A working group (subcommittee) on visitation appointed by the Connecticut governor recently met virtually to discuss the importance and need to maintain visitations while the COVID-19 crisis continues. The goal of this group is to make recommendations for proposed legislation for the 2021 legislative session that will address what has been learned so far in dealing with the pandemic.
This was the first meeting of the group that will meet weekly for the next six weeks. Industry leaders and family members were allowed to express their concerns about the negative effects of isolation on residents in long-term care facilities.
Among the questions discussed was this one posed by the work group’s chairperson, “Were they (visitation restrictions) necessary in order to keep COVID out due to testing concerns and PPE concerns? Yes, maybe,” she responded to her own question. She then added, “However, we know that the impact has been so great for residents that we need to find a different way to do this.”
Another member of the group, executive vice president of the Connecticut Association of Health Care Facilities, expressed his belief that nursing homes can more effectively use technology to improve visitation.
The group discussed the fact that technology does not work well with all residents, and that there is still a fear regarding the virus among residents. It was noted that there needs to be a balance in the recommendations to be made that will not only protect residents from contracting the virus, but also protect their rights to visits.
With cold weather approaching, along with an increase in community COVID-19 cases, it was noted that the group will need to look for “out-of-the-box” solutions, like applying to the Centers for Medicare & Medicaid Services (CMS) for outdoor tents for use with outdoor visits.
CMS guidance on nursing home visitations may be found here: https://www.cms.gov/files/document/qso-20-39-nh.pdf.
Compliance Perspective
Issue
Nursing homes are required by state and federal regulations to ensure that residents enjoy a high quality of life that includes participating in activities that meet their interests and needs, be free from involuntary isolation, and allow residents to receive or deny visitors. However, the shutdown of visitation due to the COVID-19 pandemic may place some residents at greater risk due to the negative effects of isolation causing depression, worsening of health, and a loss of desire to thrive.
Discussion Points
- Review policies and procedures to ensure the proper implementation of the CMS guidelines for visitation. Consider developing a work group within the facility to develop a balance between the need to isolate residents to prevent the spread of the Coronavirus and viable ways to meet residents’ need to interact with family, such as improved and regular use of technology.
- Train staff on how to provide quality of care for residents in the midst of the stresses brought about by COVID-19 through regulated visitation protocols and use of technology. Training should also address how to recognize and document when a resident is having a negative response to being isolated due to social distancing or isolation.
- Periodically audit the effectiveness that controlled visitation is having on residents to alleviate the negative effects of isolation.
