VISITATION UPDATES

Since March of 2021, several protocols have been put into place to prevent isolation and loneliness that was brought on by halting visitation during the beginning of the COVID-19 Pandemic in March of 2020. The Public Health Emergency for COVID-19 ended on May 11, 2023. Here are several things the state and federal government implemented in the event of future disasters or public health emergencies:

As a result of advocacy, the state legislature passed House Bill 351 Clifford’s Law. Introduced in March of 2021, it was passed by the House and Senate and signed into law by Governor Cooper in September 2021 and directed the state to develop several protocols related to visitation.

With input from stakeholders (including Friends of Residents in Long Term Care) and other interested parties, the Secretary of the Department of Health and Human Services developed ten (10) protocols. These protocols include determining if a disaster or public health emergency meets standards to limit visitation, develop a visitation plan, train staff, include the regional ombudsman, and end the Clifford’s law protocols after the emergency. These protocols will be implemented by facilities during any period of a declared disaster or emergency when a licensed nursing home, combination home, or adult care home has suspended or restricted its normal visitation policy. 

Above all, it allows each patient or resident to have at least two visits per month by a designated or pre-approved alternate visitor during any period of time when your normal visitation policy is suspended or curtailed for any reason during a declared disaster or emergency.  Read more here.

Additionally, CMS has provided an updated nursing home visitation guide. As reported by the National Consumer Voice, CMS still expects all nursing homes to adhere to infection control procedures.

Additional updates include:

• Facilities should post visual alerts in the facility alerting the public to infection control procedures and practices.

• Indoor visitation should occur in the residents room during a COVID-19 outbreak.

• Facilities must continue to follow CDC recommendations regarding infection control procedures.

Importantly, the guidance continues to state there are no current COVID-19 scernarios that would permit a facility to prohibit a resident to have visitors at anytime.  

Previous CMS Guidance around Visitation - November 2021

https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf

NURSING HOME VISITATION ALLOWED FOR ALL RESIDENTS AT ALL TIMES

On November 11, 2021, CMS directed nursing homes to open their doors wide to visitors, easing many remaining pandemic restrictions. This development, coupled with the passage of Senate Bill 191 No Patient Left Alone in North Carolina, gives residents and their loved ones clear backing in support of this primary connection needed for real quality care.

The guidance from the Centers for Medicare and Medicaid Services instructs nursing homes to allow visits at all times for all residents. Facilities will no longer be able to limit the frequency and length of visits or require advance scheduling. Although large groups of visitors are discouraged, nursing homes won't be allowed to limit the number of loved ones and friends who can pay a call on residents. We urge you to read the guidance carefully to understand the exact impact on what is allowed and what restrictions might remain in place. Changes are outlined in RED.

Senate Bill 191 does build in enforcement provisions including financial penalties for facilities not granting visitation allowed in state and federal standards. If you encounter a problem. we urge you to first contact the regional ombudsman assigned to facilities in the county the facility is located. Here is a listing of Area Agencies on Aging, ombudsmen, phone numbers and the counties they cover. If you continue to encounter visitation restrictions outside of those allowed in federal guidance, file a complaint with the Division of Health Services Regulation via their complain hotline: 1-800-624-3004 (within N.C.) or 919-855-4500.

CMS GUIDELINES ON VISITATION

For information on the most recent CMS visitation guidelines please review the summary below provided by the Center for Medicare Advocacy (2021)

Please CLICK HERE or on the image below.

The National Consumer Voice for Quality

Long-Term Care

Nursing Home Visitation and Quarantine: Frequently Asked Questions & Advocacy Strategies for Families

In March 2021, the Centers for Medicare and Medicaid Services (CMS) revised their visitation guidance based on the high COVID-19 vaccination rates of nursing home residents. The Centers for Disease Control and Prevention (CDC) also updated their guidance in March and again in April regarding when long-term care facility residents are required to quarantine.

Despite these changes, many families still have questions and concerns relating to visitation and quarantine. This new document reviews some of the most frequent questions we are asked by family members. Our responses are based on the CMS and CDC guidance and show how the guidance can be used to help families advocate for their loved ones.

The document also includes general advocacy strategies and tips if the facility is not following the guidance or is denying residents’ rights.

The National Consumer Voice for Quality Long-Term Care (2021)

Please CLICK HERE for the full summary or on the image below.

Additional documentation on visitation