“Visitation Is Now Allowed For All Residents At All Times”
Citing high vaccination rates for residents (86%) and staff (74%); interim final rules with comment (published at 86 Fed. Reg. 61555 (Nov. 4, 2021)) requiring staff to be vaccinated against COVID-19; federal regulations (42 C.F.R. §483.10(f)(2), confirming residents’ right to make choices about issues of importance to them, and §483.10(f)(4)(ii) and (iii), confirming residents’ right to deny or withdraw consent for visits); and the physical and emotion toll that social isolation during the pandemic has caused residents, the Centers for Medicare & Medicaid Services (CMS) has revised its visitation guidance to provide that “Visitation is now allowed for all residents at all times.” CMS, “Nursing Home Visitation – COVID019 (REVISED), QSO-20-39-NH (Revised Nov. 12, 2021). CMS explicitly states that “facilities can no longer limit the frequency and length of visits for residents, the number of visitors, or require advance scheduling of visits.”
The new visitation policy applies to all residents and in all situations, including residents on transmission-based precautions (TBP) or quarantine, unvaccinated residents, and residents in facilities that are having an outbreak investigation.
CMS confirms that residents may “leave the facility as they choose.” When they return, facilities should screen them for signs or symptoms of COVID -19; test them, if they have been in close contact with someone who had COVID-19; and, if not fully vaccinated, place them on quarantine. Residents developing signs or symptoms should be placed on TBP, regardless of vaccination status. Residents absent for 24 hours or more “should generally be managed as a new admission or readmission,” as recommended by the Centers for Disease Control and Prevention.
CMS suggests that indoor visits “be conducted in a manner that adheres to the core principles of COVID-19 infection prevention and does not increase risk to other residents.” These principles include physical distancing and avoidance of large gatherings.
“Nursing Home Visitation – COVID019 (REVISED) is available at https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf and from the Center for Medicare Advocacy, on request.
November 18, 2021 – T. Edelman