All Clear? Almost There for Senior Living!


Michael Gill

With Covid-19 infections now so low in assisted living and memory care communities, for the first time in a year, it is now safe to consider moving your loved one into a senior living community.

Coronavirus vaccines have to be recognized as a marvelous and stunning success in preventing Covid-19 in Travis County Long Term Care Facilities. Recent data among residents of Travis County Long term care communities (nursing homes, assisted living, and memory care communities) show the 7 day moving average of new infections at 0.1 cases per day as of March 17, 2021, compared with the peak of 22.7 daily new infections on January 22, 2021. This is even better than statistics nationwide which show that cases in nursing homes nationwide are down 80 percent from their peak.

This success is stunning for a variety of reasons. First, at the beginning of the pandemic, it was thought vaccine development would be exceptional if it were completed in 18 months. The U.S. approved two vaccines in under a year. Second, the vaccines have been extremely effective (preventing approximately 95 percent of infections) with remarkably few side effects (despite what you read in the newspapers). Third, the concept of herd immunity seems to be demonstrated by lack of virus transmission in small, fully vaccinated communities such as in nursing homes, as well as in small countries such as Israel, which has over 50 percent of its population vaccinated and has plunging case numbers.

Of course, even with these wonderful vaccines society doesn’t yet have a perfect solution to end the pandemic. We are dogged by manufacturing delays, concerning apparent side effects, unknown safety among certain populations on whom the vaccines weren’t studied (pregnant women and children under 16 to name a few), and uncertain efficacy against new mutations. We are by no means at the end of the pandemic yet. But there is ample reason to hope. The government says there will be sufficient vaccine supplies for every American by the end of May. It will take more time to get shots into arms, and recent estimates have the U.S. at a 75% percent vaccination rate by mid-July. Assuming studies show vaccine safety for children, we may be able to safely open schools on a normal schedule in August and September. Herd immunity is thought to be achieved at 70 percent or above of the population, depending on how contagious new virus mutations become.

Vaccinations in Senior Living communities began just before Christmas, and the large majority of communities had their second inoculations by February 1st. By March almost all residents of long-term care communities had received both shots plus the required two weeks to achieve full vaccination potential. The success of those vaccinations has now conclusively shown up in the numbers. The success of the vaccine naturally opens up the question as to when the “All Clear” will be given for seniors and their families to resume a visitation scheme akin to pre-pandemic restrictions.

The first answer is that the initial decision to re-open will come from the regulators, not communities. Second, it should be pointed out that there are two regulators who will make separate decisions: the nursing home regulator is Centers for Medicare and Medicaid Services (“CMS”), while for assisted living the regulator is the Texas Department of Health and Human Services (HHS). CMS revised its policy on March 10, and now allows “responsible indoor visitation at all times.” This is far from a blanket approval for unfettered visitation and gives individual nursing homes flexibility to restrict visitation as they see fit, as the word “responsible” is sufficiently ambiguous to cover a wide range of visitation policies. This is an interim policy likely to last for three to six months at least before full visitation is allowed. HHS is anticipated to issue new visitation guidelines for assisted living communities by the end of March, as their current emergency rules only last through April 3. The new guidelines will likely follow CMS precedent, easing rules for visitation but allowing some degree of flexibility to communities. Independent living communities are unregulated, but will likely follow common sense and HHS guidance.

Third, the final approval to open communities to pre-pandemic operations—the proverbial “All Clear”—will likely come sometime in the second half of the year. Pre-pandemic operations in my definition would be when families are allowed in the building, are able to hug their loved one any time they want, and residents can come and go from the building without restriction. Regulators are by their nature cautious, and the “abundance of caution” mentality will probably take longer than we want to relax final pandemic restrictions. And there is always the wild card of virus mutations when potentially a new strain of the virus emerges that isn’t covered as effectively by the vaccines.

During the first three waves of pandemic infections, from March 2020 through February 2021, the only time it was prudent to consider moving your loved one to Senior Living was when there wasn’t really any other option. With dining rooms open again, with activity schedules beginning to approach normal, and with ultra-low infection potential due to vaccinations, it is now again time to consider Senior Living a viable option for any Senior needing more care assistance, or even just for socialization.

As Always, Texas Senior Living Locators is here to help. Call (512) 402-2795 for a no-obligation consultation regarding all things Senior Living.


Leave a Comment