Area Agency on Aging: Nursing home visitation guidance expanded

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    By Kay Kaylor
    PREVIEW Columnist

    I advocate for residents in skilled nursing and assisted living residences as the regional long-term care ombudsman. I also am trained as a Senior Medicare Patrol and State Health Insurance Assistance Program counselor, all as an employee of San Juan Basin Area Agency on Aging (SJBAAA). The many aging and care concerns will be addressed here.

    A March 10 announcement on nursing home visitation from the Centers for Medicare and Medicaid Services (CMS) brought some relief to friends and family members of residents. The CMS updated guidance, in conjunction with the Centers for Disease Control and Prevention, did not address visitation in assisted living and group homes and attributed the change to the “millions of vaccinations” given in nursing homes. Further guidance will be issued over time.

    “Facilities should allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission (note: compassionate care visits should be permitted at all times),” the guidance states. 

    Outdoor visitation is still encouraged. CMS states that indoor visitation should be limited if a county’s positivity rate is equal to or more than 10 percent and if less than 70 percent of residents in the facility are fully vaccinated. “Fully vaccinated” means two weeks have passed since the second dose or single dose (for single-dose vaccines) were given. During an outbreak, visitation can resume under specific conditions (see cms.gov).

    The guidance encourages physical distancing during visits, but acknowledges “the toll that separation and isolation has taken.”

    It states that “there is no substitute for physical contact, such as the warm embrace between a resident and their loved one. Therefore, if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after.”

    Evan Shulman, CMS director, Division of Nursing Homes, said on a March 12 webinar that facilities will need time to prepare for the changes, along with state health departments, which issue public health orders. 

    He emphasized the importance of infection control practices since not everyone is vaccinated and virus transmission among those who are is still unclear. 

    After Shulman’s presentation, Robyn Grant, the director of public policy and advocacy at the National Consumer Voice, said the changes are “important steps” that will make a “tangible difference.” 

    However, fully opening nursing homes to visitation has “a long way to go,” she stated, because facilities can still choose to schedule visits and the guidance has no enforcement to prevent facilities from ignoring it, as has been the case with other guidance.

    Long-term care ombudsmen and other advocates will continue to promote the rights of residents in all licensed care homes.

    SJBAAA offers resources for people age 60 and older or on Medicare; see sjbaaa.org. For further information, please call 264-0501.