SC eases COVID-19 restrictions on indoor visitation at nursing homes
Dozens of South Carolina nursing homes and assisted living facilities may open for indoor visitation immediately due to a change in policy guidance, the governor and state health officials said Wednesday.
The change in visitation policy comes after the state received federal approval to require facilities, which must restrict indoor visitation when the COVID-19 positivity rate in their county is 10% or higher, to use the rate the state Department of Health and Environmental Control calculates rather than the rate determined by the U.S. Centers for Medicare and Medicaid Services.
All but six South Carolina counties have COVID-19 positivity rates at or below the 10% threshold, according to DHEC’s calculation, and the state’s seven-day positivity rate is currently 4.7%, its lowest point since testing began.
As a result, at least 43 long-term care facilities that previously had restricted indoor visitation due to county positivity rates will now be required to offer it as long as they meet all other criteria necessary for indoor visitation, DHEC senior deputy for public health Nick Davidson said.
In total, 177 of South Carolina’s 688 long-term care facilities currently restrict visitation, according to DHEC data.
“Too many South Carolinians have been prohibited from visiting their loved ones in long term care facilities because of overburdensome federal guidelines,” Gov. Henry McMaster said in a statement. “Prioritizing the physical health and safety of our most vulnerable citizens is critically important, but we must also protect their mental and emotional health. These updated guidelines represent important progress and will result in many facilities opening for visitation, but there’s more work to be done and we will continue pushing federal agencies to allow expanded visitation.”
Only facilities in Allendale, Barnwell, Chesterfield, Lancaster, McCormick, and York counties, which currently have rates higher than 10%, are not required to open for indoor visitation immediately, assuming other criteria are met.
Under DHEC’s guidelines, which are based on CMS and U.S. Centers for Disease Control and Prevention guidance, South Carolina nursing homes and assisted living facilities may not restrict indoor visitation unless they’re located in a county where the COVID-19 test positivity is above the 10% threshold; have had at least one coronavirus case among staff or residents in the past 14 days; or are failing to adhere to infection prevention measures that include facial masking, social distancing and screening people who enter the facility for COVID-19 symptoms.
There are currently 145 long-term care facilities in the state that have recorded at least one coronavirus infection among residents or staff in the past two weeks, according to DHEC.
The agency, which last month changed the way it calculates the positivity rate, said the CMS figure it had been using to determine indoor visitation status differs from its internal calculation because it incorporates several data sources.
DHEC officials said the agency’s calculation method of dividing the number of positive COVID-19 tests by the total number of tests administered is appropriate for determining long-term care facility visitation status because the CDC uses the same calculation.
For visitation status purposes, a county’s positivity rate is based on an average of the past 14 days of COVID-19 testing, and is updated every Thursday, meaning a facility’s visitation status could change from one week to the next.
Randy Lee, president of the South Carolina Health Care Association, lauded McMaster and health officials for securing the shift in indoor visitation rules, which he said is crucial to the mental health of nursing home residents.
“We think it is wonderful,” said Lee, whose organization advocates on behalf of the state’s long-term care facilities. “Our families have been patient in not seeing their relatives and understanding we were trying our best to protect them and take care of them, and they have been patient long enough.”
He said that just because some facilities may now open for indoor visitation does not mean they will cease taking the same preventive measures to protect against COVID-19 infection.
“This is not like you come in the front door and wander where you want to,” Lee said. “These are controlled visits because that’s what is still required. People will have to socially distance; people will have to wear masks. It’s not like it was pre-COVID.”
DHEC officials said facilities that must limit visitation because of the county’s positivity rate should still encourage indoor visitation in compassionate care situations on a case-by-case basis. A compassionate care exception is justified when a facility resident is nearing death, declining mentally or physically, grieving a loved one’s death or struggling with the transition to life at the facility, among other reasons, DHEC said.
Outdoor visits at long-term care facilities remain unaffected by the change in indoor visitation policy, as a county’s positivity rate was never factored into outdoor visitation determinations. A facility may restrict outdoor visitation only if a resident or staff member has tested positive for COVID-19 within the past two weeks, weather conditions preclude safe outdoor visitation or core infection prevention measures are not being taken.
“We’re very excited about this,” Davidson said of the loosening of long-term care facility visitation restrictions. “There’s definitely a great need to make sure that the individuals in long-term care facilities are being provided the care that they need and part of that care is visitation from their loved ones.”
As of Wednesday, all of the state’s nursing homes had completed one COVID-19 vaccination clinic and 86% had held a second clinic. All but 13 of the state’s 495 assisted living facilities have held first vaccination clinics and 86% have held second clinics, DHEC said.
The vaccination status of long-term care facility residents and staff is not factored into visitation decisions and even facilities where vaccination clinics have yet to be held must abide by the new indoor visitation policy, Davidson said.