Family members struggle with caregiving decisions for loved ones with dementia.

Federal health officials’ decision to reopen the nation’s nursing homes to visitors Wednesday was “the right thing” to do, leading long-term care advocates said. The decision was made in light of widespread coronavirus vaccine access and subsequent vast decreases in case counts and deaths.

“There is no substitute for an in-person visit, even in nursing homes that have gone to extraordinary lengths to support residents and find creative ways to keep them connected with loved ones throughout the pandemic,” said LeadingAge President and CEO Katie Smith Sloan after the official announcement Wednesday.

“[F]ederal policy now reflects the real progress that has been made in vaccinating nursing home residents and staff. This is the right thing to do,” she added. 

The Centers for Medicare & Medicaid Services on Wednesday expanded indoor visitation guidelines for nursing homes. The guidance was issued in conjunction with the Centers for Disease Control and Prevention. It came just two days after the CDC announced loosened recommendations for fully-vaccinated people in non-healthcare settings. 

The guidance is “welcome news,” the American Health Care Association/National Center for Assisted Living stated. 

“The health and wellbeing of our residents will improve, thanks to this important guidance,” AHCA/NCAL President and CEO Mark Parkinson said in a statement. 

“It has been nearly one year to the day since visitors were restricted from nursing homes, and now thanks to the vaccines, we cannot wait to safely reopen our doors,” he added. “Our dedicated staff members have done an extraordinary job filling in for loved ones and adapting visitations during this difficult time, but nothing can replace engaging with family members in-person.” 

CMS banned most visitors at nursing homes early in the pandemic as providers fought to limit the spread of COVID-19. The agency updated the guidance in September and laid out a framework for providers to facilitate in-home visitation. 

The latest guidance calls on facilities to allow “responsible” indoor visitation at all times for residents, regardless of their or their visitor’s vaccination status, unless certain scenarios arise that would limit it. Those limitations should be put in place for: 

  • Unvaccinated residents if the COVID-19 county positivity rate is greater than 10% and less than 70% of residents in the facility are fully vaccinated; 
  • Residents with confirmed COVID-19, regardless of vaccination status, until they’ve met criteria to discontinue transmission-based precautions; and 
  • Residents in quarantine until they’ve met criteria to be released. 

The guidance calls for compassionate care visits to be allowed at all times for any residents, regardless of vaccination status. Ombudsmen also should be provided with immediate access to any resident, documents state. 

The guidelines also call on providers to continue to adhere to CMS rules for COVID-19 testing, including routine staff testing, testing of individuals with symptoms and outbreak testing. Facilities should not restrict visitation for all residents as long as there is evidence that the transmission of COVID-19 is contained to a single area of the facility, officials now say.

“CMS continues to recommend facilities, residents, and families adhere to the core principles of COVID-19 infection control, including maintaining physical distance and conducting visits outdoors whenever possible. This continues to be the safest way to prevent the spread of COVID-19, particularly if either party has not been fully vaccinated,” the agency stated.