Recently, CMS Issued New Guidance for Unrestricted Visitation in Nursing Homes During the COVID-19 Public Health Emergency

Nursing homes have been severely impacted by COVID-19, with outbreaks causing high rates of infection and death. In March 2020, the Centers for Medicare & Medicaid Services (CMS) issued a memorandum providing guidance to facilities on restricting visitation of all visitors and non-essential healthcare personnel, with limited exceptions. In May 2020, CMS released additional guidance on visitation for nursing homes as states and local communities began to reopen.

This past Friday, CMS released a new memorandum containing updated guidance stating  that “(v)isitation is now allowed for all residents at all times.” Although health risks during visits remain, “if a visitor, resident, or their representative is aware of the risks associated with visitation, and the visit occurs in a manner that does not place other residents at risk (e.g., in the resident’s room), the resident must be allowed to receive visitors as he/she chooses,” CMS said in its statement.

Since the beginning of the pandemic, CMS guidance focused on protecting nursing home residents from COVID-19, which the agency concluded justified restricting visitation. However, CMS has come to recognize that physical separation from family and other loved ones has taken a physical and emotional toll on residents and their loved ones. In its recent memorandum, CMS stated that “[r]esidents may feel socially isolated, leading to increased risk for depression, anxiety, and expressions of distress. Residents living with cognitive impairment or other disabilities may find visitor restrictions and other ongoing changes related to COVID-19 confusing or upsetting. CMS understands that nursing home residents derive value from the physical, emotional, and spiritual support they receive through visitation from family and friends. In light of this, CMS is revising the guidance regarding visitation in nursing homes during the COVID-19 [Public Health Emergency].”

CMS stated that “a nursing home must facilitate in-person visitation … .” Federal regulations state that “[t]he resident has a right to receive visitors of his or her choosing at the time of his or her choosing, subject to the resident’s right to deny visitation when applicable, and in a manner that does not impose on the rights of another resident.” Therefore, failure to facilitate visitation would constitute a potential violation of the applicable regulations and the facility would be subject to citation and enforcement actions.

Face Coverings Are Still Required

Though visitation restrictions have been lifted, CMS maintained that the following “core principles and best practices” reduce the risk of COVID-19 transmission, and should be adhered to at all times:

  • Visitors who have a positive viral test for COVID-19, symptoms of COVID-19, or currently meet the criteria for quarantine, should not enter the facility.
  • Hand hygiene (use of alcohol-based hand rub is preferred)
  • Face covering or mask (covering mouth and nose) and physical distancing at least six feet between people, in accordance with CDC guidance
  • Instructional signage throughout the facility and proper visitor education on COVID-19 signs and symptoms, infection control precautions, other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene)
  • Cleaning and disinfecting high-frequency touched surfaces in the facility often, and designated visitation areas after each visit
  • Appropriate staff use of Personal Protective Equipment
  • Resident and staff testing

The information contained in the CMS updated memorandum concerning nursing homes visitations supersedes and replaces previously issued guidance and recommendations regarding visitation.

Plan for Loved Ones Who Need Nursing Home Care Now or in the Near Future

If you haven’t yet done Medicaid asset protection planning, and if you have a loved one who either needs facility care or is already a resident in a nursing home or an assisted living facility, the time to plan is now! Please contact the Law Office of Donald D. Vanarelli as soon as possible to make an appointment.

CMS Nursing Home Visitation – COVID-19 (REVISED) –

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