The General Assembly cleared a state Senate bill Wednesday that addresses patient visitations during a statewide emergency.
The Senate voted 49-0 to approve the compromise legislation for Senate Bill 191, titled “The No Patient Left Alone Act.” The House voted 79-29 on Sept. 23.
Gov. Roy Cooper has 10 days to sign or veto SB191 or let it become law without his signature.
SB191 affects hospitals, nursing homes, hospice care, residential treatment facilities and other long-term care facilities.
The main changes to SB191 involve clarifying that those facilities are required to provide notice of patient visitation rights to patients and family members, and allow compassionate care visits to patients.
Family members are defined as a spouse, child, sibling, parent, grandparent, grandchild, spouse of an immediate family member, stepparent, stepchildren, stepsiblings and adoptive relationships.
A concurrence committee took about a month to reach the compromise, which significantly expanded the scope of the legislation. Rep. Donny Lambeth, R-Forsyth, was the lead House conferee on the committee.
State Sen. Warren Daniel, R-Burke, and co-primary sponsor, said Wednesday that the latest version of the legislation reflects changes recommended by the N.C. Department of Health and Human Services.
“We have met with stakeholders and with DHHS to address any concerns they may have,” Sen. Joyce Krawiec, R-Forsyth, and a co-primary sponsor of the bill, said Sept. 23.
“Families will not be separated completely from loved ones again.”
Compassionate care visits would include:
• End-of-life situations.
• A patient struggling with a change in living environment and lack of personal family support.
• A patient grieving the recent loss of a family member or friend.
• A patient requiring additional attention because of challenges with eating or drinking. That care previously was provided by a family member or caregiver.
• A patient becoming unstable emotionally in part by being in the facility.
Visitors can be required to be screened for infectious diseases. If a visitor tests positive for an infectious disease or fails the screening, they can be denied entry.
Visitors can be required to wear personal protective equipment
The N.C. Healthcare Association said in a statement following the reaching of the compromise legislation that “as North Carolina’s hospitals are compliant with federal rules and also value the roles that family members, chaplains and others play in patients’ healing, we see no issue with it.”
“We must make sure that no patient in North Carolina is ever left alone in a hospital or nursing home while their spouse or family members are forced to wait at home or in the parking lot while their loved one is receiving care,” Daniel said in May during the Senate’s floor debate on SB191.
“A video call to a hospitalized patient, many who don’t know how to use a computer, cannot become a substitute for having a family member present during potentially life-and-death health care situations.”
Krawiec has said that non-COVID-19 patients are being adversely affected by the visitor restriction as well.
“There are a multitude of cases where residents are still not allowed to have visitors,” Krawiec said. “It should never happen again where patients are dying alone in facilities.
“There are also those who have diminished cognitive abilities who don’t understand why they are abandoned without loved ones or caregivers being allowed to visit them.”
“Isolation is a reason many residents in facilities ‘fail to thrive,’” she said.
SB191’s primary focus remains on concerns that emergency visitor restrictions can keep family members from being with loved ones and hampering their ability to serve as an advocate with hospital staff.
The patient can designate the visitor “if they have the capacity to make decisions.”
On March 12, DHHS issued an order that long-term care facilities can allow in-person visitations — indoor and outdoor — “in most circumstances” based on changes made by the federal Centers of Medicare and Medicaid Services and the federal Centers for Disease Control and Prevention.
Those agencies cited “rapidly improving trends in long-term care facilities” for allowing more visitations.
DHHS cautioned in its updated guidance that outdoor visitations still remain the best option.