When the COVID-19 crisis struck in March, Connecticut facilities, like most other affected facilities, closed their doors to visitors to stem the spreading of the virus. Friends and family members are now expressing increased frustration and concern for the physical and mental health of residents due to being unable to visit them inside the facilities for so many months.
On September 17, the Centers for Medicare & Medicaid Services (CMS) issued a directive allowing long-term care facilities to open-up for indoor visits, but with these specific requirements for the facilities to follow:
- There must not have been any new cases of COVID-19 over a period 14 days
- Facilities are to use the positivity rates of infection within their county to determine the advisability of allowing indoor visits.
Notably, the state recently reported a 3% positivity rate for infection in the southeastern part of Connecticut, and federal guidelines indicate that indoor visits, in addition to those for compassionate care and end-of-life situations, can take place if the rate is below 5%. However, some facilities continue to be slow to reinstate indoor visits out of continuing concern related to their struggles to maintain effective infection control despite diligently following guidelines from CMS and the Centers for Disease Control and Prevention (CDC).
Frustrated family members allege that the hesitancy for facilities to reopen is born of fear. They are concerned and agree with a recent study conducted by Mathematica Inc. that indicated the “policy responses came at the cost of the emotional well-being of residents in facilities.”
One facility in the state that was in the process of reopening has now again shut down visitation due to a positivity rate that was increasing in its county.
Compliance Perspective
Allowing indoor visitation while still experiencing citations regarding infection control, despite carefully following CMS and CDC COVID-19 guidelines, may place a facility in the difficult position of reducing the negative effects on residents of isolation from family and friends, while at the same time placing residents at risk for further spreading of the virus. This may lead to citations for immediate jeopardy for serious harm, and be deemed provision of substandard quality of care, in violation of state and federal regulations.
Discussion Points:
- Review policies and procedures regarding the facility’s Infection Control Plan and the role of the Infection Preventionist to determine if changes are needed.
- Train staff repeatedly on the importance of diligently following infection control protocols (hand hygiene and properly wearing and disposing of PPE.)
- Periodically audit to identify possible systemic indications of areas needing improvement in the facility’s Inspection Control Plan and its implementation.
