As skilled nursing, basic care and assisted living facilities move through North Dakota’s phased-in reopening approach, state agency officials, industry leaders, facility residents, their family members and advocates continue to work together to find a balance between residents’ health, safety, well-being and rights.
Throughout the pandemic, North Dakota has allowed exceptions to visitor restrictions at these various facilities for compassionate end-of-life care. Today, North Dakota expanded how it defines compassionate end-of-life care situations in its guidelines for reopening skilled nursing, basic care and assisted living facilities.
The expanded definition aligns with new guidance the federal Centers for Medicare and Medicaid Services (CMS) provided to states late last week.
In addition to eminent death situations, compassionate end-of-life care visitation can now include scenarios where residents are currently exhibiting documented signs and symptoms of sharp psychosocial or medical decline, which is above and beyond normal parameters, and may benefit from additional social interaction that cannot be achieved via outside visitation.
The guidelines also say these situations should only be allowed on a very limited basis, must not be considered routine, and may be granted only after careful consideration by a facility’s clinical interdisciplinary team. Facilities that believe a resident’s condition meets this expanded definition must notify a member of the state’s Vulnerable Population (VP3) Task Force, so information can be collected and utilized to help govern future plans for the state’s most vulnerable individuals.
“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.”
The updated long-term care facility guidance is available online at www.nd.gov/dhs/info/covid-19/provider-resources.html.
In response to the pandemic and to control the risk of exposure for individuals whose underlying health conditions made them more vulnerable to COVID-19, on April 6 North Dakota restricted visitation at skilled nursing, basic care and assisted living facilities. On June 5, Gov. Doug Burgum announced a phased-in approach to reopening these facilities to the public while balancing the health, safety, and well-being of facility residents.