Aging services organizations are now urging the Biden administration to provide flexibility in limiting visitation within nursing homes, citing expected surges in COVID-19 cases tied to the omicron variant.
The Centers for Medicare & Medicaid Services (CMS) in November issued guidance allowing visitation for “all residents at all times.”
While visitors should be made aware of COVID-19 risks in a nursing home, CMS said in a memo, public health emergency (PHE) limitations to resident visits will be lifted. That includes nursing homes undergoing an outbreak investigation.
Facilities can no longer curb the number of visitors, frequency or length of the visit, which were all previously acceptable under the PHE. Visits should still adhere to infection prevention protocols, CMS was quick to add — physical distancing should still be maintained during peak gathering hours, like mealtimes.
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 Friday, 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.”
The broad reach of the CMS guidance could conflict with state and local health departments too, the associations said, fostering further confusion.
While the associations said they are in favor of reducing isolation and loneliness in nursing home residents via visitation, medical directors and infection preventionists along with local health departments need “more flexibility” to make the right call.
Pre-pandemic, nursing homes were able to restrict visitors in light of influenza or norovirus outbreaks, the associations reasoned. Rescinding local level decision making is “counterintuitive and potentially dangerous” – operators already expect omicron cases to surge, along with area hospitals. In some instances, omicron is already rampant inside facilities and the surrounding community, association leaders said.
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