Massachusetts has a staff of 300 ombudsmen who field complaints and make unannounced visits to nursing homes to check on patient care, but these watchdogs have not set foot inside such a facility since the second week of March.

In an effort to contain the spread of coronavirus, government regulators more than five weeks ago banned both ombudsmen and family members from entering nursing homes and other long term care facilities.

Elder advocates and watchdog groups don’t question the rationale to curb infection, but they say the lack of oversight could undermine the care of these elders at a critical time, as nursing homes are becoming hot spots for infections.

“There’s not as many eyes looking at them,” said Alison Weingartner, executive director of the Massachusetts Advocates for Nursing Home Reform. “If you don’t have the family members, you don’t have the ombudsmen coming in to see them, there’s a potential for neglect that won’t be witnessed by anybody else.”

Almost half of the state’s COVID-19 deaths are among residents or workers at long term care facilities.

Long term care facilities said they face a shortage of 17,000 direct care nurses in Massachusetts alone and called on the state to help. Gov. Charlie Baker has promised that the state would pay $1,000 signing bonuses to new workers in these homes, recruit volunteers and dispatch healthcare professionals into care facilities hardest hit by COVID-19 and staffing shortfalls.

The State Office of Elder Affairs said the work and oversight of ombudsmen inside nursing facilities would be preferable but the ban on visits is meant to protect ombudsmen and the residents and staff of the facilities.

To address concerns, the state launched a nursing home hotline in early April that has already handled more than 2,000 calls from concerned family members.

“The resource was created so family and community members could have one central contact they can reach out to if they have questions or concerns about the care their loved one is receiving during this COVID-19 pandemic,” said Mary Lou Sudders, the state’s health and human services secretary.

Elder advocates said many family members of nursing home residents feel cut off from their loved and even more so if those nursing home residents suffer from dementia or Alzheimer’s Disease.

When COVID-19 spread through the Life Care Center of Nashoba Valley — a nursing home in Littleton — many family members with a loved one there had no idea.

“I was in shock. It was really frustrating to find out that the facility was basically infested from the news. I mean, I know they're in crisis, but you’ve got to tell the family members,” said Eva, whose 83-year-old mother has dementia and lives at the Littleton nursing home. WGBH is not using Eva’s full name because she is fearful her comments could cause reprisals for her mother.

A recent statement from Life Care Center of Nashoba Valley confirmed that more than 65 residents there have gotten COVID-19 and that a third of its staff is out sick.

Eva said it is very difficult to reach nursing staff at her mother’s nursing home.

“I was having a really hard time getting a hold of the unit,” she said. “One time that I called in and (my mother) was still sleeping and it was ten of seven. She hadn't eaten dinner (and) dinner was at five. And I was just so upset that next day, I tried to call that was just I couldn't get through.”

Eva added, “I just want a human being to go in and make sure she's OK.”

The state’s ombudsmen are supposed to make sure nursing home residents are okay, that their basic needs are being met. These paid and volunteer ombudsmen are managed by regional elder services agencies and routinely visit nursing homes to interview residents about their care and facility conditions.

During the COVID-19 pandemic, that’s not happening anymore. Chaz Rudich, an ombudsman with Elder Services of the Merrimack Valley, said his team typically visited four or five facilities a day, knocking on residents’ doors and talking with them.

But now nursing homes are in crisis and the ombudsmen are not going in. “Is there a 100 percent guarantee that everybody is doing everything that they'd need to? No, there isn't,” said Rudich. “But right now, we kind of have to trust that they're doing the right thing. Is there still going to be some bad players out there? Yes, there will be.”

Elder advocates and watchdogs like Weingartner said nursing home operators have not earned that trust. They pointed to government inspections over the last three years that found more than two-thirds of nursing homes in the state violated infection control standards.

Weingartner said that barring family members and ombudsmen increases the need for transparency from all the elder-housing facilities in the state through daily COVID-19 reports. State lawmakers are now pushing for legislation to make that happen.

Sudders said Friday the state will begin regularly releasing new, more comprehensive COVID data next week, and that enhanced nursing home data will be part of that effort.

Do you work inside a nursing home or other elder housing and have concerns you think the public deserves to know about? We want to hear from you and will not use your name. Email us at