01/13/2022

CMS updates nursing facility visitation FAQ

On January 6, the Centers for Medicare & Medicaid Services (CMS) updated the nursing home visitation FAQ. CMS notes that visitation must be permitted at all times with very limited and rare exceptions, in accordance with residents’ rights. In short, nursing homes should enable visitation following these three key points: 

• 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.
  

CMS confirmed during the January stakeholder call that visitation must be permitted even during outbreaks. CMS has also created an infographic to represent how to safely conduct visits to nursing homes. The FAQ clarifies that states may instruct nursing homes to take additional measures to make visitation safer, while ensuring visitation can still occur. This includes requiring that, during visits, residents and visitors wear masks that are well-fitting, and preferably those with better protection, such as surgical masks or KN95. States should work with CMS on specific actions related to additional measures they are considering. 

Nursing facilities should continue to consult with state and local health departments when outbreaks occur to determine when modifications to visitation policy would be appropriate. Facilities should document their discussions with the health department, and the actions they took to attempt to control the transmission of COVID-19. CMS provides additional guidance on how to conduct visitation while reducing the risk of transmission. CMS strongly encourages everyone to get vaccinated, visitation can occur regardless of the visitor’s vaccination status. There are ways facilities can and should take extra precautions, such as hosting the visit outdoors, if possible; creating dedicated visitation space indoors; permitting in-room visits when the resident’s roommate is not present; and the resident and visitor should wear a well-fitting mask (preferably those with better protection, such as surgical masks or KN95), perform frequent hand-hygiene, and practice physical distancing. 

Some other recommendations include: 

• Offering visitors surgical masks or KN95 masks. 
• Restricting the visitor’s movement in the facility to only the location of the visit. 
• Not conducting visits in common areas (except those areas dedicated for visitation). 
• Increasing air-flow and ventilation. 
• Cleaning and sanitizing the visitation area after each visit.
• Providing reminders in common areas (e.g., signage) to maintain physical distancing, perform hand-hygiene, and wear well-fitting masks.