The surreal nature of 2020 may be no better illustrated than by a recent two-day funnel cloud of activity churned by the Centers for Medicare & Medicaid Services that put nursing homes on a pedestal. You know what they say about targets posted on high perches.

First came the release of the Coronavirus Nursing Home Quality and Safety Commission report. With 25 commissioners from virtually every point on the long-term care compass, you knew from the start this was going to be an unwieldy polyglot of ideas and conclusions. 

Some would say the 27 recommendations is a healthy number. Others might say it amounts to 27 cooks in the broth.

The report appeared to hold its sponsor’s feet intriguingly close to the “get your act together” fire. Interestingly, that sponsor, CMS, didn’t see it that way. After two weeks of meditating on the independent commission’s findings, CMS leaders declared the report vindication for many initiatives they had already undertaken. This was news to at least a handful of the commissioners. 

Many agreed to call the report a “good start.” To what end, nobody’s sure yet. But the high-minded ideas within are certainly fodder for any special interest group to adopt their own. Declare victories or losses accordingly, based on where you sit.

Quickly thereafter came new federal guidance on the opening up of nursing home visitation policies. If there’s anything that’s been universal throughout the pandemic, it’s that the isolation of senior care residents has been devastating. Which is more important to save: The body or the soul? As if the two aren’t interconnected. 

The CMS guidance focused squarely on the psychosocial risks of strict visitation restrictions.

The feds have pledged ideas, edicts and even some cash for materials to help facilitate better visiting experiences. But like any overseer — be it corporate exec, Army general or federal regulatory body — CMS is leaving much of the execution up to the front-liners.

But out of its 3,132 words, only one was both underlined and bolded for emphasis in the guidance. Just one. 

The word? Must. As in “a nursing home must facilitate in-person visitation consistent with the regulations.” If you don’t, dear cautious operator, you’re risking citations and further punishment. 

So there you have it, providers. The stage has been set, and you’re on it. It’s time to deliver. Or else.