Smiling man visiting his grandmother and her friends at retirement home
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Updated nursing home COVID-19 visitation guidance issued by the Centers for Medicare & Medicaid Services was widely welcomed by long-term care providers Monday, but stakeholders are still seeking more details from the agency on how it will handle the vaccination of surveyors charged with inspecting facilities. 

“We are concerned that CMS has not clarified whether nursing home surveyors must be vaccinated; We’re still awaiting guidance,” a LeadingAge spokeswoman told McKnight’s Long-Term Care News on Monday.  “Surveyors are like everyone else who enter a nursing home for their work. Surveyors’ vaccination status is truly a critical piece of information for everyone in our shared goal of ensuring the safety and well-being of all residents, staff and visitors.” 

CMS had received questions from providers on the issue after it unveiled its long-awaited healthcare worker vaccination rule earlier this month. The agency, in response, said providers could expect COVID-19 vaccination guidance covering surveyors. 

The updated guidance, which was issued Friday, said long-term care facilities are not allowed to restrict access to surveyors based on their vaccination status or ask them for proof of vaccination as a condition of entry. 

“Surveyors should not enter a facility if they have a positive viral test for COVID-19, signs or symptoms of COVID-19, or currently meet the criteria for quarantine,” the agency wrote.

Facilities that have questions about the process a state is using to ensure surveyors can enter a facility safely should send them to the state survey agency, it added. 

CMS also acknowledged that it and survey agencies are ultimately responsible for ensuring surveyors are compliant with any vaccination expectations. Surveyors were also reminded to follow the core principles of COVID-19 infection prevention and any related infection prevention requirements set by federal and state agencies. 

“These surveys across the nation introduce many surveyors into nursing homes and with each come new risks for exposure to COVID, especially when surveyors are not required to be vaccinated against COVID-19,” said Holly Harmon, RN, vice president of quality, regulatory and clinical services, for the American Health Care Association. 

“This is counterintuitive when the federal agency is directing these same surveyors to soon penalize providers with less than perfect staff vaccination rates. We should be a united front in protecting our vulnerable residents, and that means government officials who must enter our facilities for days on end should be fully vaccinated as well,” she added. 

The updated guidance also requires providers to allow visitation for residents “at all times,” a reversal from various restrictions it had applied throughout much of the pandemic. Both organizations applauded that move. 

“CMS change to visitation is great news – a near return to normal. But the pandemic is still not over, so cooperation and collaboration is required to be sure that everyone follows core infection control principles,” the LeadingAge spokeswoman said. “Nursing home staff, residents, their families and friends all have to work together to ensure everyone’s well being.” 

Harmon added that visits are crucial to residents’ health and wellbeing, and loved ones are valued partners in delivering high quality care to residents. 

“It is key that visitors adhere to good infection prevention and control practices to protect their loved ones and other residents,” she said.