ST. LOUIS — The COVID-19 pandemic is keeping people from their relatives in care facilities. Many of them aren’t happy with the uncertainty of not being able to check on their loved ones.
Michelle Steger also knew that families find out little about how their relatives are treated in residential care. She’s been in rehabilitation facilities herself, so when her mother needed rehab for a broken hip this year, she wanted a little window into her world to make sure she was alright.
A Missouri law just passed to help her do that. As of August, residents and families can ask residential care facilities to let them install cameras in their rooms for the family to monitor. Making that happen in a pandemic, when the camera would help the most, presented an unexpected challenge for the Stegers.
Steger and her siblings haven’t seen their mother, Marilee, since the start of September, when she was placed in rehabilitation at Bethesda’s Dilworth facility.
“We haven't been able to see her at all and only talk to her on the telephone,” said Steger. “We asked about visiting and they said there's no visitors allowed.”
Steger hoped that installing a camera for monitoring would also let her communicate with her mom more often, fighting off some of the loneliness many nursing home residents have felt since facilities started restricting visitors.
“Mom has no idea how to use a camera or even how to use a smartphone. So that's why we thought, oh, this law be great. You know, my mom, we can get a camera in there. We can talk to her through the camera. But that hasn't happened,” she said.
Steger says Bethesda raised some concerns about how the camera would be installed, even though Steger’s sister offered to do it herself.
“The director emailed my sister and said, due to COVID-19 restrictions, we're not allowing any visitors. So you can't come in and hook up a camera until we're out of phase one,” Steger recalled. “They're using it as an excuse not to enforce it.”
Representative Jim Murphy expected some obstacles when he filed House Bill 1387 in December. A worldwide pandemic wasn’t among them yet.
“[Residential care facilities] were concerned about the privacy of their staff. What would happen if the nurse came in, dropped the bedpan and fumbled around?” he said. “They could become a YouTube sensation.”
The monitoring bill was one of his legislative goals for two years already, but his efforts gained momentum with the pandemic.
“When I filed this bill originally I was told it will never pass. I took it on kind of as a challenge,” said Murphy. “It was almost as if the situation caught up to the bill.”
The “Authorized Electronic Monitoring in Long-Term Care Facilities Act” includes a lot of requirements for how the video is handled and who can access it. To start, nobody is allowed to release the footage without the resident or guardian’s permission, except in cases of abuse or neglect. When footage shows suspected abuse, there are specific steps for using the footage to report the allegations. The resident or their guardian has to install a sign to notify people that recording is happening in the room. And the resident’s roommate can ask that the camera be aimed away from them or for audio recording to be limited.
Murphy said that even with COVID-19 limiting access to residential care facilities, the law is clear.
“The law’s very specific. It says you shall allow it,” he said. If a nursing home doesn’t comply with the law, he added, “They lose their license.”
The I-Team is already getting results for Steger and her mother. Moments after 5 On Your Side’s PJ Randhawa called Bethesda, the facility’s administrator called the Stegers to schedule the installation of those cameras.
In a statement, a representative of Bethesda wrote:
“Bethesda is compliant with requests for the installation of Authorized Electronic Monitoring at each of its facilities, in adherence to the criteria expressed in HB 1387, which requires us to secure resident consent prior to installation. At the same time, Bethesda is following all restrictions issued by the Centers for Medicare and Medicaid Services (CMS) regarding protecting our communities from the spread of COVID-19. This includes restricting access to our buildings to only approved essential workers and compassionate end-of-life visits with families.
“Protecting residents and staff from infection is of paramount importance, and we appreciate the cooperation we continue to receive from families, loved ones and our service companies to ensure everyone’s wellbeing as we honor requests for video installation during a pandemic.
“All of the necessary consents and forms have been received in this case, and therefore installation of the equipment has been scheduled. To ensure electrical safety for the installation, the resident-provided video equipment will be installed by independent contractors with whom Bethesda has worked – in this case, an independent IBEW systems contractor with certified technicians. In accordance to the current CMS regulations, any person entering a skilled nursing facility (including employees and vendors) is tested for COVID-19 weekly, as directed by the St. Louis County COVID-19 positivity rates, and screened daily with questions addressing signs and symptoms consistent with COVID-19, including a temperature reading. Hand-hygiene education is provided, along with readily available hand sanitizer and required personal protective equipment (e.g. masks.)”
Steger is warning other families that taking advantage of this new law may mean encountering the same obstacles.
“That is one thing that's not in the law: any kind of timeline. So if they can just make us go through hurdles until they discharge her, I think that's what they'll all do,” she said.
The Missouri Department of Health and Senior Services has two liaisons available to help residents and families through the process of installing a camera in a residential facility. Their contact information is:
Alex Tuttle, Alex.tuttle@health.mo.gov 573-751-6008
Shelly Williamson, Shelly.williamson@health.mo.gov 573-526-4872
The text of the law is available on the Missouri House of Representatives website.