COLUMBUS, Ohio — When the coronavirus pandemic restricted visits to facilities like nursing homes and psychiatric hospitals, the Ohio nonprofit that advocates for people with disabilities faced a dilemma: How do you keep tabs to make sure they’re protecting residents and patients if you can’t enter the building?

The Columbus-based Disability Rights Ohio decided to move its monitoring visits online, meeting with administrators over Skype or Zoom and getting guided tours from an employee walking around with a laptop or tablet.

Like many Ohio workplaces, Disability Rights Ohio has seen long-term benefits from the changes they implemented amid the pandemic. Virtual visits helped the nonprofit significantly increase the number of facilities it visited over a two-month period earlier this year. It’s been so beneficial that DRO will likely move to a hybrid model in the future, where some of its visits are conducted in-person but many remain online, said Amy Price, the nonprofit’s abuse and neglect team leader.

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“I think the benefit of having put this in place is that we’ll definitely see an increase in the number of places we’re able to visit per year, because we’ll take a blended approach.”

The Ohio governor’s office designates Disability Rights Ohio, a nonprofit based in Columbus, to advocate for and protect the rights of people with disabilities. That includes monitoring facilities that house people with disabilities, including nursing homes, psychiatric hospitals, youth and adult residential facilities, developmental centers, jails and prisons.

Many of the people in those facilities are part of the population most at-risk for severe illness if they contract COVID-19. Ohio’s long-term care facilities account for roughly two-thirds of the state’s coronavirus deaths, according to data released last month by the state Department of Health. The risk of spreading the virus to those residents was too great for DRO to conduct its monitoring visits.

Price gathered a team at DRO to develop a workaround. They came up with a plan to conduct virtual visits where they could interview staff and residents and get a virtual tour of the facility, she said.

The time DRO advocates saved on driving to and from facilities helped them significantly increase their monitoring. From April 21 to June 19 the nonprofit conducted 86 virtual visits, Price said. By comparison, DRO conducted 18 in-person visits from Oct. 1 to March 17, and typically conducts 45 to 55 in-person visits per fiscal year.

Planning a virtual visit

Disability Rights Ohio’s visits are primarily focused on compliance issues, including checking the physical space of a facility to ensure it’s safe for people with disabilities. The nonprofit also reviews the care, treatment and services provided to people with disabilities, Price said.

The virtual visits typically last four to six hours, Price said. They begin with a meeting between DRO advocates and the administrative team for the facility. Those meetings have often focused on coronavirus preparedness amid the pandemic, including a review of the facility’s supply of personal protective equipment and its plan in case a resident needs to be isolated.

“Our scope is to be another set of eyes and advocates to ensure things are operating within standards and within codes, and that rights are being protected,” Price said.

Heartland Behavioral Healthcare, a state-run regional psychiatric hospital in Massillon, had a virtual visit with DRO just after Memorial Day. Switching to an online meeting was seamless, CEO Andrea Bucci said.

“They came in with a very good understanding of exactly what they wanted to look at,” Bucci said. “They had a pre-established agenda.”

The visit also includes a facility tour, where DRO advocates can look over bedrooms, bathrooms and dining areas. Heartland had its patient rights advocate walk around with a laptop to show those spaces.

Residents have the opportunity to speak with DRO advocates toward the end of the visit. Those visits are confidential, so the facility arranges a room where a resident can speak with advocates via video conference or by phone, Price said.

Heartland residents already used iPads to meet virtually with friends and family members, so using them to meet with DRO advocates was no issue, Bucci said.

“Already they had an understanding, so they were able to navigate it easily,” she said. “I think the process, overall, was very well-received by our patients.”

Once the visit is completed, Disability Rights Ohio will provide a written summary with any concerns that need to be addressed. While the nonprofit has the authority to investigate complaints of abuse or neglect, it passes on any serious concerns to state licensing agencies, which would impose any penalties.

Potential long-term benefit

DRO is still conducting all of its visits online, and Price acknowledged they aren’t perfect. Advocates don’t have a chance to see the physical spaces as well as they could in-person, so they may need to ask the facility to take photos and send them after the visit.

Perhaps the biggest downside to conducting visits over the internet is that DRO advocates have less face-time with residents, Price said. Advocates will often introduce themselves around the facility and spend some time in a common space. That could help residents who are hesitant to speak with an advocate grow comfortable enough to raise any concerns, she said.

“I don’t know if we get to all the residents who want to talk to us,” Price said.

It’s also more difficult to communicate with nonverbal residents, and almost impossible if the facility is in a remote area with limited access to the internet, she said.

Even still, Price said DRO has seen benefits to the online visits. Some visits will still need to be conducted in-person, especially at facilities where issues have been reported. But moving to a hybrid model could allow DRO to conduct significantly more visits each year, Price said.

“As things start to open up, we won’t rely on virtual monitoring for everything,” she said. “But we will probably keep components of it.”

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