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Nursing Home Visitation

22 February 2021

The below text is taken from the Centers for Disease Control and Prevention (CDC) pertaining to nursing home visitation.  Where indoor visitation is allowed, visits must be scheduled in advance.  We cannot accommodate unscheduled visits.  Where visitation is not permitted, we can offer window visits or FaceTime/Skype and virtual visits.  

Guidance

Visitation can be conducted through different means based on a facility’s structure and residents’ needs, such as in resident rooms, dedicated visitation spaces, outdoors, and for circumstances beyond compassionate care situations. Regardless of how visits are conducted, there are certain core principles and best practices that reduce the risk of COVID-19 transmission:

 Core Principles of COVID-19 Infection Prevention

  • Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions or observations about signs or symptoms), and denial of entry of those with signs or symptoms
  • Hand hygiene (use of alcohol-based hand rub is preferred)
  • Face covering or mask (covering mouth and nose)
  • Social distancing at least six feet between persons
  • Cleaning and disinfecting high frequency touched surfaces in the facility often, and designated visitation areas after each visit
  • Appropriate staff use of Personal Protective Equipment (PPE)
  • Resident and staff testing conducted as required.

These core principles are consistent with the Centers for Disease Control and Prevention (CDC) for nursing homes, and should be adhered to at all times. The risk of transmission can be further reduced through the use of physical barriers (e.g., clear Plexiglas dividers, curtains). Visitors who are unable to adhere to the core principles of COVID-19 infection prevention should not be permitted to visit or should be asked to leave. By following a person-centered approach and adhering to these core principles, visitation can occur safely based on the below guidance.

 Indoor Visitation

Whether a facility can allow indoor visitation is based on 2 key measures.  1.  No new onset of COVID-19 cases in the past 14 days and 2.  County positivity rates, set by CMS, in green/yellow. 

Facilities should accommodate and support indoor visitation based on the following guidelines:

  1. There has been no newonsetof COVID-19 cases in the last 14 days and the facility is not currently conducting outbreak testing;
  2. Visitors should be able to adhere to the core principles and staff should provide monitoring for those who may have difficulty adhering to core principles, such as children;
  3. Facilities should limit the number of visitors per resident at one time and limit the total number of visitors in the facility at one time (based on the size of the building and physical space). Facilities should consider scheduling visits for a specified length of time to help ensure all residents are able to receive visitors; and
  4. Facilities should limit movement in the facility. For example, visitors should not walk around different halls of the facility. Rather, they should go directly to the resident’s designated visitation area.

 Facilities should use the COVID-19 county positivity rate, found on the COVID-19 Nursing Home Data site, as additional information to determine how to facilitate indoor visitation.  

  • Counties with test percent positivity <5.0% or with <20 tests in past 14 days: Green.
  • Counties with test percent positivity ≥5.0% to ≤10.0% or with <500 tests and <2000 tests/100k and >10% positivity over 14 days: Yellow.
  • Counties with test percent positivity >10.0% and not meeting the criteria for “Green” or “Yellow”: Red

 Facilities may also monitor other factors to understand the level of COVID-19 risk, such as rates of COVID-19-Like Illness, visits to the emergency department or the positivity rate of a county adjacent to the county where the nursing home is located.

 We believe the guidance above represents reasonable ways a nursing home can facilitate in person visitation. Except for on-going use of virtual visits, facilities may still restrict visitation due to the COVID-19 county positivity rate the facility’s COVID-19 status, a resident’s COVID-19 status, visitor symptoms, lack of adherence to proper infection control practices, or other relevant factor related to the COVID-19 PHE.