Q. My wife has been in nursing home for about 6 months, and I haven’t been allowed to see her since March due to COVID-19. The facility has been in “Lockdown” and won’t permit visitors. I really miss her. Is there any way to get around this?

A.  Yes, there may well be a way to work around this blanket ban on visitation. The California Department of Public Health (“DPH”) just released a new directive which provides for both indoor and outdoor visitation, depending upon conditions. That directive is addressed to “Long Term Care Facilities” and, on its face, would primarily apply to nursing homes, but its directives should also guide other facilities, such as Assisted Living Facilities. In part, that directive provides for “Exceptions” to the visitation ban, and mandates rules for both “inside facility visitation” and for “outside” visitation, which I summarize as follows:

Exceptions: The list of exceptions to the ban includes health care workers, the Ombudsman, visitation for end of life, and –most interesting to me and my colleagues—visitation to take care of “legal matters that cannot be postponed.. such as estate planning”.

Inside Visitation: The directive requires the Nursing Home (more properly called a “Skilled Nursing Facility” or “SNF”) to allow the resident to designate one visitor for inside visitation, but subject to conditions, among them: absence of new COBID-19 cases in the SNF for 14 days. The SNF “shall” also offer alternatives for other visitors, e.g. virtual visits by phone or video communication.

Outside Visitation: If the conditions for inside visitation are not met, then the SNF “shall” provide outdoor and other visitation options, including:  allowing visits on the facility premises where there is 6 feet or more of physical distancing and with the wearing of masks. The outdoor visits may also include visits through a resident’s window.

In all cases, safety guidelines must be observed, such as visitor screening for fever and COVID-19 symptoms, physical distancing, and the need to disinfect visiting areas after each resident – visitor meeting.

The person to person visitation – whether inside or outside—should be arranged in advance with the facility.  If you receive pushback, you might consider sending a written request.  A sample letter, prepared by California Advocates for Nursing Home Reform (“CANHR”) is on its website, and a link to same is on our own website as apart of our on-line version of this article.

Likewise, a copy of the most recent directive from the California Department of Public Health is available on our site, and you may wish to include a copy in your letter. It is identified as AFL 20-22.4 (issued 8/25/2020) and is entitled “Guidance for Limiting the Transmission of COVID-19 in Long Term Care Facilities”.

For those readers whose loved ones are not in SNF’s, but are in other senior care facilities such as Assisted Living Facilities (“ALF’s”), I would suggest referring to CANHR’s guidance on topic, which is in the form of a checklist entitled “Visitation Rights in California Long Term Care Facilities During the COVID-19 Emergency”: page 2 has a checklist for visitation rights in “Residential Care Facilities For The Elderly”, which would include ALF’s. More recently, the CA Department of Social Services has issued “Updated Guidance” for Assisted Living Facilities, which is referenced below and was issued under date of 10/06/2020.

Visitation by loved ones is crucial to the well-being of residents, and I would encourage those visits, albeit with appropriate safety precautions.

References: CMS Guidance to Nursing Homes of 09/17/2020;   **11/12/2021. Updated CMS Guidance Restoring Visitation in most cases, without restriction.;   

Updated Alert from “California Advocates For Nursing Home Reform” as of 03/11/2021;

Updated “Guidance for Limiting the Transmission of COVID-19 in Long-Term Care Facilities”, from California Dept. of Public Health, as of 03/08/2021

CA Dept. of Public Health Guidance (8/25/2020); CANHR’s “https://canhrnews.com/Visitation Rights In California Long Term Care Facilities During the COVID-19 Emergency”; CANHR’s  “Visitation Guide for California Long Term Care Facilities and Hospitals”; CANHR’s “Sample Letter to Nursing Homes to Demand Outdoor Visitation

CA Dept. of Social Services “Updated Guidance” regarding Visitation for All Adult and Senior Care Program Residential Licensees; 10/06/2020; PIN 20-38-ASC

Visitation Exceptions for legal and other specified matters. See this summary from the CANHR website

Note:  This article appeared in the print versions of the Castro Valley Forum and the San Leandro Times on September 2 and 3, 2020, respectively.