May 6—With Mother's Day only days away, state officials acknowledged Wednesday that nursing homes can't stop families from taking grandma off premises for a ride or a visit to the family home on her special day.
That message surfaced as state health officials met in a biweekly teleconference with nursing home administrators and outlined their latest approach to COVID-19 safety measures.
State officials have ripped up nursing-home guidelines they implemented last week. They now suggest administrators rely on federal guidelines for nursing homes and the state's Universal Best Practices, which were adopted by Gov. Chris Sununu's Economic Reopening Taskforce and go into effect Friday.
"We're in a new environment," said Dr. Elizabeth Talbot, the deputy state epidemiologist.
That new environment has been highlighted in recent days by the case of Leo Buote, a resident of Hanover Hill Health Care in Manchester who wanted to visit Billy's Sports Bar and Grill for lunch and a beer.
Owner Bill Laberge eventually delivered the meal to the 96-year-old World War II veteran. Laberge may soon see Buote on a Billy's barstool.
In discussions on Wednesday, state officials said they can't stop a resident from leaving a home.
"The resident still has a right to leave, to go visit," said Susan Buxton, the long-term care ombudsman for New Hampshire. But she said a returning resident may face some restrictions, including isolation.
During Mother's Day 2020, most nursing homes erected tents that allowed for visits under strict guidelines for social distancing, screening and masking, said Brendan Williams, president of the New Hampshire Health Care Association, a trade group of nursing homes.
This Sunday, with the forecast calling for sunny weather but highs in the low 60s, visits can take place both inside and outside.
But Williams said indoor visitation is labor-intensive. Guests have to be screened, and homes likely will have to schedule appointments for Mother's Day visits.
As for social excursions, Williams said federal guidelines are confusing and seem to suggest a don't-ask, don't-tell approach to exposure risks, such as going to a restaurant, he said.
The new flexibility comes after more than a year of orders and strict regulations in the face of a pandemic that hit New Hampshire nursing homes especially hard.
"Nursing homes are highly regulated. We're used to FAQs and bright lines. Bright lines are easy to follow. In the case of social excursions, there's more ambiguity," Williams said.
Inside the nursing home, many activities that had been forbidden — card playing, communal dining, sharing newspapers, visiting parks — can now resume. Administrators have the flexibility to make sure they are safe, state officials said.
For example, if everyone on a bus trip to a park is fully vaccinated, they would not have to wear masks or socially distance on the ride, Talbot said. If unvaccinated residents wanted to go on a trip, they would have to take a separate bus and mask up.
"One of the key messages here is you can choose to allow these events to take place — look at how you can make it safe," said Dr. Benjamin Chan, the state epidemiologist.
But officials cautioned that privacy laws prevent administrators from disclosing whether a resident has been vaccinated. So although a nursing home can segregate vaccinated and unvaccinated people on buses and dining rooms, they just can't tell the residents why, said Kristie Holtz, who works in the office of Health and Human Services Commissioner Lori Shibinette.
Officials also cautioned that we're still in a pandemic.
Chan said vaccination and non-medical actions such as masking and social distancing will keep infection rates low.
"We're not out of it yet," he said.