THE NO PATIENT LEFT ALONE ACT.

View NCGA Bill Details2021
Senate Bill 191 (Public) Filed Monday, March 8, 2021
AN ACT PROVIDING PATIENT VISITATION RIGHTS WILL NOT BE IMPACTED DURING DECLARED DISASTERS AND EMERGENCIES AND DIRECTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO IMPOSE A CIVIL PENALTY FOR ANY VIOLATION OF THOSE RIGHTS.
Intro. by Daniel, Krawiec, Britt.

Status: Ch. SL 2021-171 (Oct 15 2021)

SOG comments (1):

Long title change

Senate committee substitute to the 1st edition changed the long title. Original title was AN ACT PROVIDING PATIENT VISITATION RIGHTS THAT WILL NOT BE IMPACTED DURING DECLARED DISASTERS AND EMERGENCIES AND DIRECTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES, DIVISION OF HEALTH SERVICE REGULATION, TO DEVELOP AND DISSEMINATE FREE INFORMATIONAL MATERIALS EXPLAINING THESE RIGHTS TO HOSPITALS, NURSING HOMES, COMBINATION HOMES, HOSPICE CARE FACILITIES, ADULT CARE HOMES, SPECIAL CARE UNITS, AND CERTAIN RESIDENTIAL TREATMENT FACILITIES LICENSED UNDER CHAPTER 122C OF THE GENERAL STATUTES.

Bill History:

S 191/S.L. 2021-171

Bill Summaries:

  • Summary date: Oct 18 2021 - More information

    AN ACT PROVIDING PATIENT VISITATION RIGHTS WILL NOT BE IMPACTED DURING DECLARED DISASTERS AND EMERGENCIES AND DIRECTING THE DEPARTMENT OF HEALTH AND HUMAN SERVICES TO IMPOSE A CIVIL PENALTY FOR ANY VIOLATION OF THOSE RIGHTS. SL 2021-171. Enacted Oct. 15, 2021. Effective Nov. 1, 2021.


  • Summary date: Sep 23 2021 - More information

    Conference report makes the following changes to the 3rd edition.

    Makes the following changes to proposed GS 131E-79.3. No longer provides that the requirement that licensed hospitals allow patients to receive visitors to the fullest extent permitted is notwithstanding any provision of this Article, GS Chapter 166A of the General Statutes, or any other provision of law to the contrary. Corrects the name of the Centers for Disease Control and Prevention. Adds the following. Requires hospitals to provide notice of the patient visitation rights in this act to patients and, when possible patients' family members; sets out contact information that must be included in the notice. Requires each hospital to allow compassionate care visits. Allows a hospital to require compassionate care visitors to submit to health screenings necessary to prevent the spread of infectious diseases, and allows a hospital to restrict a compassionate care visitor who does not pass a health screening requirement or who has tested positive for an infectious disease. Allows a hospital to require compassionate care visitors to adhere to infection control procedures. Sets out a non-exhaustive list of compassionate care situations that require visits. Requires the North Carolina Medical Care Commission (Commission) to adopt rules necessary to require each hospital to have written policies and procedures for visitation.

    Deletes the content of proposed GS 131E-112.5 (patient visitation rights for nursing home residents and combination home residents) and replaces it with the following. Requires each licensed nursing or combination home to allow patients and residents to receive visitors to the fullest extent permitted under any applicable rules, regulations, or guidelines adopted by either the Centers for Medicare and Medicaid Services or the Centers for Disease Control and Prevention or any federal law. Provides that if the Centers for Medicare and Medicaid Services, the Centers for Disease Control and Prevention, or any other federal agency finds a nursing or combination home has violated any rule, regulation, guidance, or federal law relating to a patient's or resident's visitation rights, the Department of Health and Human Services (DHHS) may issue a warning about the violation and give the nursing or combination home not more than 24 hours to allow visitation; if visitation is not allowed after the 24-hour warning period, a civil penalty of no less than $500 for each instance on each day the nursing or combination home was found to have a violation is to be imposed. Provides that if circumstances require the complete closure of a nursing or combination home to visitors, the nursing or combination home must use its best efforts to develop alternate visitation protocols that would allow visitation to the greatest extent safely possible; if those alternate protocols are found to violate any rule, regulation, guidance, or federal law relating to a patient's or resident's visitation rights, a civil penalty may be imposed in an amount no less $500 for each instance on each day the nursing or combination home was found to have a violation. Requires giving notice of the patient and resident visitation rights in this act to patients and residents and, when possible, their family members; sets out contact information that must be included in the notice. Requires each nursing or combination home to allow compassionate care visits. Allows requiring compassionate care visitors to submit to health screenings necessary to prevent the spread of infectious diseases, and allows restriction of a compassionate care visitor who does not pass a health screening requirement or who has tested positive for an infectious disease. Allows a nursing or combination home to require compassionate care visitors to adhere to infection control procedures. Sets out a non-exhaustive list of compassionate care situations that require visits.

    Deletes the content of proposed (1) GS 131E-207.5 concerning patient visitation rights for residents of hospice care facilities; (2) GS 131D-7.5 concerning patient visitation rights for adult care home residents and special care units residents and (3) GS 122C-32 concerning patient visitation rights for residents of residential treatment facilities, and replaces them with provisions that are substantively similar to those in GS 131E-112.5 described above.

