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Indiana’s Public Health Emergency Extended until November 1, 2020

Posted Sep 24, 20204 min Read

Regulatory & Clinical

On September 24, 2020, Governor Holcomb issued Executive Order 20-44, which extends Indiana’s public health emergency until November 1, 2020.  It was previously set to expire on October 2, 2020.  The federal public health emergency has been extended through January 22, 2021.

With the renewal of the public health emergency, the Indiana State Department of Health’s (ISDH) waivers for comprehensive care facilities (nursing facilities) and residential care facilities (licensed assisted living communities) are effective through November 1, 2020.  If the public health emergency is extended beyond November 1, the waivers will continue through that date.  For a summary of the waivers currently in effect, please click here.

Governor Holcomb also recently announced that Indiana will enter Stage 5 of Indiana’s Back on Track Plan, meaning there are no longer capacity restrictions on restaurants and other venues, although social distancing must continue to be maintained and the face covering requirement will continue statewide through October 17, 2020.  Indiana’s entering of Stage 5 has not impacted ISDH’s Visitation Guidelines.  Under ISDH’s Visitation Guidelines, all long-term care facilities should continue to offer at least four hours of visitation Monday through Friday and over each weekend, unless one of the following applies:

  • The facility has had a facility-onset COVID-19 case in the past 14 days (an outbreak), as defined by ISDH’s Visitation Guidelines.  However, while indoor visitation must be paused during an outbreak until there have been no new facility-onset COVID-19 cases for 14 days, outdoor visitation should continue during an outbreak.  The presence of an outbreak may also warrant the discontinuation of outdoor visitation, but facilities are strongly encouraged to contact ISDH prior to discontinuing outdoor visitation and document the reasons necessary to pause outdoor visitation.
  • The local department of health has otherwise restricted indoor visitation (for the most up-to-date county visitation restriction list, please click here).
  • The facility is in county over 10% positivity, per CMS’s QSO 20-39 (please note, QSO 20-39 does not apply to assisted living communities; for IHCA/INCAL’s summary on QSO 20-39, please click here).

Importantly, if a county is over 10% positivity or a facility is in an outbreak, visitation for compassionate care situations can still occur.  CMS has stated that the term “compassionate care situation” does not exclusively refer to end-of-life situations and does not indicate only family members can visit for these circumstances (i.e., a clergy member offering support may be appropriate in compassionate care situations).  Examples of other types of compassionate care situations include, but are not limited to:

  • A resident, who was living with their family before recently being admitted to a nursing home, is struggling with the change in environment and lack of physical family support.
  • A resident who is grieving after a friend or family member recently passed away.
  • A resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), is experiencing weight loss or dehydration.
  • A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).

IHCA/INCAL will update you if any changes to ISDH’s Visitation Guidelines are made.