HealthcareStatewide NewsNew State Nursing Home Guidelines Allow for Long-Awaited Reunions

A new set of nursing home visitation guidelines was released which will allow designated caregivers to visit regularly even if there are COVID-19 positive cases within a facility.
September 23, 2020
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After over six months of separation, Beverly Wenzel is eagerly anticipating a visit with her 90-year-old father whom she hasn’t been able to see in person since early March.

After Governor Abbott announced the reopening last week, Texas Health and Human Services (HHS) released its rules governing visitation to these lonely and vulnerable Texans. 

“I am glad the door is opened, and I can physically get it and see him. He’ll recognize my voice,” she said. Her father resides at Crossroads Nursing and Rehabilitation Center in Hearne, which has said it plans to start visits on September 24 by appointment. 

 “Although visitation restrictions have partially protected the physical health of residents, the practice also has resulted in unintended harm. Residents experience loneliness, anxiety, and depression due to prolonged separation from families and loved ones. These measures also compromise the ability of families and guardians to validate resident well-being and safety, and caused significant distress for families,” a recent study commissioned by the federal government on the quality of nursing homes during coronavirus noted.  

Unlike the previous Phase I visitation rules released in August which gave nursing homes discretion about whether to allow visitation, under the latest regulations nursing homes must apply to HHS for approval to allow visitation.

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Nursing homes must begin to allow closed window visits, end-of-life visits, and essential caregiver visits under rules effective Thursday, September 24. These visits do not require HHS approval.

A resident may have up to two designated essential caregivers, who are over age 18 and will provide care and support to a resident in his room or a visitation area. 

“This might include spending time with the resident engaging in activities; it doesn’t have to be providing personal care services,” Catherine Anglin, program manager with HHS said during a webinar Wednesday afternoon.

Even if a facility has COVID-19 positive cases within the facility, essential caregiver visits must still be allowed. However if a resident acquires COVID-19, the essential caregiver visits will be halted until the resident recovers.

While these essential caregivers can visit their loved ones and are not required to keep a physical distance, they will have to wear masks and “have a negative COVID-19 test result from a test performed no more than 14 days before the first essential caregiver visit.”

These caregivers will generally have visits limited to two hours, although nursing homes can make exceptions to that time limit where appropriate.  

The policies and procedures governing essential caregiver visits include a testing strategy, training in using personal protection equipment (PPE) and infection control, and a written agreement that the caregiver agrees to abide by the policies. 

Wenzel and her mother are the designated essential caregivers for her father. She is concerned about her mother, who is wheelchair bound, being able to wear the necessary PPE and whether she can get to his room for a one-on-one visit.  

Patty Ducayet, the state long-term care ombudsman, held a Facebook Live session with families today to explain the new rules.

“I want you to celebrate this,” Ducayet told the Facebook audience. “You are changing things through your advocacy.” 

She said she is often asked what is next. “What we always want to be looking toward is that further where rights are restored and these emergency rules are no longer needed.”  

Texas Caregivers for Compromise, an advocacy group seeking access to nursing homes by family members, has been contacting the governor’s office regularly with a petition of over 20,000 signatures seeking an essential caregiver designation, like Minnesota created in July.  

Mary Nichols, a leader in the group, is hopeful about the new rules. She stated on social media, “[T]his group has helped move a mountain and we have something we have not had in 191 days: hope.” 

For visitors other than essential caregivers who would like to visit loved ones inside the nursing home, the nursing home must seek and receive a designation by HHS allowing visitors. If not approved, facilities must develop a plan on how to meet the requirements to allow visitors.  

When a facility receives the visitation designation, open window visits, outdoor visits, and indoor visits by appointment with plexiglass barriers will also be allowed. 

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Kim Roberts

Kim Roberts

Kim Roberts is a reporter for the Texan in the DFW metroplex area where she has lived for over twenty years. She has a Juris Doctor from Baylor University Law School and a Bachelor's in government from Angelo State University. In her free time, Kim home schools her daughter and coaches high school extemporaneous speaking and apologetics. She has been happily married to her husband for 23 years, has three wonderful children, and two dogs.