CMS Revises Nursing Home Visitation Guidance

March 11, 2021

 

On March 10, 2021, the Centers for Medicare and Medicaid Services’ Center for Clinical Standards and Quality  revised its visitation guidance for nursing homes (https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf),  taking into account the impact of COVID-19 vaccinations.  While continuing to emphasize the importance of maintaining infection prevention practices, given the continued risk of COVID-19 transmission, CMS has clarified and added additional requirements and best practices, including, but not limited to, the following:

  • Nursing homes should continue to screen visitors for signs and symptoms of infection and deny entry to individuals who have had close contact with someone infected with COVID-19 in the prior 14 days regardless of the visitor’s vaccination status.
  • Visitors should not be required to be tested or vaccinated or to show proof of such as a condition of visitation.
  • Outdoor visitation is preferred even when the resident and visitor are fully vaccinated against COVID-19.
  • Indoor visitation should be allowed at all times for all residents regardless of vaccination status, but should be limited for instances of high risk of COVID-19 transmission, such as for:
    • Unvaccinated residents, if the nursing home’s COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated;
    • Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue Transmission-Based Precautions; or
    • Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.
  • Residents who are fully vaccinated should be permitted to choose to have close contact (including touch) with their visitor while wearing a well-fitting mask and performing hand hygiene before and after.
  • Compassionate care visits should be allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak.

Finally, the guidance provides additional protocols regarding indoor visitation during an outbreak and points out that federal and state surveyors are not required to be vaccinated and should be permitted to enter the facility unless exhibiting signs and symptoms of COVID-19.   PLEASE NOTE: individual states may still have stricter restrictions.

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