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CMS updates nursing home guidance to allow for indoor visits

The agency advises that infection-control measures be put in place during visits, such as social distancing and outdoors visits when possible.

Mallory Hackett, Associate Editor

Federal health officials have lifted COVID-19 nursing home visit limitations and now say that indoor visits are allowed under most circumstances, according to new guidance released by the Centers for Medicare and Medicaid Services on Wednesday.

The agency now recommends that "responsible indoor visitation" should be allowed at all times for all residents, regardless of whether the resident or visitor has received a COVID-19 vaccine.

CMS continues to advise that infection-control measures be put in place during visits, such as social distancing and holding interactions outdoors when possible.

Under the updated guidance, CMS prohibits visits only in situations involving unvaccinated residents:

  • if the county COVID-19 positivity rate is above 10%, and fewer than 70% of residents are fully vaccinated.
  • with residents who currently have COVID-19.
  • with residents currently in quarantine.

It also allows for "compassionate care visits," including in end-of-life situations, or if a resident is experiencing a sharp decline in health, at any time regardless of COVID-19 circumstances.


This guidance will help to alleviate feelings of loneliness and isolation among residents of senior living communities – who were unable to accept visitors up until now under COVID-19 distancing precautions. 

The updated visitation guidance is thanks to the more than three million doses of COVID-19 vaccines administered within nursing homes through the Pharmacy Partnership for Long-term Care Program, CMS said in its announcement.

Since the end of December 2020, cases among nursing home residents have steadily declined, according to CDC data.

The move was applauded by politicians and advocacy groups alike for reconnecting nursing home residents and their families.


Last September, CMS issued recommendations for nursing homes to facilitate outdoor visitation and allow for indoor visits if there hadn't been any new COVID-19 cases for two weeks.

In addition, the CDC shared this week that fully vaccinated people can spend time with other fully vaccinated people indoors without wearing masks or social distancing. This group can also visit with unvaccinated people from a single-household who are at low risk for severe COVID-19 disease.

It notes that vaccinated individuals should continue to wear masks in public and avoid medium to large gatherings.

These new guidelines signal that the U.S. is making meaningful progress at getting the pandemic under control. As of March 11, more than 98.2 million vaccine doses have been administered, and more than 10% of the total population is fully inoculated, according to the CDC.


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

"That is why, now that millions of vaccines have been administered to nursing home residents and staff, and the number of COVID cases in nursing homes has dropped significantly, CMS is updating its visitation guidance to bring more families together safely.

"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."

"Last month, I urged CMS to release clear guidance on nursing home visitation policies," Richard Neal (D-Mass.), the House Ways and Means Committee chairman, said in a statement. "I am glad to see CMS issue clear, updated guidance today in accordance with the CDC for nursing homes to safely expand visitation options during the pandemic, which will be incredibly helpful for patients and families."

"There is no substitute for an in-person visit, even in nursing homes that have gone to extraordinary lengths to support residents and find creative ways to keep them connected with loved ones throughout the pandemic," Katie Smith Sloan, president and CEO of LeadingAge, said in a statement.

"As we wrote in our Feb. 24 letter to the Biden administration, COVID-19 vaccines are the most significant development of the pandemic. 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."

Twitter: @HackettMallory
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