End-Of-Life Care Visits and COVID-19 – Since implementing the restrictions in March as the pandemic spread, the State of North Dakota has exempted hospice providers and other end-of-life care clinicians from its regulations restricting access. However, the new definition broadens the types of individuals who can still access those facilities, says Hospice News’ recent article entitled “North Dakota Redefines Nursing Home End-of-Life Visits During Pandemic.”
“Our knowledge about the coronavirus and data on its local impact across our state continues to grow,” said North Dakota Department of Human Services Executive Director Chris Jones. “We appreciate the opportunity to work with the Task Force on Reuniting Residents and Families, the North Dakota Long-Term Care Ombudsman and our colleagues in the North Dakota Department of Health to develop common sense guidelines that reflect new information and are responsive to the needs of individuals and their families.”
Under the state’s new definition, the term used by the state, “compassionate end-of-life care visitation,” now will add social visits for skilled nursing or assisted living residents, who are showing signs or symptoms of psychosocial or medical decline from isolation that exceed normal parameters.
The expanded definition comports with recent guidance to states from the Centers for Medicare and Medicaid Services (CMS).
North Dakota’s revised state guidelines stipulate that these situations are only permitted on a very limited basis. They shouldn’t be thought to be routine. The decision to permit these types of visits would be made by the resident’s clinical interdisciplinary team. Facilities must report these cases to the state’s Vulnerable Population (VP3) Task Force.
Nursing homes have been particularly attacked by COVID-19 in the pandemic. More than 111,000 confirmed COVID-19 cases to date have happened among residents of skilled nursing facilities, in addition to more than 76,000 suspected cases, according to the U.S. Centers for Medicare & Medicaid Services (CMS). These infections have resulted in more than 30,000 deaths.
More than 50% of hospice provider respondents to a Hospice News reader survey said that they thought their organizations would benefit from the states’ “reopening,” compared to 30% of respondents who said it would have a negative impact.
Fewer than 20% thought removal of restrictions wouldn’t impact their clinical or business operations.
A major factor in these results was the expectation that it would become less difficult for hospices to access patients receiving care in nursing homes or assisted living facilities.
Reference: Hospice News (June 30, 2020) “North Dakota Redefines Nursing Home End-of-Life Visits During Pandemic”