Florida could soon allow nursing home visits — even during a pandemic.

TALLAHASSEE — Mary Shannon Daniel reads almost every comment in the Facebook support group.

It’s meant for Florida families attempting to visit loved ones in long-term care, and the posts pile up quickly — especially in the last few months during the omicron wave of the coronavirus.

“We haven’t seen our loved ones in 2 weeks.”

“My dad is locked down as we speak. … No visits in, no visits out.”

“It’s been over a month due to positive cases.”

She answers all of the posts she can, informing families about current federal guidance that says families should be allowed to visit facilities, COVID-19 outbreak or not.

“Why is the burden on the families to have to educate?” said Shannon Daniel, who took a job washing dishes at her husband’s facility just to see him during the early days of the pandemic. “Having a loved one in long-term care is already a really stressful situation. We’re tired of fighting this fight.”

If a measure backed by Gov. Ron DeSantis clears the Legislature, Shannon Daniel said she hopes families won’t have to fight facilities to let loved ones in.

The proposals, House Bill 987 and Senate Bill 988, establish broad protections for nursing home and hospital visitors.

The bills would prohibit the facilities from requiring any vaccinations for visitors, a move that is consistent with federal guidelines related to the current pandemic. They would require facilities to establish policies that allow family members to have physical contact with the loved ones they’re visiting.

The House version would make providers recognize an “essential caregiver” for a patient or resident, who would be eligible to visit for at least two hours every day. That’s not in the Senate bill. Some differences are yet to be worked out between the bills.

Under both measures, family members would be allowed to visit their loved ones in the following circumstances almost without exception:

• childbirth;
• end-of-life situations;
• situations in which a resident has recently moved into the facility and is struggling with the transition;
• cases in which a resident is having trouble eating or drinking, or is experiencing emotional distress;
• and instances where a resident is grieving a recent loss.

DeSantis has championed the idea of expanding visitation rights this legislative session.

“People need their loved ones there,” DeSantis said while speaking at a Federalist Society conference in February. “Most of the nursing homes and hospitals have made efforts to do that; not all of them have done it adequately. So we’re looking to enact effectively a ‘patient’s bill of rights.’”

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A potential downside?

Some experts say the rules may be overly broad and could lead to unintended consequences in the future. For example, the Senate’s proposal would allow visitation in special circumstances even if the visitor has previously violated a facility’s infection control rules.

Lindsay Peterson, a professor and researcher at the University of South Florida School of Aging Studies, said that provision could open a provider’s doors to people who pose a danger to residents.

“If we’re in this situation again, and facilities are required to allow someone who doesn’t want to follow infection control in the midst of a raging pandemic — something like this really ties their hands,” Peterson said.

Amid the coronavirus pandemic, keeping family out hasn’t stopped the virus from spreading at nursing homes. By September 2020, around the time DeSantis reopened nursing homes to visitors, Florida had a long-term care resident death rate from coronavirus that was higher than the national average, according to an AARP tracker.

The state’s long-term care death rate today from the virus is half the national average, per that same tracker.

“The problem is they couldn’t keep everybody out,” Peterson said. “Staff were coming and going, and so as long as you’ve got staff coming and going, then there’s that risk anyway.”

Sen. Ileana Garcia, R-Miami, the Senate sponsor, said her bill is not intended to allow people who have flouted safety rules to be allowed into facilities anyway.

“We’re going to revisit the language on that,” Garcia said. “As much as we want the patients to have someone with them, we don’t want someone to come in that’s been suspended.”

While federal guidelines note that facilities should allow visitors even if they have not received a COVID-19 vaccine, the bill goes further. Both the House and Senate versions bar facilities from requiring “proof of any vaccination or immunization.”

”I don’t believe you should have to show a vax card to see your loved one,” said Rep. Jason Shoaf, R-Port St. Joe, the House bill sponsor, during a committee meeting on Feb. 28. “In Florida, we have taken a position that we’re not going to force people to get vaccinated, and I don’t think that it’s a good time to start doing it now.”

The nursing home industry supports the bills, as does Shannon Daniel. AARP Florida and the labor group Service Employees International Union have not taken a position on them.

The House and Senate measures each cleared their final committees Monday with healthy bipartisan support. Both are destined for floor votes in the coming days.

Isolation takes mental health toll

At the dawn of the pandemic, long-term care facilities across the country closed their doors to visitors in an effort to protect vulnerable residents inside. Research has since shown the move had devastating effects on the mental and physical health of patients.

In part because staff shortages plagued the industry long before coronavirus, family visitors have often played a key role in caring for residents.

One study of Connecticut nursing homes found weight loss and depression significantly increased among residents during coronavirus-related lockdowns, while cognition declined.

In another University of South Florida School of Aging study, which is currently awaiting publication, Florida long-term care administrators reported a severe decline in residents with dementia due to the loss of visits.

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