North Dakota revises ‘compassionate care’ definition to allow visitation for some declining nursing home residents

By Hannah Shirley, Grand Forks Herald, Jul 1 2020 

Residents of North Dakota’s long-term care facilities who have experienced dramatic physical or mental decline due to isolation during the pandemic will be allowed in-person visits with family and loved ones.

Previously, residents of locked-down nursing homes and long-term care facilities were only allowed such visits as part of compassionate end-of-life care. North Dakota revised its definition of compassionate care on Tuesday, June 30, to include residents who are exhibiting “sharp psychosocial or medical decline” that is “above and beyond normal parameters” whose health could benefit from additional social interaction.

North Dakota Department of Human Services Director Chris Jones said that finding the balance between keeping residents of nursing homes and long-term care facilities safe from coronavirus and maintaining their quality of life has been a push and pull since the beginning of the pandemic.

“What we’re really trying to do collectively is thread the needle between friends and family being able to spend time with their loved ones, yet at the same time, maintain a level of safety for all residents,” Jones said. “With all of these unknowns, people have different levels of anxiety, and I just want everyone to know that that’s something that weighed heavily on all these decisions. It’s not one way versus the other.”

The revised definition is in line with guidance issued by the Centers for Medicare and Medicaid Services last week.

According to the North Dakota Department of Health, compassionate care visitation should be offered on a limited basis and should not be considered routine. Facility staff are instructed to notify Gov. Doug Burgum’s Vulnerable Population Task Force about any resident who is granted in-person visitation on the basis of compassionate care.

The announcement comes as North Dakota’s 218 nursing homes and long-term care facilities move forward through a smart restart plan. Christopher Larson, chairperson of the Reuniting Residents and Families Task Force, said that, as of Tuesday, all but one of the state’s facilities had progressed to Phase One of the plan, which allows for congregate activities within the facility, and 114 facilities had moved on to Phase Two, which allows for limited one-on-one visitation.

Shelly Peterson, president of the North Dakota Long Term Care Association, added that, as of Tuesday afternoon, only five people of the 10,000 people who live in North Dakota nursing homes and long-term care facilities have active cases of COVID-19.

Larson, a resident of a North Dakota nursing home, said in a Tuesday afternoon press conference that he was excited by the morning’s announcement that the state would redefine compassionate care.

“It has been a long three months,” he said. “Being a resident of a long-term care facility, I know what this is like. To say that I’m happy would be an understatement.”