The COVID-19 pandemic has hit hospice facilities particularly hard, with increased risk of severe outcomes among aging patients, thus adding significant strain on hospice staff and support systems. But there’s another side to the story: patients’ mental health.
As noted by Psychiatric Times, the lack of in-person activities such as congregate dining and family visits “can lead to new or recurrent mental health conditions, post-traumatic symptoms, and even life-threatening states due to failure to thrive, especially in those who survived infection.”1
To help alleviate this issue, the CMS and CDC have issued updated guidance on in-person hospice visits, making it easier for family members to see loved ones and bolster their mental health.2 But what do these changes mean for care providers?
Here are three changes hospices can expect as in-person regulations evolve.
Streamlined Visitation Schedules
Informed by the increasing availability of vaccines — the CDC reports that more than 78 percent of Americans 65 and older have received at least one dose — in-person visitations are now a priority. The new guidance makes it clear that responsible indoor visitation should be permitted at all times for all residents wherever possible, regardless of vaccination status.3
While this is welcome news for hospice staff who have been solely responsible for the physical, mental and emotional well-being of patients over the past year, this prioritization also presents a potential problem. Here’s why: To reduce risk for patients and staff members alike, visitation scheduling and management is key. Too many people on-site at the same time creates COVID health concerns.
Coupled with the reality that many hospices are now struggling to both hire and retain staff, renewed demand for in-person visits can significantly increase scheduling complexity. Integrated and intuitive scheduling tools are critical to help bridge this operational gap and optimize in-person visits.4
Delivery of Detailed Documentation
According to the CDC, hospices should create a plan for visitation that includes mandatory check-ins, symptom screening and contact tracing.5 This detailed documentation is especially critical if an outbreak occurs. Staff needs the ability to quickly identify potential close contacts and determine the most likely path of transmission within hospice facilities.
This ability to deliver comprehensive data collection — and commensurate action as required — also impacts provider reputation. According to Hospice News, “quality measures and consumer reviews will drive decision making versus general brand recognition.”6 Hospice agencies that demonstrate the ability to proactively mitigate in-person visit risk with detailed documentation are therefore better positioned for sustained market success.
Rapid Responses to Potential Risks
Under certain circumstances, hospices may still need to limit visitation access. The new CMS guidance, for example, points out that if the hospice county’s COVID positivity rate is more than 10 percent, or if fewer than 70 percent of residents are vaccinated, reductions on the number of visitors or the length of visits may be necessary.7
For hospice providers, this requires the ability to respond rapidly as risks emerge. In practice, this could mean quarantining specific patients or portions of the facility itself, increasing sanitization and disinfection protocols, and following up with family members to keep them in the loop. This makes it critical for hospice companies to deploy software solutions that make it easy to track, record and review COVID protocol compliance at-a-glance.
Informed by rising vaccination rates, in-person visits are now a priority for hospice providers and patient families. To both protect residents and bolster client confidence, however, it’s critical for companies to streamline visit scheduling, deliver detailed documentation and rapidly respond to changing circumstances.
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1 Psychiatric Times, “The Impact of COVID-19 on Mental Health in Long-Term Care,” November 10, 2020.
2 Hospice News, “CMS, CDC Update Nursing Home Visit Guidelines for Hospices, Other Visitors,” March 10, 2021.
3 CDC, “COVID-19 Vaccinations in the United States,” April 11, 2021.
4 Bloomberg, “COVID Takes Toll on Hospice Care,” March 29, 2021.
5 CDC, “Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes,” March 29, 2021.
6 Hospice News, “Hospice Expected to Grow in 2020, Increase Focus on Social Determinants,” January 23, 2020.
7 CMS, “Mom’s Vaccinated: When Can I Visit Her Nursing Home?” March 2021.