The federal government cracked open another window toward pre-COVID normalcy in nursing homes on Tuesday with new guidance approving communal dining and activities for fully vaccinated residents.
The Centers for Disease Control & Prevention (CDC) stressed that the new guidance only applies if every person in the dining or activity room has been fully vaccinated — the presence of a single unvaccinated person, or someone whose status is unknown, still requires the use of masks and distancing.
“For example, when planning for group activities or communal dining, facilities might consider having patients/residents sign up in advance so their vaccination status can be confirmed and seating assigned,” the CDC advised. “If vaccination status cannot be determined, the safest practice is for all participants to follow all recommended infection prevention and control practices including maintaining physical distancing and wearing source control.”
The CDC additionally clarified that vaccinated residents and visitors can engage in unprotected close contact and touch while in the resident’s room or a designated visitation area, away from other visitors or staff. Residents who have received the vaccine may also have physical contact with unvaccinated visitors as long as both parties wear the required personal protective equipment (PPE).
“Visitors should wear source control and physically distance from other healthcare personnel and other patients/residents/visitors that are not part of their group at all other times while in the facility,” the CDC warned.
The guidance builds on a set of Centers for Medicare & Medicaid Services (CMS) regulations that reopened nursing homes to the outside world in mid-March 2021 after nearly a year under COVID lockdowns; the CDC noted that its guidelines remain subject to different interpretations by local and state authorities as situations change.
The CDC guidance also calls for the suspension of indoor visits — outside of compassionate care situations — for unvaccinated residents if the resident vaccine uptake rate of a facility sits below 70%, or if the COVID-19 positivity rate in the surrounding county rises above 10%.
Facilities in outbreak status should also follow CMS and other local guidelines when determining whether or not to allow visitors.
A wide range of other infection control best practices should still remain in effect at facilities, the CDC stressed, from screening visitors for COVID-19 symptoms to close management of visitor flow within a building to continued counseling of visitors on the best safety strategies and potential risks.