2020 changed the way family celebrated the holidays. This was especially true for families with loved ones in skilled nursing facilities (SNFs). However, the 2021 holidays look like they will be brighter and visiting loved ones in SNFs will be easier thanks to new federal and state guidance.
On November 12, 2021, the Centers for Medicaid & Medicare Services (CMS) issued revised visitation guidelines for SNFs. The New York State Department of Health (DOH) released revised visitation guidelines for SNFs on November 16, 2021.
Under the revised guidelines SNF residents can now attend family gatherings outside of the facility.
SNFs must now allow indoor visitations for all residents, without limiting the number of visitors per resident, at any given time, and without requiring proof of vaccination or a negative COVID-19 test. SNFs must continue to maximize social distancing, and masks should be worn during visitations in communities with high COVID-19 infection rates. As an additional safety measure, in-room visitation is not recommended for unvaccinated or immunocompromised residents.
Compassionate care visits are now allowed even when circumstances cause a facility to restrict other visitation types.
SNFs in communities with high COVID-19 infection rates are encouraged to offer or recommend COVID-19 testing for visitors. SNF staff may ask visitors if they are vaccinated, but visitors are not required to be vaccinated or tested. Masks are recommended for visitors who do not disclose vaccination status.
Routine testing of unvaccinated SNF staff remains part of the CMS guidance. Additionally, SNFs must continue to follow CMS guidance for testing individuals who have symptoms and must continue outbreak testing.
Visitors are allowed during an outbreak investigation, but they should be informed of the risk of visiting, and they should use PPE during visitation regardless of their vaccination status.
SNFs must allow residents to leave the facility. SNF staff are advised to remind the person accompanying the resident to follow all recommended infection prevention practices including face coverings/masks, physical distancing, and hand hygiene. Residents who leave an SNF for 24 hours or more are to be treated as a new admission/readmission following the CDC’s interim infection recommendations. An SNF retains the right to test residents returning from an outing who 1) exhibit symptoms, (2) had close contact with an infected individual, or (3) exhibit ambiguity about their adherence to safety measures.
While it is tempting to have a big, old-fashioned celebration this year, COVID-19 has not been eradicated. Large gatherings may increase the risk of exposure for vulnerable guests. Guests who are SNF residents may have underlying health concerns that put them at a higher risk for serious illness. Exposure to an infected guest may also impact their return to their SNF.
Some families have added new precautions to their celebrations:
- Limiting the number of guests
- Letting guests know that a vulnerable guest will be attending
- Increasing ventilation
- Encouraging social distancing
- Asking about possible COVID-19 exposures
- Verifying vaccination
- Requiring negative test results
This year we are all grateful for the opportunity to return to a glimmer of normality even with the additional precautions needed to provide peace of mind, and the chance to enjoy the holidays together