    Deletes former Section 7 of the act, which required DHHS, by October 1, 2021, to adopt rules to implement the provisions of this act, and set out additional provisions governing those rules.

    Changes the act's effective date to November 1, 2021 (was, when the act becomes law).


  • Summary date: Aug 18 2021 - More information

    House amendment makes the following changes to the 3rd edition. 

    Amends GS 131D-7.5, which requires licensed adult care homes and special care units to allow residents to receive visitors of their choice except when any of three described circumstances have been established by clear and convincing evidence. Adds new authority for the Department of Health and Human Services (DHHS) to issue a warning to a facility found to have violated the statute and give the facility up to 24 hours to allow visitation. Now requires DHHS to impose a civil penalty of at least $500 for each instance on each day the facility was found to have a violation only if visitation is not allowed after the 24-hour warning period (previously, required DHHS to impose the penalty with no qualification related to a warning).


  • Summary date: May 5 2021 - More information

    Senate amendment makes the following changes to the 2nd edition. 

    Amends GS 131E-79.3 to add that the requirement that licensed hospitals permit patients to receive visitors to the fullest extent permitted under any applicable rules, regulations, or guidelines also includes those adopted by the Centers for Disease Control; makes conforming changes. 


  • Summary date: Apr 28 2021 - More information

    Senate committee substitute makes the following changes to the 1st edition. 

    Revises and adds to the act's whereas clauses. Changes the act's long title.

    Deletes the provisions of proposed GS 131E-79.3 and replaces them with the following provisions. Requires licensed hospitals to permit patients to receive visitors to the fullest extent permitted under any applicable rules, regulations, or guidelines adopted by the Centers for Medicare and Medicaid Services (CMS) or any federal law. Authorizes the Department of Health and Human Services (DHHS) to issue a warning to a hospital found by CMS or any other federal agency to have violated any rule, regulation, guidance, or federal law relating to a patient's visitation rights, giving the hospital 24 hours to allow visitation, after which DHHS is authorized to impose a penalty of no less than $500 for each instance on each day of the violation in addition to federal fines and penalties. Directs hospitals to use their best efforts to develop alternate visitation protocols that would allow visitation to the greatest extent safely possibly in the event the hospital is completely closed to visitors, with identical authority granted to impose civil penalties for alternate protocols which violate rules, regulations, guidance or federal law relating to a patient's visitation rights.

    Revises proposed GS 131E-112.5 (concerning nursing homes and combination homes), GS 131E-207.5 (concerning hospice care facilities), and GS 122C-32 (concerning residential treatment facilities), to also make the civil penalty provisions of new GS 131E-79.3 applicable to those facilities.

    Revises proposed GS 131D-7.5 to now require any licensed adult care home or special care unit to allow residents to receive visitors of their choice unless, when established by clear and convincing evidence, infection control issues are present; visitation interferes with the care of other patients; or visitors engage or have engaged in disruptive, threatening, or violent behavior of any kind. Authorizes DHHS to impose civil penalty of at least $500 for each instance on each day a facility is found to be in violation. 

    No longer requires DHHS to develop and disseminate to each described facility free informational materials explaining the enacted statutory rights. Instead, directs DHHS to adopt implementing rules by October 1, 2021, including a requirement that facilities provide notice of the patient visitation rights in the act to patients, residents, and when possible, family members of patients and residents, which must include the contact information for entities responsible for investigating violations.


  • Summary date: Mar 8 2021 - More information

    Includes whereas clauses. Names the act "The No Patient Left Alone Act."

    Enacts GS 131E-79.3 to require licensed hospitals to ensure the opportunity for at least one visitor to visit an admitted patient during  a period in which a disaster, emergency, or public health emergency has been declared, subject to the facility's normal visitation policy (defined as the policy that was in effect at a facility on January 1, 2020). Requires that at least one parent, guardian, or person standing in loco parentis be allowed the opportunity to visit and be present while a minor is receiving hospital care, subject to custody orders or custody agreements. Requires the minor's visitor to have access to a waiting area when the visitor cannot be in the room with the minor patient due to a medical procedure or other reason. Requires that one immediate family member, defined as a spouse, child, sibling, parent, grandparent, grandchild, or the spouse of an immediate family member, have the opportunity to visit an admitted adult patient, subject to the facility's normal visitation policy, as defined. Specifies that immediate family member includes stepparents, stepchildren, stepsiblings, and adoptive relationships. Provides that these statutory rights cannot be terminated, suspended, or waived by the hospital, the Department of Health and Human Services (DHHS), or the Governor upon a disaster or emergency declaration. Prohibits requiring patients to waive these statutory visitation rights. Authorizes licensed hospitals to require a visitor to submit to health screenings, or restrict a visitor who does not pass a health screening requirement or who tests positive for an infectious disease. Allows hospitals to require visitors to adhere to infection control procedures, including wearing personal protective equipment. Mandates that licensed hospitals post informational materials developed by DHHS explaining these statutory rights. 

    Enacts the following statutes, making the patient visitation rights and facility responsibilities specified in new GS 131E-79.3 apply to licensed nursing homes and combination homes, licensed hospice care facilities, licensed adult care homes and special care units, and licensed residential treatment facilities, respectively: GS 131E-112.5; GS 131E-207.5; GS 131D-7.5; and GS 122C-32.

    Requires DHHS to develop and disseminate to each described facility free informational materials explaining the enacted statutory rights. 


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