To protect the elderly and sick from the spread of the novel coronavirus, visits by family and friends to some area nursing homes are being strictly controlled.

Secretary of Veterans Affairs (VA) Robert Wilkie announced Tuesday that visitors will not be allowed to enter the agency’s 125 nursing homes around the country. The VA operates two inpatient facilities in the area, known as Community Living Centers, one at the Audie L. Murphy VA Hospital and the other at Kerrville VA Hospital.

But 15 nursing homes in San Antonio have contracts to care for VA patients. Although they are not affected by the mandate, at least one has decided to bar visitors, while others are tightening their visitor screening protocols.

Nursing home residents are considered to be at particular risk for coronavirus. In Washington, 19 deaths from the virus known as COVID-19 have been tied to a nursing home that became the epicenter of that state’s outbreak.

The VA has estimated roughly half of all veterans are over 65 years old, and many have underlying health conditions that make them more vulnerable to disease.

The continuing care retirement community Blue Skies of Texas provides skilled nursing care for veterans at two locations in San Antonio but is not a VA nursing home.

Blue Skies is following recommendations from the Texas Health and Human Services Commission, posting signs at the entrances urging visitors not to enter if they have symptoms of respiratory illness, said Darrell Jones, president and CEO of Blue Skies.

On Thursday, the staff also began screening potential visitors to its nursing, assisted living, and memory care facilities.

“We’re making sure that we’re checking people as they are coming in” and making sure they don’t have a cough, fever, or sore throat, Jones said, as well as screening for travel to certain parts of the world. “We don’t want to put our population at risk, so even though we’re doing it differently [than the VA], it’s the same outcome.”

Many of the procedures Blue Skies is implementing are similar to those developed during the influenza virus H1N1, or swine flu, outbreak in 2009, he said.

“We’re not locking down our facilities … but we are communicating with families of our residents, telling them what we’re doing and how we stepped up and increased our infection control,” he added.

Freedom House at Blue Skies West is one of the locations where Connie Wyckoff sits with people in hospice.
Blue Skies West Credit: Bonnie Arbittier / San Antonio Report

Meridian Care, which has 44 patients at its Monte Vista nursing home and is a VA contractor, has implemented a no-visitor policy after starting with limited visiting hours last week.

“We are currently disinfecting everything. We’re screening residents, we’re screening employees, we’re screening vendors,” said Administrator John Villarreal, adding that the facility is limiting vendor entry as well.

Texas HHS, the agency that regulates the 3,240 nursing and assisting living facilities throughout the state, also is encouraging care facilities to ensure policies allow employees to stay home when ill and monitor and isolate residents with fever or acute respiratory symptoms.

A Brookdale Senior Living spokeswoman said its 10 facilities in the San Antonio area also are following state guidance, which varies among the 45 states where the company operates.

“We have a command center set up … with both local leadership at the community level, district leadership, corporate leadership,” she said. “There’s just constant planning going on and discussions … analyzing the what-ifs.”

Among the procedures Brookdale has put in place is canceling sponsored outings and group visits to its facilities.

Morningside Ministries operates 170 skilled nursing and rehabilitation units, or beds, at its Medical Center community and 42 memory care units and 40 skilled nursing units in Boerne.

The president of Morningside Ministries Senior Living Communities posted a letter on its website outlining steps it is taking to protect residents, including increased sanitation and daily use of a Xenex germ-sterilizing machine.  

At The Towers on Parklane, where JoAnn Dick lives in the independent living apartment community, everything is being disinfected, including the shuttles that transport residents and the shopping carts they use to carry groceries to their apartments.

She said some residents are cutting back on travel plans so as not to get infected or carry the virus back into the community when they return. “Because we’re all vulnerable at our ages,” Dick said.

St. Francis Nursing Home on West Woodlawn Avenue has closed to visitors. LaVonne González usually visits her 90-year-old mother, who has Alzheimer’s disease, there five days a week.

St. Francis Nursing Home is currently not allowing visitors due to the possibility of spreading the novel coronavirus (COVID-19). Credit: Scott Ball / San Antonio Report

“When she does see me, her eyes brighten up like she does recognize me still and I’m afraid that if I don’t get to see her … I’m just afraid,” she said. “But I do realize the seriousness of this. And I do realize that … I could walk in there and be a carrier and I don’t even know it. And if I hurt those people, I would be devastated.”

In talking points provided by the National Center for Assisted Living, the assisted living voice of the American Health Care Association, the organization advised nursing homes with no confirmed cases of coronavirus to discourage family members from moving their elderly loved ones out of the facility.

“Moving the elderly or frail is risky and often can cause other complications that have long-lasting impacts,” it states. “Research around moving residents out of buildings because of natural disasters and other emergency events has proven this over time.”

Shari Biediger

Shari Biediger is the development beat reporter for the San Antonio Report.