Lee Fleisher, M.D., CMS chief medical officer

One year after the coronavirus pandemic prompted a near total moratorium on visits to nursing home residents, the Centers for Medicare & Medicaid Services has announced widely expanded visitation guidance.

“Facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor,” the agency declared Wednesday.

The revisions are a response to the remarkable drop in the number of nursing home COVID-19 cases and deaths that have followed a December vaccine rollout, as well as successful infection control efforts, CMS said. 

Administrators should not restrict visitation for all residents as long as COVID-19 transmission is known to be contained to a single area of a facility, the guidance further states. But all visitation should be suspended when a positive case is found, until staff members complete at least one round of outbreak testing, the agency added. 

Details of the new guidance, including a variety of cautions and advice on continued limits and measures, are available on the agency’s visitation webpage and summarized in a fact sheet. There are no corresponding changes regarding current COVID-19 testing guidelines or infection control protocol.

The astounding drop in COVID-19 cases among nursing home residents — fully 90% at last count — is attributable mainly to the vaccination campaign developed and coordinated by the federal government in record time last year, say industry advocates.

COVID-19 vaccines have proven to be the most significant development of the pandemic, said LeadingAge President and CEO Katie Smith Sloan. Her organization, among others, has pushed for visitation relief for residents ever since the success of the long-term care vaccine program became apparent.

“With today’s announcement, federal policy now reflects the real progress that has been made in vaccinating nursing home residents and staff. This is the right thing to do,” Smith Sloan said in response to the new CMS revisions.

In its announcement, CMS acknowledged a year’s-worth of stress and loneliness suffered by residents, their family and friends, due to measures it called “aggressive” but necessary to protect residents, who have comprised an estimated 40% of the COVID-19 death toll in the United States.

“CMS recognizes the psychological, emotional, and physical toll that prolonged isolation and separation from family have taken on nursing home residents and their families,” said Lee Fleisher, M.D., CMS chief medical officer and director of its Center for Clinical Standards and Quality.

“This is an important step that we are taking, as we continue to emphasize the importance of maintaining infection prevention practices, given the continued risk of transmission of COVID-19.”

Senior living industry groups said they are hopeful that release of the visitation rules for nursing homes will spur states to make similar recommendations for assisted living communities soon.