Rules for visiting nursing homes in Florida may soon change


Mary Shannon Daniel reads almost every comment from the Facebook support group.

It’s aimed at families in Florida trying to visit loved ones in long-term care, and the posts are piling up quickly — especially in the last few months during the omicron wave of the coronavirus.

“We haven’t seen our loved ones for 2 weeks.”

“My dad is locked up as we speak. … No inside visits, no outside visits.

“It’s been over a month due to positive cases.”

She responds to any messages she can, advising families of current federal guidelines that families should be allowed to visit facilities, COVID-19 outbreak or not.

“Why do families have the burden of having to educate?” said Shannon Daniel, who agreed to do the dishes at her husband’s establishment just to see him during the early days of the pandemic. “Having a loved one in long-term care is already a very stressful situation. We are tired of fighting this fight.

If a measure backed by Gov. Ron DeSantis clears the Legislative Assembly, Shannon Daniel said she hopes families won’t have to fight facilities to let loved ones in.

The proposals, House Bill 987 and Senate Bill 988, establish broad protections for visitors to nursing homes and hospitals.

No vaccinations required for visitors

The bills would prohibit facilities from requiring vaccinations for visitors, a move consistent with federal guidelines related to the current pandemic. They would need facilities to establish policies for family members to touch loved ones they are visiting.

The House version would require providers to recognize an “essential caregiver” for a patient or resident, who would be eligible to visit for at least two hours a day. It is not in the Senate bill. Some differences still need to be resolved between the bills.

Under both measures, family members would be allowed to visit loved ones in the following circumstances almost without exception:

Childbirth.

End of life situations.

Situations where a resident has recently moved into the facility and is struggling with the transition.

Cases in which a resident has difficulty eating or drinking, or experiences emotional distress.

Case where a resident mourns a recent loss.

DeSantis has championed the idea of ​​expanding visitation rights for this legislative session.

“People need their loved ones there,” DeSantis said. while speaking at a Federalist Society conference in February. “Most nursing homes and hospitals have made efforts to do this; not all have done so adequately. We are therefore seeking to effectively enact a “patient’s bill of rights”. »

A potential downside?

Some experts say the rules may be too broad and could have unintended consequences in the future. For example, the Senate proposal would allow visits in special circumstances even if the visitor has already violated a facility’s infection control rules.

Lindsay Peterson, a professor and researcher at the School of Aging Studies at the University of South Florida, said the provision could open the doors of a provider to people who pose a danger to residents.

“If we are in this situation again and facilities are needed to allow someone who does not want to follow infection control in the midst of a raging pandemic – something like that really ties their hands” , Peterson said.

During the coronavirus pandemic, keeping family out hasn’t stopped the virus from spreading in nursing homes. In September 2020, around the time DeSantis reopened nursing homes to visitors, Florida had a long-term care resident death rate from coronavirus that was higher than the national average, according to an AARP tracker.

The state’s long-term care death rate today from the virus is half the national average, according to that same tracker.

“The problem was they couldn’t keep everyone out,” Peterson said. “Staff were coming and going, and as long as you have staff coming and going, then there’s that risk anyway.”

Sen. Ileana Garcia, R-Miami, the Senate patron, said her bill was not intended to allow people who violated safety rules to enter the facilities anyway.

“We’re going to revisit the language on this,” Garcia said. “Even though we want patients to have someone with them, we don’t want someone coming who has been suspended.”

While federal guidelines note that facilities must allow visitors even if they haven’t received a COVID-19 vaccine, the bill goes further. Both the House and Senate versions prohibit institutions from requiring “proof of any vaccination or immunization.”

“I don’t believe you should have to show a vax card to see your loved one,” Rep. Jason Shoaf, R-Port St. Joe, the House bill’s sponsor, said during a February 28 committee meeting. Florida, we’ve taken a position that we’re not going to force people to get vaccinated, and I don’t think now is the right time to start doing that.

The nursing home industry supports the bills, and so does Shannon Daniel. AARP Florida and the labor group Service Employees International Union have not taken a position on them.

The House and Senate measures each approved their final commissions on Monday with healthy bipartisan support. Both are slated for floor votes in the coming days.

Isolation has taken a toll on mental health

On the eve of the pandemic, long-term care facilities across the country closed their doors to visitors in an effort to protect vulnerable residents inside. Research has since shown that the move had devastating effects on patients’ mental and physical health.

In part because staffing shortages plagued the industry long before the coronavirus, family visitors have often played a key role in resident care.

A study of Connecticut nursing homes found that weight loss and depression increased dramatically among residents during times linked to the coronavirus locks, while cognition declined.

In another study from the School of Aging at the University of South Florida, which is currently awaiting publication, Florida long-term care administrators reported a sharp drop in the number of residents with dementia due to loss of visits.

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