CMS Updates Nursing Home Visitation Guidance to Emphasize Mandatory Ombudsman Access

The federal government on Thursday again updated its guidelines for nursing home visitations amid the ongoing COVID-19 pandemic, warning providers that they must continue to facilitate in-person or remote visits by long-term care ombudsmen.

Citing sections of the Social Security Act, the Centers for Medicare & Medicaid Services (CMS) clarified that the CARES Act or other coronavirus-focused rules do not supersede the legal requirement for ombudsman access; in fact, the CARES Act requires nursing homes to cooperate with state ombudsman offices to arrange visits through the duration of the public health emergency, CMS noted.

“The CARES Act does not repeal or amend CMS requirements under sections 1819 or 1919 of the Act or implementing regulations,” CMS advised in a revision to an existing memo to State Survey Agencies. “Nor does it place a time limit or expiration date (e.g., until September 30, 2020) on the CMS requirements providing for resident access to the Ombudsman program, but instead affirms that the current pandemic requires the Ombudsman program and long term care facilities to support resident access and communication in a variety of methods.”


While CMS banned non-essential visits to nursing homes early in the coronavirus crisis in an attempt to stop the spread of COVID-19, exceptions have always been in place for compassionate care and end-of-life visits, as well as inquiries by long-term care ombudsmen.

The agency in late June issued a detailed FAQ with clarifications around the acceptable definitions of compassionate care, which can include visits to residents who recently moved in as well as those who experienced the loss of a friend or family member.

That FAQ also advised operators to provide unfettered access to ombudsmen, with virtual communications acceptable only if conditions were unsafe.


“Since ombudsmen are critical resources for residents and their families, nursing homes should facilitate their in-person access as soon as is practicable,” the agency noted.

CMS in May released its blueprint for resuming all nursing home visits, recommending that facilities remain closed until universal testing can reveal significant declines in infection rates.

States, however, maintain the ultimate authority to reopen nursing facilities to the public, with many already implementing modified visitation schedules that focus on carefully scheduled outdoor visits.

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