Long-term care COVID-19 restrictions eased after citizen speaks out at press event

 No Patient Left Alone Act filed at General Assembly prior to NCDHHS guidance changes

This combination image shows the late Peggy Martin Wall, the mother of Tim Wall, before the state's restrictions went into affect and nearly a year after. Wall asked Gov. Roy Cooper a question during a press event in Raleigh on March 10, 2021.

RALEIGH — During a press conference on March 10 announcing an agreement on a bill to reopen the state’s schools, a citizen asked Gov. Roy Cooper a blunt question about reopening long-term care facilities.

“When can we have a bipartisan effort on opening up long-term care homes?” asked Tim Wall of Kernersville. “My mom died two weeks ago.”

Wall told North State Journal that his 88-year-old mother had suffered from dementia for a number of years and was placed in long-term care at Summerstone Health and Rehabilitation Center.

Just after Christmas, on Dec. 28, Wall’s mother tested positive for COVID-19 but was asymptomatic. Following her positive test, Summerstone notified Wall his mother would be placed in COVID lockdown in a room other than her own. He was told he would not be able to see her despite having a compassionate care visitation exception. During the time he was separated from his mother, staff had told her “she was doing fine.”

It took a slew of phone calls with facility administrators and state intervention for Wall to regain access to his mother. At that point, Wall found providers had not been following her care plan, and she was in bad shape.

On a visit on Jan. 5, Wall found she had been passing blood in her stool and ended up calling 911. His mother was transported to a hospital where she was admitted for internal bleeding from a previously undiagnosed cancerous tumor.

Wall’s mother was transferred to hospice on Jan. 12, and the bleeding from the tumor eventually led to her death. She passed away on Feb. 15, and not from COVID-19.

Wall went on to ask Cooper and the lawmakers present on March 10, “When is it going to change? The residents are vaccinated. The staff are not willing to be. There need to be essential caregivers. Isolation is killing.”

“I am so very sorry that has happened to you and your family,” Cooper replied. “And I’ve talked to a number of people who have lost loved ones during this COVID crisis. I know already that there are discussions going on to ease visitation restrictions in our nursing homes and rest homes, because there has been significant success in getting vaccinations.”

Cooper said they know how important human comfort is and that he would talk to N.C. Department of Health and Human Services (NCDHHS) Secretary Mandy Cohen about the issue.

Two days later, on March 12, NCDHHS issued a press statement announcing changes to the guidance for long-term and nursing home facilities, saying that NCDHHS was rescinding Secretarial Order 6: Visitation for Long-term Care Facilities.

Secretarial Order 6 had restricted visitation and movement within facilities based on guidance from the Centers for Medicare and Medicaid (CMS) issued on Sept. 17, 2020.

According to the statement by NCDHHS, “The change aligns with new guidance released this week from the Centers of Medicare and Medicaid Services and the Centers for Disease Control and Prevention and reflects rapidly improving trends in long-term care facilities.”

Outdoor visitation is encouraged by NCDHHS, who urges patients and residents who are not yet vaccinated to refrain from indoor visits. In addition, NCDHHS says that new long-term care residents will not have to quarantine if they are fully vaccinated and if they haven’t had close contact with someone with COVID-19 in the previous 14 days.

“Fully vaccinated and non-immunocompromised health care providers with higher risk exposures who are asymptomatic also do not need to be restricted from work,” NCDHHS’s press statement reads.

William Lamb, Executive Director of the Friends of Long-Term Care, has been hearing from families of long-term care residents since the start of the COVID-19 pandemic.

“As time wore on, the negative effects of separating families from their loved ones started to become very pronounced,” Lamb told North State Journal.

Lamb said that they heard from families that their loved ones had lost the will to live, had become depressed, anxious and combative. He said many nursing facility residents didn’t understand what was going on and those with varying stages of dementia struggled to cope.

Friends of Long-Term Care (FORLTC) was formed in 1987 and is a 501(c)(3) nonprofit organization “working on behalf of North Carolina individuals residing in nursing homes, adult care homes (assisted living), continuing care retirement communities (CRCs), and private homes who need daily assistance with their social, psychological, medical, or financial needs.”

When asked about NCDHHS’ recent guidance change, Lamb said that “on the surface, it’s fine,” but the problem may be with facility interpretations, noting that for the facilities who are reticent to open up, the language has to be “absolutely unambiguous.”

Lamb said that while some compassionate care visitation exceptions were granted, those exceptions were “not well understood by the industry,” and exceptions were unevenly applied.

“Individual family members literally had to beg to be able to have a visitation which was allowed even under fairly strict restrictions,” Lamb said. “It was a huge problem.”

Wall concurs with Lamb, telling North State Journal that NCDHHS’ recent changes “do nothing.”

Lamb underscored the critical need for family to have access to residents and patients because he said that in some facilities if there was a COVID outbreak, the next day “you had a lot of people [staff] who didn’t show up.”

While they’ve been trying to work with NCDHHS, Lamb says the agency was in “lockstep” with guidance from CMS and the Centers for Disease Control. He and other long-term care advocates are seeking a “statutory grounding that recognizes the right of a resident to have visitation.”

The statutory grounding Lamb and other advocates are looking for may be in the works.

Early in March, lawmakers filed Senate Bill 191, titled “The No Patient Left Alone Act.” The bill’s primary sponsors are Sens. Warren Daniel (R-Burke), Joyce Krawiec (R-Forsyth) and Danny Britt (R-Robeson).

Senate Bill 191 seeks to establish hospital and nursing facility visitation rights for immediate family members in the event of a disaster declaration or public health emergency. A similar bill, Senate Bill 730, was filed in 2020 but did not make it to the governor’s desk. The bill failed on June 25, 2020, after the Senate failed to concur with a House substitute.

About A.P. Dillon 446 Articles
A.P. Dillon is a North State Journal reporter located near Raleigh, North Carolina. Find her on Twitter: @APDillon_