NC may soon allow outdoor visits at some nursing homes, draft policy shows

Some North Carolina nursing home residents may soon be able to see their friends and family face to face, without a window pane or iPad screen in between, for the first time in months.

State health officials have been circulating a draft visitation policy to industry representatives and advocates, telling them a shift toward allowing some outdoor visits could come as soon as Friday.

To try to prevent the novel coronavirus from getting into nursing homes, where it was likely to spread quickly and cause severe symptoms among sick and elderly residents, Gov. Roy Cooper issued an executive order in March that dramatically restricted visitation.

Since then, families have had to rely almost exclusively on phone calls, videoconferencing apps like Zoom and FaceTime, and visits to their loved one’s window to stay connected. But those methods haven’t worked well for some residents with cognitive deficiencies or difficulty hearing.

Lauren Zingraff, executive director of Friends of Residents in Long Term Care, said the strict visitation policy has led to a second epidemic: a deep sadness and loneliness that has robbed some residents of the will to keep living.

“Visitation saves lives,” Zingraff said, quoting a social media campaign that her organization has participated in, along with other advocacy groups around the country.

She called the state health department’s latest proposal “a step in the right direction.”

Vowed to ‘be there for each other’

Pat Weaver is also feeling hopeful about the proposed visitation policy. Her husband can no longer communicate easily with words due to a degenerative brain disease, so she’s eager to to reestablish a connection in person. Before the pandemic, she visited her husband every day.

“We took vows to say we would be there for each other — the state made us promise that — so it bothers me that the state can so easily take that away,” Weaver said.

Earlier in the pandemic, she bought a vinyl enclosure called an Under the Weather Pod in an effort to be able to safely see her husband of 40 years outside the Triad-area nursing home where he lives.

The nursing home allowed her to use it just once.

“When I was able to see him that way, he was able to hear me say, ‘I love you,’ and he said, ‘I love you,’ back,” Weaver said.

For the first time in months, she said, “there was a true connection, a shared experience.”

Weaver said she is more than willing to follow the rules imposed by the state to try to keep residents safe and thinks other families will feel that way too.

The N.C. Health Care Facilities Association, a nursing home trade group, has sounded a note of caution about the reopening proposal.

“We are eager to begin welcoming visitors back to our nursing homes, but we know that before that can safely happen, we must slow the spread of the virus in our communities,” Adam Sholar, the association’s president and CEO, said in a written statement.

Recent research suggests a strong correlation between the prevalence of the virus in the surrounding community and nursing home outbreaks.

Other types of residential facilities in North Carolina were allowed to begin setting up outdoor visits last month.

What the draft visitation policy says

The draft policy reviewed by The News & Observer states visitors must be screened for symptoms of COVID-19, bring and wear a mask, use hand sanitizer, stay in the designated area, with social distancing, and visit only one person.

Visits must be scheduled and won’t be allowed if a facility has an ongoing outbreak, defined as two or more cases among residents or staff. Nursing homes may restrict visiting based on several factors, including the prevalence of the virus in the surrounding community and the availability of personal protective equipment and staff.

The draft policy sets out several criteria that must be met for a nursing home to offer outdoor visits. The facility must have a written visitation plan, a written COVID-19 infection control plan and a written testing plan, among other preparations.

The draft policy does not require participating facilities to have completed a round of coronavirus testing on all residents and staff. According to a survey of 76 North Carolina nursing homes in late June, roughly half of the state’s nursing homes had undergone universal testing. The state recently agreed to underwrite this type of testing, with the goal of completing tests in all of the state’s more than 400 nursing homes by the end of August.

Several other states have reopened nursing homes to visitation with conditions.

Maryland, Virginia and Tennessee all allow some in-person visits, but require nursing homes to have completed baseline testing first.

Some advocates would like to see North Carolina explore a special designation, with expanded visitation allowances, for family members and friends who frequently visited a nursing home resident before the pandemic, providing care for that person.

Both Minnesota and Indiana have included an “essential caregiver” provision in their reopening plans.

That change would be a relief to Weaver, who would be able to again help nursing home workers decode her husband’s expressions and provide for his needs.

“That’s a more long-term solution,” she said.