A patient that I have become very close to went to an ECF, but before leaving asked me to visit them as a friend.

I'm conflicted, to be honest I would love to visit them, but I'm worried that it could be seen as a HIPAA violation. Am I wrong?

I don't see a problem.

As long as you have completely ended the nurse part of the relationship. This means that you can't have anything to do with medical records (or come dressed in scrubs) at the ECF, or if the patient become a patient at your facility again, you must try your hardest to not have her in your assignment.

I might not have a popular opinion. But it is possible to separate one's professional from one's personal life.

There's no HIPAA violation here. Of course you can't look in her chart at the ECF; you can listen to her tell you anything she wants to tell you, and if she wants nursing or medical advice you refer her to her caregiving team; you can tell her team anything (that's not a violation at all; though many people think they can''t even listen to visitors or family, they're wrong). If she insists that you become involved or that she wants people to be able to tell you things, she can sign a form with them authorizing them to speak to you with PHI, if you like; you can refuse if you prefer.

As to caring for her if she returns to your hospital after a stay in ECU, there's no HIPAA violation there either. You would be able to access her PHI as for any other patient in your care, and with the same limits. You may, however, prefer to keep her care separate, unless she insists, and wants to sign a release as above.