Hospitals in new or resurgent COVID-19 hotspots enact stricter visitation policies

As feared, incidents of COVID-19 are increasing in certain pockets of the country and this has hospitals reconsidering their visitation policies.

Early in the pandemic, hospitals restricted or even suspended in-person visits for patients' families in an effort to control the spread of the coronavirus, and in most instances it appeared to be an effective preventive measure. As the number of COVID-19 cases began to drop, health systems gradually began to ease some of these restrictions.

Now, though, the coronavirus is resurgent in many areas, adding to fears that it will compound with influenza to create difficulties for patients and healthcare systems seeking to control the spread. Limited or restricted visitation policies have been re-implemented at several organizations as a result.

WHAT'S THE IMPACT?

Mayo Clinic hospitals in Wisconsin are among the higher-profile entities that are restricting visits. According to WQOW in Eau Claire, the Mayo Clinic reinstated its no-visitor policy in northwest Wisconsin in response to a growing number of cases in the area. 

To make up for the lack of visitors, area hospitals will offer Zoom calls to patients so they can connect with families at the bedside. There are also some exceptions to the policy, including end-of-life care and some pediatric care in certain instances.

Hospital Sisters Health System, which also services the area, has implemented a similar policy and will not allow visitors, effective 7 a.m. on Thursday. There will be some exceptions: pediatric patients younger than 18, for example, will be allowed two parents or guardians to be present if they live in the same household; surgery patients and obstetrical patients may have one support person present. 

Mountain Health Hospitals in West Virginia will also be enacting a no-visitor policy in response to community spread of the disease in that state. Cabell Huntington Hospital and St. Mary's Medical Center, both operated by Mountain Health Network, are implementing the restrictions this week, according to WSAZ.

The restrictions apply to many who were previously considered essential caregivers, though one such caregiver will be allowed to visit with patients who are on pediatrics, labor and delivery, and neonatal care, depending on the policies of each unit. Visitors for end-of-life patients will be considered on a case-by-case basis. 

Minors will be allowed one parent or guardian. If an essential caregiver is needed for assistance, they – and only they – will be allowed to accompany the patient, but they'll be asked to wait in their vehicle during the appointment. Mountain Health said it will reassess this policy on a weekly basis and make adjustments based on the spread of COVID-19 in the community.

Cottage Health, located in Santa Barbara County, California, is among the minority of organizations that is actually relaxing its visitation policies due to lower coronavirus case counts in the region it serves. This week, New Times reported that limited visitation will resume, with most hospitalized patients permitted one or two visitors during the day, and overnight by request at certain locations. 

Visitors will be asked to wear face masks at all times, and enter and leave only once per day. Whole cafeterias and waiting areas will remain closed. At some locations, such as Santa Ynez Valley, visitors will have to remain in the patient's room for the duration of the visit.

Dignity Health hospitals in the state also relaxed their policies this week, allowing for one "care partner" per patient, with the option to request more on a case-by-case basis. Visitation allowances will be made based on the clinical condition of the patient.

Restrictive visitation policies are among the tools used by hospitals and health systems to mitigate the spread of COVID-19, in addition to personal protective equipment, sanitation protocols and frequent testing.

THE LARGER TREND

Limiting visitations was a key piece of guidance issued back in April by the Centers for Medicare and Medicaid Services, which based its recommendations on Centers for Disease Control and Prevention guidelines. The guidance was meant to help healthcare systems expand their capacity to treat patients with the disease and isolate them from others who aren't infected.

In June, the Office for Civil Rights at the U.S. Department of Health and Human Services reached an early case resolution with the State of Connecticut after the state issued an executive order regarding non-visitation policies for short-term hospitals, outpatient clinics and outpatient surgical facilities that ensures that people with disabilities are not denied reasonable access to needed support persons.

OCR also reached an ECR with Hartford HealthCare Corporation after it agreed to grant a 73-year old woman with aphasia access to support persons to help with her communication and comprehension in her treatment.

In May, OCR received complaints from Disability Rights Connecticut, CommunicationFIRST, the Arc of Connecticut and Independence Northwest: Center for Independent Living of Northwest Connecticut. The complaints allege that Connecticut guidance regarding hospital visitation for people with disabilities violates the Americans with Disabilities Act, Section 504 of the Rehabilitation Act and Section 1557 of the Affordable Care Act, which are enforced by OCR.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com