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DOH and CMS Provide Clarifications on Visitation, Social Interaction, and Outbreaks

The Department of Health (DOH) and the Centers for Medicare and Medicaid Services (CMS) have provided clarifications on guidance related to visitation, social interaction, and outbreaks in response to questions from providers and associations. DOH replied via email to questions posed by LeadingAge NY about outdoor visitation and situations when a staff positive does not trigger an outbreak. According to the email from Valerie Deetz:

Outdoor visitation is generally always expected, including during an outbreak, except for residents who are isolated due to confirmed COVID-19 and for residents who are quarantined. Quarantined residents include those identified as exposed through contact tracing and those who reside on affected units where residents are cared for using all recommended PPE. Outdoor visitation is not expected during inclement weather.

This was reiterated in slightly different terms in an April 26th Integrated Health Alerting and Notification System (IHANS) notification to all nursing homes, which stated:

Outdoor Visitation- permitted for any resident not on quarantine or isolation. (preferred even when resident and visitor are fully vaccinated when weather permits) . . . Indoor Visitation during an Outbreak- Please note, outdoor visitation is NOT suspended. See QSO-20-39-NH page 4 for detailed directions.

In addition, the email from Valerie Deetz clarified that:

If a staff member tests positive, but has not worked in the facility in the 7 days before the collection date of the positive sample or at any time during the isolation period when potentially infectious, there is no need to initiate outbreak testing or to report the staff member on HERDS and no need to suspend visitation.

As previously reported, the Centers for Disease Control and Prevention (CDC) and CMS have updated visitation, social interaction, and testing guidance over the past two weeks to relax certain requirements in light of more widespread vaccination. Members are advised to continue to follow the New York State DOH guidance until we are instructed otherwise. Nevertheless, it is worth staying informed of the CDC and CMS guidance, as they may signal future changes in DOH guidance. Further clarifications of the CMS guidance were provided on an April 29th CMS stakeholder call and are reviewed in a LeadingAge National article available here. In addition to the clarifications noted in the article, LeadingAge National reports that CMS has stated that outdoor visitation may continue in an outbreak, even for those on the “affected unit,” provided they are not on transmission-based precautions for confirmed or suspected “close contacts” as defined by the CDC. They specified that people are not technically on transmission-based precautions just because they are on an outbreak unit. LeadingAge NY is urging New York State officials to align their guidance with the CMS and CDC directives.

Contact: Karen Lipson, klipson@leadingageny.org