Opening back up! Great news!

North Carolina nursing homes AND assisted living facilities will be opening up for visitors as early as next week.

Last week the Centers for Medicare and Medicaid Services (CMS) issued guidance allowing visitation in long term care facilities (which include both assisted living and skilled nursing facilities). The CMS guidance was cautious in tone, but noted that widespread vaccination was mitigating risks (particularly in view of the mental and emotional damage that isolation takes on residents).

The CMS guidelines said that in the event of an outbreak in a facility, local authorities could shut down visitation.

CMS (which administers both Medicare and Medicaid) has direct impact on skilled nursing homes because that’s where the federal dollars (and, of course, federal regulation) for nursing homes comes from.

As I have written before, however, skilled nursing homes are not the same as assisted living facilities, and neither Medicaid nor Medicare pay for assisted living. It is the North Carolina Department of Health and Human Services (NCDHHS) that regulates assisted living facilities.

For a few days this week we were in the strange position of having more liberal visiting rules in skilled nursing homes (where the population is much more vulnerable) than assisted living facilities.

It was no surprise, then, when on Tuesday, March 16, DHHS issued open visitation guidelines subject to a few restrictions.

The NC Guidelines say that long term care facilities MUST allow visitation to the maximum extent allowed in the guidelines.

The NC Guidelines say that while outdoor visitation is preferable, indoor visitation is allowable. Further, it says that while maintaining social distancing is probably best, close physical contact (that’s bureaucratese for “HUG”) is possible if the resident has been fully vaccinated and everyone is masked.

Of course, there are sensible restrictions. First, open visitation applies only to facilities that are not in outbreak status. If a new case is detected, the visitation allowances can be suspended until the outbreak is controlled. Finally, there are some restrictions on unvaccinated residents in facilities with less than 70% vaccination rate and located in ‘Covid-hot’ counties.

You can read the NC Guidelines right here.

Don’t rush the front doors on Monday! Please be patient as the management of these facilities determine how to implement the guidance and make necessary changes.

This is great news. As the son of a 103 year-old mother who has been locked down for a year I know what a toll the isolation can take. For most of them, the isolation may be ending.