVID-19 Facility Specific Updates" page can be found afternoons Monday through Friday on its website at www.lcgh.net.

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