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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, according to updated guidance from the Centers for Medicare & Medicaid Services. 

The declaration from CMS comes after the agency was questioned by providers on the issue after it unveiled its long-awaited healthcare worker vaccination rule earlier this month. The rule sets a Jan. 4, 2022, deadline for all eligible staff to be fully vaccinated against COVID-19. CMS, in response, said providers could expect COVID-19 vaccination guidance covering surveyors.

“If facilities have questions about the process a state is using to ensure surveyors can enter a facility safely, those questions should be addressed to the state survey agency,” the agency wrote in the revised memo. “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.” 

CMS also acknowledged that it and survey agencies are ultimately responsible for ensuring that surveyors are compliant with any application 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. 

The guidance was issued within a Friday memo that updated COVID-19 nursing home visitation guidance that requires providers to allow visitation for residents “at all times” now after implementing restrictions earlier during the pandemic.

“[Friday’s] guidance update reflects that, while visitors, residents, or their representatives should be made aware of the risks associated with visiting loved ones, visitation should now be allowed for all residents at all times,” the agency said in a statement. “CMS has consistently updated its visitation guidance through the COVID-19 PHE, and this update represents our most comprehensive action to bring residents and loved ones closer together.” 

While visitation can’t be restricted, CMS encouraged providers to offer testing to visitors if they’re located in counties with substantial or high levels of community transmission. 

It also encouraged facilities to educate and encourage visitors to become vaccinated. 

“Visitor testing and vaccination can help prevent the spread of COVID-19 and facilities may ask about a visitors’ vaccination status, however, visitors 6 are not required to be tested or vaccinated (or show proof of such) as a condition of visitation,” CMS stated. “If the visitor declines to disclose their vaccination status, the visitor should wear a face covering or mask at all times.”