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New rules increase visitation in long-term care

Rule changes increase visitation in long-term care

New federal guidance and the rescinding of governor’s orders are allowing North Dakota long-term care facilities to loosen their visitor restrictions.

Chris Larson with the Reuniting Residents and Families Task Force said the response to the new visitation rules at the Mayville facility where he lives has been “amazing.”

“There were people cheering,” he said. “This is so much better for our residents to be able to have that family contact or that friend contact because they’ve been without it – for some of these people – a year.”

The Reuniting Residents and Families Task Force held a news conference Wednesday with the North Dakota Long Term Care Association and North Dakota VP3 Team (vulnerable people in basic, assisted living and skilled nursing facilities) to discuss the status of long-term care visitation.

Locally, Trinity Homes had no update on its visitation policies Thursday, and Minot Health and Rehab could not be reached for comment.

Under new guidance released by the Centers for Medicare & Medicaid Services last week, a nursing home with a positive COVID-19 case is no longer obligated to shut down indoor visitation for 14 days.

Instead, facilities must temporarily stop visitation and test within three to seven days for additional cases. Re-opening will depend on the spread of cases. If no additional cases are found, the facility can re-open unaffected areas of the building to visitation as long as the infected resident is isolated or an infected staff member had been isolated to a specific unit or area. If testing finds additional cases only within the same unit as the original case, indoor visitation still can open for the rest of the facility.

As of Wednesday, North Dakota had six residents and 26 staff members in long-term care facilities who were positive for COVID-19. That compares to the peak of more than 1,630 cases on Nov. 13 last year.

Rosanne Schmidt, a regional coordinator for the North Dakota VP3Team, said only about 15 of the state’s 79 skilled nursing facilities are currently limiting visitation while conducting testing after positive cases in their facilities.

“We can do more things with visitation for those that are vaccinated,” Schmidt added. The CMS benchmark is 70% vaccination, and North Dakota is at about 90% among nursing home residents, she said.

Shelly Peterson, executive director for the North Dakota Long Term Care Association, said the vaccination rate as of last week among employees of basic care, assisted living and skilled nursing facilities was 54.4% for the first dose. For both doses, it is 51%.

“I, personally, am really pleased with that 54%,” Peterson said. “What we saw was some hesitancy with health care workers, and what we’re seeing now is continued numbers increasing each week.”

She said health care workers who have been initially cautious are choosing to be vaccinated as the wider rollout of the vaccine continues, especially as they see the potential for a facility to be shut down temporarily if a case occurs.

Long-term care has accounted for 10% of COVID-19 cases confirmed in the state since the start of the pandemic but 60% of the deaths, Peterson said.

“Almost one out of two residents did contract COVID in a long-term care facility. But of those that did, almost 80% lived. Unfortunately, our death count has been 886 as of this morning, and those deaths have been really difficult, but what has been also really difficult is the visitation restrictions,” she said.

In addition to the new CMS guidance, the recent termination of two governor’s executive orders gives assisted living and basic care centers more latitude in decision-making around their visitation.

“We really have been a national leader in a lot of categories, and one of those has been just the ability to have open visitation far earlier than many of the other states that are to our borders,” said Seth Fisher, a regional coordinator with the VP3 Team. “We just need to continue to do our part to use those great tools that we now have in our toolbox of encouraging and promoting that vaccination amongst both residents and healthcare workers.”

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