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South Carolina Announces Updated Nursing Home Visitation Guidelines

State Request Approved by Federal Partners will Allow Additional Nursing Home Visitation

March 10, 2021

COLUMBIA, S.C. — South Carolina has received federal approval to update visitation guidelines for nursing homes and community residential care facilities, announced the South Carolina Department of Health and Environmental Control (DHEC) and Governor Henry McMaster. These updated guidelines require facilities to use DHEC’s percent positive by county data to help determine their visitation status. This update will result in more facilities who were previously restricting visitation based solely on a county’s percent positive rate greater than 10 percent allowing in-person, indoor visitation.

As of today, any facility that meets the following standards must allow in-person, indoor visitation:

•    a less than or equal to 10 percent positivity rate in the county in which the facility is located, using DHEC’s data, and
•    no COVID-19 cases among staff and/or residents in the past 14 days, and 
•    maintained CMS’ core principles of COVID-19 infection prevention 

Prior to the change in guidelines, 177 facilities were not allowing visitation. Of those, 43 facilities specifically cited county percentage positive as the reason and are in one of the 40 counties that now have a percentage positive of 10 percent or less should be able to open to visitation if they otherwise meet the criteria above.

“Too many South Carolinians have been prohibited from visiting their loved ones in long term care facilities because of overburdensome federal guidelines,” said Gov. Henry McMaster. “Prioritizing the physical health and safety of our most vulnerable citizens is critically important, but we must also protect their mental and emotional health. These updated guidelines represent important progress and will result in many facilities opening for visitation, but there’s more work to be done and we will continue pushing federal agencies to allow expanded visitation.”

Vaccinations of Long-term Care Residents and Staff
As of today, 100 percent (193 out of 193) of the state’s nursing homes have had their first COVID-19 vaccination clinic completed and 86 percent (166 of 193) have had their second clinic completed, with additional clinics scheduled. A total of 98 percent (485 of 495) of the state’s community residential care facilities have had their first vaccination clinic completed and 86 percent (424 of 495) have had their second clinic completed, with additional clinics scheduled.

In total, more than 61,500 doses of COVID-19 vaccine have been given to our state’s roughly 40,000 long-term care facility residents, and more than 36,700 doses have been given to the approximately 40,000 workers who care for them.

“When COVID-19 first spread across the country, long-term care facilities were devastated as the virus took its toll on nursing home residents who were among the most vulnerable to the virus,” said Dr. Edward Simmer, DHEC Director. “In South Carolina, efforts had been underway to prepare long-term care facilities for the arrival of the virus, and DHEC has worked with facilities to help implement disease prevention protocols. Still, we lost many loved ones to this deadly virus. That’s why we prioritized nursing home residents among the first to be vaccinated, and after a massive statewide effort, nearly all long-term care facility residents in the state now have had the opportunity to get their life-saving shots.”

“Allowing visitation to the greatest degree possible consistent with safety for residents, staff, and visitors, is extremely important to residents' mental and physical health and also for their families,” said Simmer. “The updated guidelines will help ensure as many residents as possible can have safe, in-person contact with family and friends.”

DHEC’s Percent Positive by County Data
Until today, visitation guidelines for outdoor and indoor visitation at nursing homes and community residential care facilities (commonly referred to as assisted living facilities) have been based on percent positive data from the Centers for Medicare & Medicaid Services (CMS). However, the data that CMS/U.S. Centers for Disease Control and Prevention (CDC) receives is based on several different data sources used to calculate percent positives. Today’s updated guidelines direct South Carolina’s long-term care facilities to instead use DHEC’s percent positive by county data.

DHEC uses the tests-over-tests method for calculating percent positive, which is the same method used by the CDC. Therefore, the state-generated percent positive data is appropriate to use for determining visitation.

The county positivity rate is based on an average of the past 14 days and the report is updated on the DHEC’s website weekly, on Thursdays at 1 p.m. Additional details about the updated guidelines requiring facilities to use DHEC’s percent positive by county data include:

•    The county positivity rate must be greater than 10 percent in order for facilities to use this reason for not allowing indoor visitation. 
•    These guidelines replace the previous use of CMS data to determine visitation status for purposes of indoor visitation.
•    As of the most recent data, 40 of 46 counties have positivity rates that are less than or equal to 10 percent. This means the current county positivity rate shouldn't affect visitation except for the six counties (Allendale, Barnwell, Chesterfield, Lancaster, McCormick, and York) with rates higher than 10 percent.
•    Trends in county percent positivity rates can go up or down from one report to the next. This means, a facility’s visitation status could change from one week to the next, based on the data.
•    DHEC will continue to provide weekly updates on the current visitation status for all nursing home and congregate care residential facilities in the state, online here.

Facilities with limited visitation because their county’s percent positive rate exceeds 10 percent should still encourage safe indoor visitation during compassionate care situations. Compassionate care situations aren’t limited to end-of-life situations; other examples include when a resident’s physical or mental health is declining, if a resident is grieving the passing of a loved one, if a resident needs encouragement with eating or drinking, or when a new resident is struggling with transition. These examples are not a complete list and facilities should allow compassionate care visits on a case-by-case basis. 

Facilities should also continue to allow outdoor visitation, virtual visits, and window visits consistent with DHEC’s guidelines. The public is strongly encouraged to contact the nursing home or assisted living facility to confirm their visitation status and policies and procedures prior to planning to visit a loved one.

For the latest information about nursing homes and extended care facilities impacted by COVID-19, including cases and deaths, visitation status, and county percent positivity rates, click here. For the latest COVID-19 information in South Carolina, click here.



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