On Oct. 15, 2021, Governor Roy Cooper signed Senate Bill 191, “The No Patient Left Alone Act,” into law.  The law expressly provides that patient visitation rights in health care facilities will not be impacted during declared disasters and emergencies.  The law became effective Nov. 1, 2021.

The No Patient Left Alone Act reflects the legislature’s explicit intent to address the unintended consequences of the COVID-19 pandemic to patients and residents of hospitals, nursing homes, combination homes, hospice care facilities, adult care homes, special care units, and residential treatment facilities.  The legislature specifically finds that, in compliance with the rules, regulations, and guidelines of the Centers for Medicare and Medicaid Services and federal law, these patients and residents “should not be denied visitation by visitors of their choosing throughout the period of hospitalization or residential treatment.” 

The law contains several key elements.  Health care facilities must provide notice of patient visitation rights to patients and residents, and, when possible, their family members.  The required notice must include the contact information for the agency or individuals tasked with investigating violations of patient and resident visitation.

In addition, health care facilities must allow compassionate care visits.  Compassionate care situations that require visitation include, but are not limited to: (1) end-of-life situations; (2) a patient who was living with his or her family before recently being admitted to the facility that is struggling with the change in environment and lack of physical family support; (3) a patient who is grieving after a friend or family member recently passed away; (4) a patient who needs cueing and encouragement with eating or drinking, previously provided by family or caregivers, is experiencing weight loss or dehydration; and (5) a patient, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently when the patient had rarely cried in the past.  

However, compassionate care visits are not without limit.  The law contemplates that circumstances may require the complete closure of the health care facility.  If that occurs, the facility must use its best efforts to develop alternate visitation protocols to allow visitation to the greatest extent safely possible.  Further, facilities may require compassionate care visitors to submit to health screenings, and may restrict visitors who do not pass a screening requirement or who test positive for infectious disease.  Facilities may also require compassionate care visitors to adhere to infection control procedures, including wearing personal protective equipment.

If a health care facility violates the law, the North Carolina Department of Health and Human Services may issue a warning.  If visitation is not allowed after a 24-hour warning period, the Department is required to impose a civil penalty in an amount not less than five hundred dollars ($500.00) for each instance.  This penalty is in addition to any fine or civil penalty that the Centers for Medicare and Medicaid Services or other federal agency may choose to impose.

The No Patient Left Alone Act establishes patient visitation as a priority in North Carolina.