NC lawmakers look to fine hospitals, nursing homes that block visitors

Senate Bill 191, titled the No Patient Left Alone Act, would fine any nursing home or hospital $500 a day for preventing any patient from having visitors. Sponsors say the federal Centers for Medicare and Medicaid Services now forbids such visitation restrictions, especially for disabled people who need access to a caregiver.

"Blanket visitation policies that forbid visitation is in violation of federal law, no doubt about it," Sen. Jim Perry, R-Lenoir, told members of the Senate Health Care committee on Thursday. "You don't get to press pause on federal law."

The state Department of Health and Human Services locked down long-term care facilities early in the pandemic to protect the elderly and frail residents who were at high risk from the virus. Hospitals statewide took similar steps to protect their patients and staff.

Perry and other bill sponsors said they recognize the moves were well-intended, but they carried consequences where many people wasted away from loneliness or died without their families nearby.

Sen. Warren Daniel, R-Burke, shared the story of Scott Starnes, who spent more than a month in hospitals before dying last summer from injuries suffered in a head-on collision. During that time, his fiancee was allowed to visit him once, and no other family members were allowed in.

"No hospital patient or nursing home resident in North Carolina should be forced to remain isolated, alone, separated from their family," Daniel said. "Even more important, no patient should be forced to pass from this world to the next alone."

Daniel filed a similar bill last year, without a proposed fine, but it failed to pass amid concern that facilities might get in trouble with CMS. But the agency updated its regulations on visitation during the pandemic.

Senators heard Thursday from a nurse who cared for Starnes and from family members of people in nursing homes who said they and their relatives suffered during the mandated pandemic-related separation.

"We are not visitors. We are caregivers," said Bob Wilson, whose wife has been in a Burlington nursing home since suffering a stroke five years ago.

Wilson said he documented 22 areas where his wife's physical and mental health declined in the seven months he wasn't allowed in to be with her.

Bill Lamb, chairman of advocacy group Friends of Residents in Long-term Care, said scientific studies have shown people suffer when prevented from seeing loved ones. Even as the state has relaxed visitation restrictions at care facilities in recent months, he said, families still find themselves fighting for access.

"We have many people that are still suffering now that need their family members," said Sen. Danny Britt, R-Robeson. "Folks in these long-term treatment facilities, they need their family members in order to survive."

Sen. Gladys Robinson, D-Guilford, said she understands the frustration – she wasn't with her mother when she died last year – but she worries about the possibility of more people dying in a future pandemic if hospitals and nursing homes remain wide open.

"We want to be there, but we also have to make sure that we are taking care of the larger public," Robinson said. "We don't know what's coming; we don't know what's next."

Isolation dangerous to nursing home residents' mental health

Daniel suggested that patients are at much less risk from family members who come in and go straight to their rooms than they are from staff members who come and go from the facilities and then go from one room to the next inside.

Wilson agreed, saying all coronavirus outbreaks at nursing homes were traced to staffers.

"The lockdown was never meant to stop the virus. It was meant to stop deaths, and it failed at that," he said.

The bill, which has several steps to pass yet, would mandate visitation at facilities regulated by CMS. At adult care homes and special care units that aren't under federal regulation, residents would be permitted visitors except when infection control issues are present, visitation interferes with patient care or visitors have engaged in disruptive, threatening or violent conduct. But any exception to visitation must be "established by clear and convincing evidence," the bill states.