The Centers for Medicare & Medicaid Services (CMS) has issued a clarification to its nursing home visitation guidance, just a few days after a some of the largest aging services organizations urged government officials to provide flexibility in limiting visitation due to the latest surge in COVID-19 cases.
In a nursing home visitation frequently asked questions issued on Dec. 23, CMS reiterated that residents must allow visitors at all times, however the government agency added, “with very limited and rare exceptions, in accordance with residents’ rights.”
CMS, in its latest FAQ, detailed three things skilled nursing facility staff should keep in mind when allowing for visitation: Adhere to the core principles of infection prevention, especially wearing a mask, performing hand hygiene, and practicing physical distancing; don’t have large gatherings where physical distancing cannot be maintained; and work with your state or local health department when an outbreak occurs.
For example with the upcoming holidays, as facilities are expected to have a high volume of visitors, CMS noted that should physical distancing not be able to be maintained between residents “the facility may restructure the visitation policy, such as asking visitors to schedule their visit at staggered time slots throughout the day, and/or limiting the number of visitors in the facility or a resident’s room at any time.”
The latest statement is a notable tone change from the CMS guidance issued one month earlier that allowed visitation for “all residents at all times.”
The November memo from CMS also noted that while visitors should be made aware of COVID-19 risks in a nursing home, public health emergency (PHE) limitations to resident visits would be lifted.
That included the number of visitors, frequency or length of the visit, which were all previously acceptable under the PHE.
LeadingAge, the American Health Care Association and National Center for Assisted Living (AHCA/NCAL) and the Society for Post-Acute and Long-Term Care Medicine (AMDA) sent a letter to CMS Administrator Chiquita Brooks-LaSure on Dec. 17, suggesting the agency give facilities flexibility to place temporary visitation restrictions to protect residents and adhere to infection prevention protocols.
“As the guidance is written, it appears that a facility is not permitted to place any restriction on visitation, regardless of staffing levels, community positivity rates, or severity of facility outbreak,” the associations said in the letter. “We are concerned that the absolute, unconditional language may pose a risk to nursing homes and their residents, placing skilled nursing facilities in precarious situations when outbreaks occur.”
In an email newsletter, the Center for Medicare Advocacy said it did not agree with CMS’ decision to update the visitation guidelines.
“The Center is concerned that many nursing facilities failed to follow CMS’s absolute guidance in November and will exploit the December 23 FAQs to expand the ‘very limited and rare exceptions’ to bar or limit visitors,” the national, non-profit, law organization wrote. “Vaccinations and boosters, not barring families, are the key to preventing COVID-19 infections and deaths.”
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