July 7, 2020
CMS Debuts New Visitation Guidelines

Feds allow nursing home visits prior to Phase III reopening

SpecialtyRx shares its top 3 takeaways from the latest CMS memo

 
The long-term care community has finally received some much-needed clarity.

Since late April, operators have waited patiently for more specific pandemic protocols related to resident visitation. The Trump Administration’s 3-phase ‘Opening Up America Again’ plan initially discouraged family visits until Phase III with the exception of some compassionate care situations. But many operators wondered—what does that mean?

In a 4-page ​FAQ document published on June 23, 2020, CMS helped interpret particular nursing home restrictions while shedding light on some of the murkier details of their original gating criteria​. Overall, LTC operators and senior advocates were pleased with the news.

To appreciate the agency’s recent update, it’s important to understand their initial Phase III benchmarks for safe visitation.
 
Phase 3 Criteria
 

Reunited and it feels so good

While some states continue to see surges in new coronavirus cases, others have successfully stabilized their populations and have been hoping to reunite residents with loved ones. Leaders at the Centers for Medicare and Medicaid Services appear to acknowledge the importance of regular visitation.

“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,” reads the memo.

All in all, the publication signals a light at the end of a very dark tunnel. Beyond its clarification of visitation protocol, the FAQs also touch on how facilities can safely resume social activities and more. Here are our top 3 takeaways.

 

Compassionate care’ does not mean end-of-life

While death bed scenarios were used as an example early on, CMS now states that facilities can use best judgment when it comes to admitting visitors prior to Phase III.

“For example, for a resident who was living with their family before recently being admitted to a nursing home, the change in their environment and sudden lack of family can be a traumatic experience,” says the memo. “Similarly, allowing someone to visit a resident whose friend or family member recently passed away, would also be consistent with the intent of these situations.”

 

Use of outdoor space is 100% acceptable

Even if a facility has yet to satisfy all criteria for Phase III reopening, CMS says it’s okay to get creative. Their guidance points do not solely apply to inside visitation, but allow for flexibility such as the use of outdoor spaces so long as social distancing, fever screening, and routine cleaning are exercised.

“Facilities can create spaces for residents without COVID-19, including those who have fully recovered, to participate in outdoor visitation sessions with their loved ones, such as in courtyards, on patios, or even in parking lots.”

 

Recreational activities are a go

In recent weeks, staff have gone above and beyond as they strive to keep residents actively engaged and socially stimulated. This has been a struggle given many states’ strict social distancing guidelines. Now, CMS clarifies that “The current guideline is not intended to completely restrict communal activities, except in the case of a resident with symptoms consistent with COVID-19 or a confirmed case.”

So, as long as appropriate precautions are observed, nursing homes may facilitate arts and crafts activities, book clubs, bingo, and communal dining.
 

Note: CMS advises operators to make reopening decisions and implement creative alternatives in coordination with state and local officials.

 

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