Updated Nursing Home Guidance Allows for Most Indoor Visits


Nursing homes should allow most indoor visitations at all times for all residents, regardless of a resident’s or visitor’s vaccination status, according to updated recommendations from federal health officials.

The guidance, from Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC), takes into consideration nationwide COVID-19 vaccine rates as well as the importance of visitations for nursing home residents.

“While CMS guidance has focused on protecting nursing home residents from COVID-19, we recognize that physical separation from family and other loved ones has taken a physical and emotional toll on residents and their loved ones,” CMS said.

CMS has revised its recommendations on nursing home visitations throughout the COVID-19 pandemic. The original guidance, issued in March of 2020, restricted all visitors and non-essential health care personnel under most circumstances.

The latest revisions expand allowances for indoor visits for the first time.

According to the new recommendations, facilities should limit indoor visitations only in situations with a high risk of COVID-19 transmission, including:

  • For unvaccinated residents: If the county’s COVID-19 positivity rate is greater than 10%, and fewer than 70% of residents in the facility are fully vaccinated.
  • For residents with confirmed COVID-19 infection and those under quarantine, whether vaccinated or unvaccinated: Until they have met the criteria to discontinue transmission-based precautions. 

Compassionate care visits should be allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak, CDC said. “Compassionate care visits include visits for a resident whose health has sharply declined or is experiencing a significant change in circumstances.” 

Despite the changes, facilities should continue to follow core principles for preventing COVID-19, such as screening all people who enter the facility for COVID-19 symptoms, masks that cover the mouth and nose, hand hygiene, and social distancing, CMS said. 

One of the Texas Medical Association’s priorities during this legislative session is balancing the emotional-support needs of residents in long-term care facilities with the need to quarantine those elderly and vulnerable residents if they test positive. That includes backing bills that would allow residents to designate at least one “essential caregiver” whom the facility couldn’t prohibit from in-person visitation, even if the resident tests positive for COVID-19. 

Residents and staff at long-term care facilities and anyone older than 65 have been among the top priorities for COVID-19 vaccine eligibility, along with physicians and other health care professionals. “More than half of all Texas seniors have gotten at least one dose of vaccine, and 30 percent are now fully vaccinated,” the Department of State Health Services said last week.

Last Updated On

March 15, 2021

Originally Published On

March 15, 2021

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