We have had some family members disagree with our visitation policy. The tension has worsened due to the pandemic, and state and local authorities clamping down to protect long-term care residents. How stringent can we be about visitation times and what can we do to or about violators? 

On Sept. 17, the Centers for Medicare & Medicaid Services advised state survey agency directors of new regulations on visitation in nursing homes. (See QSO 20-39N: https://www.cms.gov/files/document/qso-20-39-nh.pdf). CMS acknowledged that the policy of separation of family from residents led to “increased risk for depression, anxiety, and other expressions of distress.” 

In response, CMS  issued new guidance, which would allow increased family visitation. Outdoor visitation is preferred, weather permitting. Indoor visitation is allowed if there is not a new onset of COVID -19 cases and the county positivity rate is below 10%.  

With respect to your visitation policy, if you have not revised it in light of the pandemic, it may not be enforceable. New state policies or edicts are intended to protect residents or staff from spreading the COVID-19 virus. If your visitation policy complies with state regulations and edicts, you can enforce the policy and punish those who violate the policy. 

If you have not updated your visitation policy, then you should have it reviewed by legal counsel who has knowledge of all state and local requirements. These requirements are based upon a declared public health emergency and they are intended to prevent the spread of COVID-19 to seniors and staff serving seniors. To reduce liability, now is the time to update your policy.

Your new policy should follow state laws if they are more restrictive than the new CMS guidance.