The number of investigations into suspected abuse and neglect of adults at New Mexico long-term care facilities fell sharply amid the COVID-19 outbreak as nursing homes were closed to in-person visitation.
The Adult Protective Services Division of the state’s Aging and Long-Term Services Department conducted an average of 459 investigations per month into abuse and neglect allegations between January and March of this year. But that number fell to 294 in April and 332 in May, Cabinet Secretary Katrina Hotrum-Lopez said Friday.
“We didn’t want to make our clients more vulnerable, and so we did a lot of things virtually,” Hotrum-Lopez told legislators at an online meeting of the Legislature’s Health and Human Services Committee. “When we started closing down, we saw a drop and a decline in the types of complaints that we would actually investigate.”
The care people receive in congregate-care facilities has been under scrutiny almost from the beginning of the COVID-19 crisis — first with deadly outbreaks of the novel coronavirus at nursing homes statewide and later as families began to chafe against the restrictions that often limited their visits to communicating through nursing home windows.
As the virus began to spread in New Mexico in March, state officials issued an emergency order limiting contact at nursing homes to people whose loved ones were receiving end-of-life care and prohibiting other visitors.
Earlier this month, Gov. Michelle Lujan Grisham relaxed the state’s restrictions, allowing for outdoor visitation by appointment with group home residents at long-term care facilities with no active COVID-19 cases and only in counties with low case rates.
The governor has acknowledged the difficulties families have experienced since they have been able to visit loved ones, noting earlier this month that she hadn’t been able to see her own mother.
“Long-term care residents and their families have suffered over these long months of the pandemic,” Lujan Grisham said.
Still, she has emphasized the importance of protecting some of the most high-risk members of the population from COVID-19.
When the restrictions were tightened — and even now with limited visitation — long-term care officials have had to change how they conduct investigations, speaking by phone or online with more residents and staff.
“You’ll see in the past that we just really strictly did in-person investigations,” Hotrum-Lopez said. “Now, in the present, we’re doing more phone and FaceTime and socially distant investigations.”
With that new approach, officials expect the number of investigations they conduct to rise going forward.
“We’re excited about the new changes that we’re implementing and are excited to start to see our investigations go back up,” said Emily Floyd, director of the Adult Protective Services Division. “We know that abuse, neglect and exploitation did not take a break because of COVID, and we are hopeful that we can start to really address those going forward.”
The restrictions on nursing homes have affected not just investigations but other services that require visitation.
“We’ve always relied on staff and residents, or families and residents, to tell us really what was going on in these facilities,” Hotrum-Lopez said. “Since no one has access, we’ve had to pivot that, too.”
The lack of visitation has affected the ability of family members to understand the medical condition of their loved ones, and the department didn’t realize this “as early as we should have,” the secretary said.
“We kept hearing from family members that they didn’t know that their loved one had fallen. They didn’t know that there was something really going on,” she said. “Finally, when they got to see the resident, even through a window visit, there had been a definite decline.”
Some legislators on the committee praised the department’s efforts to adapt to the pandemic and monitor nursing homes despite the restrictions.
“I think you’re doing great work,” said Sen. Liz Stefanics, D-Cerrillos.
Yet others were critical of how state officials have responded to COVID-19.
“I was glad to hear Secretary Hotrum-Lopez say you weren’t on top of this early enough,” said Rep. Debbie Armstrong, D-Albuquerque. “You weren’t.
“I hope that we’re actually learning big lessons from this because we were not prepared,” Armstrong added. “We were not prepared in long-term care for an emergency anywhere near this.”