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CMS issues ‘long overdue’ visitation guidelines for nursing homes

By James M. Berklan, McKnight’s Long Term Care News, June 25 2020

The Centers for Medicare & Medicaid Services excited the provider community and brought clarity to numerous aspects of restarting visits at nursing homes Wednesday.

Controlled visitation is allowed before a geographic area actually gets to phase three of reopening protocols, the federal agency noted in a seven-point “Frequently Asked Questions” document that was dated Tuesday.

“CMS recognizes the toll of separation from family and other loved ones while at the same time recognizing the need to balance the safety of residents and staff,” the agency noted in its FAQs.

“We have learned a lot more” since the agency issued its first memo on visitation in March, explained CMS nursing home division head Evan Shulman on a call with industry stakeholders Wednesday afternoon. “Anything we can do to bring residents closer to their loved ones, we want to be able to do. However, we also want to make sure it can be done safely.”

Many of the protocols mentioned in the four-page FAQ document involve expected pandemic practices such as the wearing of face coverings and social distancing during visits. In-person meetings should be allowed in outside areas or well-designed indoor spaces, and involve individuals not displaying any COVID-19 symptoms.

The guidance points are a welcome addition, said Jodi Eyigor, LeadingAge’s director of nursing home quality and policy, during the group’s daily coronavirus conference call Wednesday.

“These are long overdue,” she said. “We are excited for a little bit more clarity and we are excited for what the clarity brings.”

She noted that, according to CMS, nursing homes should still generally wait to allow visitations until phase III, which means 28 days with no COVID cases, and adequate PPE, staffing and testing capabilities present.

“Also, communal activities can take place before phase three, so we’re super excited about that,” Eyigor added, noting that protocols still must be followed for them.

Book clubs, crafts, movies, and Bingo are all activities that “can be facilitated with alterations to adhere to the guidelines for preventing transmission,” CMS noted.

The document also clarifies provisions for compassionate care. In brief, it is allowed for more than just end-of-life situations, but should not be allowed routinely, and should be governed by local authorities and managers.

And regardless of various other conditions, ombudsman representatives shall always have access to residents. Providers must accommodate wishes to have such contact, whether in person or by computer or telephone, for example.