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COVID-19 Update: CMS Updates Nursing Home Visitation Guidelines

October 01, 2020
Compliance By Cathy Benfer, Manager Recruitment Services

The COVID-19 pandemic has been difficult for everyone, especially residents of skilled nursing and assisted living facilities. On Thursday, September 17, 2020, the Centers for Medicare & Medicaid Services (CMS) changed their prior guidance regarding facility visitation.

These new recommendations were shared with the individual State Survey Agencies citing CMS’s understanding of the need for nursing home residents to have visits with loved ones to improve their psychosocial wellbeing.


Update hand writing with a blue mark on a transparent board


While outdoor visits are still encouraged, this newly revised plan will provide residents and family members a way to visit indoors with some restrictions still in place prior to and during the visit There are, however, some core principles that will need to be observed and written into individual facility plans.

  • Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions or observations about signs or symptoms), and denial of entry of those with signs or symptoms
  • Hand hygiene (use of alcohol-based hand rub is preferred)
  • Face covering or mask (covering mouth and nose)
  • Social distancing at least six feet between persons
  • Instructional signage throughout the facility and proper visitor education on COVID19 signs and symptoms, infection control precautions, and other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene)
  • Cleaning and disinfecting designated visitation areas after each visit and high frequency touched surfaces often
  • Appropriate staff use of Personal Protective Equipment (PPE)
  • Effective cohorting of residents (e.g., separate areas dedicated COVID-19 care)
  • Resident and staff testing conducted as required at 42 CFR 483.80(h) (see QSO-20- 38-NH) \

Visitors also have the following recommendations to consider prior to potential visitations:

  1. There has been no new onset of COVID-19 cases in the last 14 days and the facility is not currently conducting outbreak testing.
  2. Visitors should be able to adhere to the core principles and staff should provide monitoring for those who may have difficulty adhering to core principles, such as children.
  3. Facilities should limit the number of visitors per resident at one time and limit the total number of visitors in the facility at one time (based on the size of the building and physical space). Facilities should consider scheduling visits for a specified length of time to help ensure all residents are able to receive visitors.
  4. Facilities should limit movement in the facility. For example, visitors should not walk around different halls of the facility; rather, they should go directly to the resident’s room or designated visitation area. Visits for residents who share a room should not be conducted in the resident’s room.

CMS also recommends that facilities be cognizant of the COVID-19 county positivity rate before enacting an indoor visitation plan.


Does your facility need assistance reviewing your policies and procedures to ensure compliance with the new visitation guidelines? Contact LW Consulting, Inc. for help.

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