Centers for Medicare and Medicaid Services Relaxes COVID-19 Restrictions on Nursing Homes Visits
November 9, 2020
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Updated Guidelines Allow Outdoor and Indoor Visitation Beyond Compassionate Care

On September 17, the Centers for Medicare and Medicaid Services (CMS), a division of the U.S. Department of Health and Human Services (HHS), released a memorandum, relaxing visitation restrictions concerning nursing homes. The new guidelines were implemented in acknowledgment of the fact that residents significantly benefit from visitations with friends and family, both psychologically and physically. These guidelines took effect immediately.

Under the September guidelines, nursing homes are still expected to follow what CMS calls the “core principles” of COVID-19 prevention. This includes screening visitors and workers for symptoms, denying entry to those with symptoms, wearing face masks, practicing proper hand hygiene, social distancing, and any other measures consistent with the coronavirus guidelines for nursing homes laid out by the Centers for Disease Control and Prevention (CDC).

Outdoor and Indoor Visitation Under September Coronavirus Guidelines

As expected, outdoor visitation is preferred as it allows for increased space and airflow, which lowers the risk of viral transmission. Nursing homes are also expected to accommodate and support indoor visitation as long as:

  • There has not been a new onset of COVID-19 in the last 14 days;
  • Outbreak testing is not currently underway at the nursing home;
  • Visitors actively follow CDC guidelines;
  • Staff monitor those, such as children, who may have trouble adhering to CDC guidelines on their own;
  • The number of visitors is limited for everyone’s health and safety; and
  • Movement within the facility is limited, with visitors only permitted to go to visitation rooms, unless a resident is unable to leave their room due to their condition.

The memorandum states that visitation beyond compassionate care is deemed safe unless the county positivity rate is over 10%. On the other hand, outdoor visitation, as of date, will not be limited by county positivity rate. In addition, CMS will provide funds for safety measures needed to facilitate in-person visits at nursing homes.

What Is Compassionate Care?

“Compassionate care” is defined as “‘medical and emotional care for patients with terminal diseases, and may include hospice care” by the National Association of Community Health Centers (NACHC). Therefore, many different scenarios may warrant compassionate care visits. Some examples include:

  • A resident who recently moved to a nursing home and is having trouble getting acclimated to the new environment;
  • A resident who is experiencing grief following the loss of a loved one;
  • A resident who previously needed encouragement from friends and/or family to eat and is now having trouble doing so in the nursing home;
  • A resident who has demonstrated emotional distress; and
  • End-of-life situations.


What Do These Relaxed Restrictions Mean for Residents Amid Coronavirus?

The new CMS guidelines will allow residents to see their loved ones in person while maintaining everyone’s health and safety. Facilities cannot restrict visitation without reasonable cause consistent with the CMS State Operations Manual’s Guidance to Surveyors for Long Term Care Facilities, which outlines rules and regulations for nursing homes during the coronavirus pandemic. If a nursing home fails to facilitate visitation according to the September guidelines, it could be punished by a citation or other disciplinary action.

Are All Residents Included in the New Guidelines?

All residents are technically included in the new guidelines. The only residents who cannot participate in in-person visits are those who are on transmission-based precautions. These precautions are not to be continued if deemed unnecessary per CDC guidelines, therefore allowing for in-person visitations as soon as safety allows.

Representing Residents in Senior Care Facilities for Decades

At Ashcraft & Gerel, we know how stressful it can be to have your loved one under the care of a nursing home, especially during a global pandemic. If you are dealing with a nursing home that is in violation of CMS guidelines, or abusing or neglecting your loved one, our attorneys want to help. For more than 65 years, we have protected the rights of our most vulnerable citizens in care facilities and have recovered more than a billion dollars for our clients. Our offices are located throughout Washington, D.C., Maryland, and Virginia.

For fearless legal representation, contact Ashcraft & Gerel online. We offer services on a contingency fee basis, so you will not have to pay unless we win your case.