The scope and state enforcement related to visitation in nursing homes and assisted living facilities in South Carolina are controversial and are constantly evolving. In the past few weeks, the South Carolina Department of Environmental Control (DHEC) has added three more sets of guidelines and requirements: A “Compassionate Care Visitors Memorandum”, “DHEC Guidelines for External and Internal Visits” and an “Order of Public Health “requiring weekly visitation reports (click here).
Nursing homes and assisted living facilities understand the importance of visitation for the well-being and mental health of their residents, as well as the impact on their families. On the other hand, the facilities have been working hard to understand state and federal guidelines on how to conduct visitation safely and by various means: personally, visits to windows; outdoor visitation; videoconferencing and telephone visits, etc.
Updated guidelines for internal and external visits. DHEC updated its guidance on external and internal visitation on October 9, 2020. This guidance replaces DHEC’s “Guidelines for external visitation”, published on September 1, 2020, and also includes guidelines for limited internal visitation. Click here to see the “DHEC Guidelines for External and Internal Visitation”.
As a starting point, DHEC emphasized that facilities cannot restrict personal visitation, unless “a reasonable clinical or safety cause” is present. These clinical or safety causes include the facility’s COVID-19 status, the resident being in isolation or quarantine for COVID-10, the county’s positivity rate (greater than 10% for internal visitation) or lack of adherence to infection control.
The guidance also establishes criteria to restrict internal and external visitation, and reminds the facilities that virtual visits and windows remain allowed in all scenarios. A discussion of the orientation of compassionate care visits is presented below, along with the additional “Compassionate Care Visit Memorandum”. In addition to the guidelines regarding internal and external visitation, the “DHEC Guidelines for internal and external visitation” establish related to the “Fundamental Principles of Infection Prevention COVID-19”, “Installation Requirements”, “Resident Requirements” and “Requirements of the Visitor. “
Compassionate care visits. As noted in the “DHEC Guidelines for external and internal visits”, compassionate care visits are permitted regardless of the visitation status of the facility. DHEC defines compassionate care visits to include not only end-of-life situations, but also cases where a newly admitted resident is struggling with a change of environment and lack of physical family support, a resident who is suffering due to a friend or family member who recently passed away, a resident who needs encouragement to eat or drink, a resident who is experiencing emotional problems, rarely speaks or cries more often and other situations.
The new “Memorandum of Compassionate Care Visits” recommends that nursing care and assisted living facilities establish a policy that addresses compassionate care visits. Click here to see the “Memorandum”. Although DHEC emphasizes that compassionate care visits “should not be routine”, both DHEC and CMS recognize that compassionate care visits extend to end-of-life situations.
Public Health Order Requesting Weekly Visit Reports. In addition to the “Compassionate Care Visit Memorandum” and “DHEC Guidelines for Internal and External Visitation”, DHEC also issued a “Public Health Order” on October 7, 2020 reminding nursing homes and assisted living facilities of their obligation to encourage visits by residents with minimal restrictions. The Order also requires detailed weekly reports on visitation and, if visitation is not permitted, the reasons why visitation is not permitted. Click here to see the “Order”.
The “Public Health Order” clearly urges nursing homes and assisted living facilities to provide visitation, unless there is an objective reason to restrict it. With weekly reports due to DHEC, state nursing homes and assisted living facilities will be under constant scrutiny to see if the facilities are adjusting visitation policies quickly and appropriately.
Conclusion: Visitation remains a controversial issue, due to the need to balance the residents’ well-being and mental health needs, as well as the impact on their families, with the need to protect residents, employees and visitors from the transmission and dissemination of information. COVID-19. Although visitation restrictions need to be imposed to protect residents, DHEC’s new “Public Health Order” aims to ensure that visitation is not unduly restricted. As a result, nursing home facilities and assisted care facilities must adjust visitation on a continuous, almost daily basis.