SC nursing homes must offer indoor visits in all but limited instances
Barely a week after easing restrictions on indoor visitation at South Carolina nursing homes and assisted living facilities, state health officials announced Friday that even more of the state’s long-term care residents may now visit indoors with their loved ones.
Nursing homes and assisted living facilities now must allow indoor visitation at all times and for all residents, except in specific circumstances and for specific residents, the state Department of Health and Environmental Control said.
Indoor visitation at long-term care facilities may be restricted only for unvaccinated residents when the test positivity rate in the county is higher than 10% and fewer than 70% of facility residents have been fully vaccinated. Visitation also may be restricted for any residents actively infected with COVID-19 or quarantining due to COVID-19.
The only time an entire facility can restrict indoor visitation is immediately after a new coronavirus case has been identified while the facility is testing residents and staff to determine the extent of the outbreak. Once facility-wide testing has occurred, the home would be required to reopen for indoor visitation, with limitations applying only to areas of the home where COVID-19 cases were detected, for infected or quarantined residents and for unvaccinated residents in facilities located in high-infection counties where fewer than 70% of residents are fully vaccinated.
People are considered fully vaccinated two weeks after receiving their second shot of the Pfizer or Moderna vaccine, or two weeks after receiving the one-shot Johnson & Johnson vaccine, according to the U.S. Centers for Disease Control and Prevention.
“Residents of nursing homes and assisted living facilities, as well as their families and friends, benefit emotionally, mentally and physically from being able to see their loved ones,” DHEC Senior Deputy for Public Health Nick Davidson said in a statement announcing the shift in policy. “While visitation limitations were necessary for protecting the health of residents during the pandemic, current recommendations are now to allow for visitation with disease prevention protocols in place.”
Fully vaccinated residents are permitted to hug and touch their indoor visitors, as long as all wear masks and wash their hands before and afterward, according to the new guidance.
Prior to Friday’s policy shift, 177 of the state’s nearly 700 long-term care facilities reported they were not allowing visitation based on the previous guidelines, agency officials said.
South Carolina’s latest update to its long-term care visitation policy follows a recent announcement by the U.S. Centers for Medicare and Medicaid Services changing its guidance on when indoor visitation is appropriate.
The federal agency announced March 10 that due to significant reductions in COVID-19 cases and a high rate of vaccination among nursing home residents, facilities should allow indoor visitation at all times and for all residents, except in certain circumstances.
DHEC’s new policy mirrors new federal guidance.
Even in cases of outbreak, CMS no longer recommends prohibiting all indoor visitation if the outbreak is confined to a particular part of the facility. If COVID-19 testing reveals the outbreak is affecting only a single area of the nursing home, it recommends restricting visitation in just that area of the facility and permitting it elsewhere.
DHEC eased restrictions on its indoor visitation policies last week on the same day CMS released its new guidelines, but had not aligned its policies with the more permissive federal guidance until Friday.
The agency last week updated its visitation policy to require that long-term care facilities use the county positivity rate it calculates rather than the positivity rate determined by CMS, which is generally higher.
DHEC, like the CDC, calculates the county positivity rate by dividing the number of positive COVID-19 tests in a county by the total number of tests administered in that county. CMS, on the other hand, takes additional data sources into account in its calculation, officials said.
After DHEC changed its calculation last week, dozens of nursing homes and assisted living centers that had prohibited indoor visitation due to an elevated COVID-19 positivity rate in their county were able to reopen, as long as they met all other criteria necessary for indoor visitation.
All but six South Carolina counties had positivity rates at or below the 10% threshold at the time of last week’s policy change As of Friday, all 46 counties in the state had sub-10% positivity rates.
DHEC officials did not immediately know how many of the state’s 688 long-term care facilities had fewer than 70% of residents fully vaccinated against COVID-19, and said the number would be difficult to determine because residents are admitted to and discharged from homes daily.
As of Friday, nearly 29,000 of South Carolina’s approximately 40,000 long-term care facility residents had received two COVID-19 vaccine shots, according to DHEC data.
The agency is leaving it up to facilities to determine whether they meet the 70% vaccination threshold, Davidson said.
If nursing homes and assisted living facilities don’t comply with the new visitation guidance, DHEC has the authority to take enforcement actions against them, he said.
Davidson did not say what action might be taken against non-compliant facilities, but encouraged residents to report those they believe are not abiding by DHEC’s new visitation policy and said the agency would follow up.
He also recommended people contact facilities before planning a visit to confirm their visitation status.
A list of all state nursing homes and assisted living facilities with their current visitation status is available on DHEC’s website, but won’t reflect any changes that result from Friday’s policy update until the last week of the month, officials said.
This story was originally published March 19, 2021 at 3:06 PM.