Happy older couple looks out over a vista

The Centers for Disease Control and Prevention on Tuesday released new guidance that allows fully vaccinated nursing home residents to resume dining activities without masking or social distancing restrictions.

It also permits visitations and personal contact among residents and visitors who are fully vaccinated. If visitors and residents are both fully vaccinated, they can visit without masks and without social distancing as long as they are alone in their room or in a visitation room without unvaccinated individuals.

“This is a huge victory for residents who have been longing to touch their family members for over a year,” said Amy Stewart, Vice President of Education and Certification Strategy, for the American Association of Post-Acute Care Nursing (AAPACN).

It also means dining at the same table with other fully vaccinated residents without masks and social distancing.

“This, too, is a huge win for residents who have longed to share a meal with one another,” Stewart said, adding a cautionary note: “The one thing providers need to think about it the impact this might have on unvaccinated residents because they need to continue to use source control measures and remain socially distanced from others. These residents may feel a sense of increased isolation as a result.”

Officials also eased guidance for fully vaccinated healthcare workers (HCP).

“In general, fully vaccinated HCP should continue to wear source control while at work. However, fully vaccinated HCP could dine and socialize together in break rooms and conduct in- person meetings without source control or physical distancing,” the guidance says.

If unvaccinated healthcare personnel are present, however, “everyone should wear source control and unvaccinated HCP should physically distance from others.”

That mirrors language given regarding residents’ dining in communal areas or participating in a group activity. In those cases, social distancing and mask wearing is recommended when any unvaccinated resident is participating.

“If unvaccinated patients/residents are dining in a communal area (e.g., dining room) all patients/residents should use source control when not eating and unvaccinated patients/residents should continue to remain at least 6 feet from others,” the guidance says.

In addition, quarantining is no longer recommended for new residents at post-acute facilities if they are fully vaccinated and have not had prolonged close contact with someone with SARS-CoV-2 infection in the prior 14 days.

People are considered fully vaccinated for COVID-19 when they reach two weeks or longer after receiving the second dose in a two-dose series involving the Pfizer-BioNTech or Moderna vaccines, or are two weeks or later after having received a single-dose vaccine (Johnson and Johnson (J&J)/Janssen).

The CDC said that facilities might need to limit the total number of visitors in the facility at one time “in order to maintain recommended infection control precautions.” Providers also might need to limit the number of visitors per patient at one time to maintain any required physical distancing.

Visits for patients who share a room should “ideally” not take place in that room.

“An unvaccinated roommate should not be present during the visit,” the CDC counsels . “If neither patient/ resident is able to leave the room, facilities should attempt to enable in-room visitation while maintaining recommended infection prevention and control practicesexternal icon, including physical distancing and source control.”

If visits are taking place in a designated area in the facility, operators should schedule them so that multiple meetings are not taking place, “to the extent possible.”

“If simultaneous visits do take place, however, everyone in the designated area should wear source control and physical distancing should be maintained between different visitation groups regardless of vaccination status,” the guidance emphasizes.

LeadingAge late last week had called for the CDC and the Centers for Medicare & Medicaid Services to take “immediate action” on updating nursing home visitation, activities and dining policies in light of the effectiveness of the COVID-19 vaccines. 

“As the vaccination rates of nursing home residents and staff have increased dramatically and as states and the federal government begin to relax restrictions on businesses and in public places, this must also occur in long-term care communities,” LeadingAge President & CEO Katie Smith Sloan wrote in a letter to the agencies. 

She added, “the CDC has issued guidance for vaccinated people for safe visitation and socialization. The same should be done for nursing home residents and those in other senior living environments; we have the data to safely adjust visitation guidance in a way that protects older adults from both the coronavirus pandemic and social isolation.”  

Earlier in the day, federal health authorities issued sweeping new mask-wearing guidance for fully COVID-19 vaccinated people in the general public.

This is a developing story. Please check back for updates.