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Alabama Nursing Home Association responds to new federal visitation guidance

The Centers for Medicare and Medicaid Services released updated visitation guidance for nursing homes Wednesday.

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The Centers for Medicare and Medicaid Services released updated visitation guidance for nursing homes Wednesday, March 10, 2021. The new guidance is effective March 10, 2021, and outlines circumstances under which nursing homes may offer visitation. Each nursing home resident is allowed two visitors at one time under Alabama’s updated Safer at Home Order.

“We are pleased the federal government recognized the decrease in COVID-19 cases in nursing homes and revised the visitation restrictions to benefit residents and families,” Alabama Nursing Home Association President and CEO Brandon Farmer said. “These changes were just announced this afternoon and we will provide technical assistance to help our members implement the changes. We are encouraging all our members to follow the new guidance and increase visitation opportunities when appropriate.”

All visitors must still be screened and adhere to infection control principles.

Below are the CMS guidelines for visitation.

Indoor Visitation

Facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor, unless certain scenarios arise that would limit visitation for:

  • Unvaccinated residents if; 1) the COVID-19 county positivity rate is greater than 10 percent; and 2) less than 70 percent of residents in the facility are fully vaccinated;
  • Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue transmission-based precautions; or
  • Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.

Indoor Visitation During an Outbreak

While outbreaks increase the risk of COVID-19 transmission, a facility should not restrict visitation for all residents as long as there is evidence that the transmission of COVID-19 is contained to a single area (e.g., unit) of the facility. Facilities should continue to adhere to CMS regulations and guidance for COVID-19 testing, including routine staff testing, testing of individuals with symptoms, and outbreak testing.

When a new case of COVID-19 among residents or staff is identified, a facility should immediately begin outbreak testing and suspend all visitation until at least one round of facility-wide testing is completed. Visitation can resume based on the following criteria:

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  • If the first round of outbreak testing reveals no additional COVID-19 cases in other areas (e.g., units) of the facility, then visitation can resume for residents in areas/units with no COVID-19 cases. However, the facility should suspend visitation on the affected unit until the facility meets the criteria to discontinue outbreak testing.
  • If the first round of outbreak testing reveals one or more additional COVID-19 cases in other areas/units of the facility (e.g., new cases in two or more units), then facilities should suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak testing.

Compassionate Care Visits

Visits for compassionate care, such as an end-of-life situation or a resident in decline or distress should be allowed at all times for any resident (vaccinated or unvaccinated), regardless of the above scenarios. In addition, facilities and visitors should continue all infection prevention and control practices.

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