Now in the eighth month of the COVID-19 pandemic, the toll of physically separating residents from families is impacting everyone involved, including the dedicated facility staff members who are doing everything in their power to provide the best possible care in an extremely difficult situation.

“Long-term care administrators and staff members understand how stressful this situation is for the families who want to spend time with their loved ones, but the visitation restrictions issued by Centers for Medicare and Medicaid must be followed,” said Shelly Peterson, president of the North Dakota Long Term Care Association. “As the COVID-19 pandemic intensifies in our state and region, so do the government requirements governing visitation.

“Administrators across the state would love to relax visitation guidelines, but these decisions are not in their hands. To care for the elderly, we must comply with federal mandates,” Peterson said. “Facility staff members are doing everything they can to make the best of these difficult circumstances. They are physically and emotionally exhausted, yet they continue to focus on virtually connecting residents with their families. Our long-term care teams truly are healthcare heroes who deserve recognition for their compassion and commitment.

“The best way out of this visitation restriction is for us to follow the guidance of health professionals. If everyone would wear masks and socially distance to reduce the level of COVID in the community, we know we could dramatically reduce these rates in our long-term care facilities. We are all in this together, and we need the community support on this issue. The strongest predictor of whether or not we’ll see cases in a long-term care facility is community spread,” she said. Nationwide, stringent requirements were put in place early in the pandemic, then relaxed depending on the level of COVID-19 outbreak, now tightened again as North Dakota and other Midwest states became COVID-19 hotspots.

The new CMS guidance virtually shut down all in-person, in-facility visitations in nursing homes statewide. This is because of the current outbreaks and high county positivity rates. At the current time, only telephone, electronic/virtual and outdoor visitations are allowed. CMS has clarified that outdoor visitation must take place in structures that are distinctly separate from the facility, so facilities are searching for creative ways to make this happen.

Basic care and assisted living facilities in the state are not governed by CMS, and, on Nov. 5, 2020, the Vulnerable Population Protection Plan (VP3) team issued separate guidance permitting basic care and assisted living facilities to create safe indoor spaces for family visitation. Unfortunately, as with nursing facilities, the level of community spread and spike in long-term care cases is making indoor visitation in basic care and assisted living very challenging.

The North Dakota Long Term Care Association urges the public to help us open up visitation in long-term care. Reducing community spreads is one way that can happen. If this does not happen, visitation inside nursing homes will need to be very limited per federal regulations.

NDLTCA is a professional and advocacy organization representing the 218 assisted living, basic care and nursing facilities in North Dakota. It is an affiliate of the American Health Care Association and the National Center For Assisted Living, representing not-for-profit and proprietary facilities in our state.

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