Visitor restrictions at long-term care facilities and adapted voting procedures due to the pandemic are clouding the prospects of nursing home residents getting to a ballot box this November, advocates warn.

Many facilities across the country served as polling places prior to the onset of COVID-19 to make the voting process simpler for residents. But states are making changes, making it harder for nursing home residents to get access in some cases, a report by Market Watch detailed.

Also, many states have typically had election officials deliver ballots to nursing homes, wait, collect their ballots and take them back to the local election office. But that’s “likely not feasible” this year, according to a spokesman for the Iowa Secretary of State. 

The report noted that guidance from the Centers for Disease Control & Prevention — that many areas are following — recommends that polling places be moved away from long-term care facilities. Residents could be forced to vote by mail this year, which could mean additional work for staff members.

Though some states plan to keep polling places at facilities, others are trying to find alternative solutions that allow residents to vote safely. In Florida, for example, election officials plan to deliver ballots to nursing homes in bags with ultraviolet lights to disinfect the materials, drop them off at facilities and collect them a day later. 

Some states, like Tennessee, are calling on already busy workers to receive training on election procedures and help residents with their ballots if election officials are prohibited from entering facilities. Advocates, however, have questioned the likelihood of that actually happening. 

“Election commissions and nursing homes are both struggling to figure out how to handle this during the pandemic,” said Randy Horick, vice chair of Tennessee Citizen Action, in the report. 

In Ohio, providers explained that election officials will likely be allowed to enter because “they can’t spare staff to oversee voting” amid their current responsibilities. 

The American Health Care Association/National Center for Assisted Living told the news organization that providers “will do everything possible to ensure residents can get the information and materials they need to participate in the election, while also staying safe from COVID.”