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Federal Nursing Home Visitation/Regs Effective Immediately

Changes in visitation, rules and regulations for nursing homes may have a dramatic effect on services provided in nursing homes. These changes, done yesterday by the Centers for Medicare and Medicaid Services include:

  • communal activities and dining
  • entry of healthcare workers and other specialists
  • access to a resident by representatives of protection and advocacy systems
  • access to Long Term Care Ombudsman
  • required visitation compliance by nursing homes
  • compassionate care visits
  • visitor testing
  • indoor visitation
  • outdoor visitation
  • core principles of infection prevention

September 17th, the Centers for Medicare & Medicaid Services (CMS) issued revised guidance providing detailed recommendations on ways nursing homes can safely facilitate visitation during the coronavirus disease 2019 (COVID-19) pandemic. After several months of visitor restrictions designed to slow the spread of COVID-19, CMS recognizes that physical separation from family and other loved ones has taken a significant toll on nursing home residents. In light of this, and in combination with increasingly available data to guide policy development, CMS is issuing revised guidance to help nursing homes facilitate visitation in both indoor and outdoor settings and in compassionate care situations.  The guidance also outlines certain core principles and best practices to reduce the risk of COVID-19 transmission to adhere to during visitations.

“While we must remain steadfast in our fight to shield nursing home residents from this virus, it is becoming clear that prolonged isolation and separation from family is also taking a deadly toll on our aging loved ones,” said CMS Administrator Seema Verma. “With the Trump administration’s unprecedented efforts to bolster testing resources and deploy infection control support, we believe nursing homes should be able to resume visitations reuniting residents with their families within the recommendations outlined in our guidance.”

In the revised guidance issued today, CMS is encouraging nursing homes to facilitate outdoor visitation because it can be conducted in a manner that reduces the risk of transmission.  Outdoor visits pose a lower risk of transmission due to increased space and airflow. The guidance released today also allows for indoor visitation if there has been no new onset of COVID-19 cases in the past 14 days and the facility is not conducting outbreak testing per CMS guidelines.  Indoor visitation is subject to other requirements as well as indicated in the guidance.

The guidance also clarifies additional examples of compassionate care situations.  While end-of-life situations have been used as one example, there are other examples including: 

  • When 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.
  • When a resident who is grieving after friend or family member recently passed away.
  • When a resident needs help and encouragement with eating or drinking, previously provided by family, is experiencing weight loss or dehydration.
  • When a resident who used to talk to others, is experiencing emotional distress, seldom speaking, and crying frequently (when he/she had rarely cried in the past).

For additional details on the revised nursing home visitation guidance released today, visit here:

QSO-20-39-NH (PDF)

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