Throughout the pandemic, nursing home visitation has been a source of frustration for residents and their families.   The Centers for Medicare and Medicaid Services (CMS) issued visitation guidelines when the pandemic began.  In response, nursing facilities restricted visitors and non-essential health care workers except under certain compassionate care situations such as end of life cases.

CMS guidance evolved over the past year.  In September of 2020, they encouraged indoor visitation so long as there was not an outbreak.   Now with the administration of vaccines, the infection rates in nursing homes have dropped significantly.   Last month, CMS further encouraged states to loosen restrictions on visitation.   The revised guidance has three types of visitation scenarios.

First, facilities should allow responsible visitation for all residents, regardless of vaccination status of the resident or visitor.  They can limit visitation for unvaccinated residents if the COVID county positivity rate is greater than 10 percent and less than 70 percent of the residents in the facility are fully vaccinated.   In addition, those residents with confirmed COVID-19 infections and those in quarantine can have visitor restrictions until they are cleared.

For those who are allowed visitation, CMS has said that, if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting facemask. Regardless, visitors should physically distance from other residents and staff in the facility.

There are additional visitation guidelines for those facilities suffering an outbreak.   Facilities can restrict visitation until they have done the required testing and determined the location of the outbreak.  Then visitation can continue to other areas of the facility not affected by the outbreak.  For many facilities, an outbreak will bring an end to visitations until the testing has determined that it has been brought under control.

Lastly, CMS advised that compassionate care visits for those residents facing end of life prognosis or are in serious decline, should be allowed for any resident, whether they are vaccinated or not.

Part of the problem for some facilities is how they are going to host visitors.  Keep in mind, the CMS guidance places no obligations on the facility to require visitors to be vaccinated.   Given the risk, many facilities may not allow visitation in resident rooms.   As the weather improves, outdoor visitation is a likely solution for those facilities wanting to comply with the visitation guidance but not put their staff and residents at risk.