Except in certain compassionate care situations, the Centers for Medicare & Medicaid Services (CMS) has called for extremely strict limitations on visitation at nursing homes to stem the spread of the Coronavirus pandemic.

The March 13 guidance from CMS, Transmittal QSO20-14, specifically states:

RESTRICT VISITATION

Nursing Homes should restrict visitation of ALL visitors and non-essential health care personnel, except for certain compassionate care/end-of-life situations.

Potential visitors should be notified that they should defer visitation until further notice. Forms of communications can include signage, calls, letters, posts on websites, posts on other social media sites.

For individuals who want to enter pursuant to compassionate exception:

• Decisions to permit visitation should be made on a case by case basis
• Nursing Homes should actively screen visitors and individuals with signs or symptoms of a respiratory infection, such as fever, cough, shortness of breath, or sore throat should not be permitted even in end-of-life situations
• hand hygiene and use of Personal Protective Equipment (PPE) is required
• visitors should be advised to refrain from physical contact with residents and others
• create dedicated visiting areas that can be easily sanitized for visitation
• document with whom visitor comes into contact

14-DAY MONITORING

Visitors and staff should be advised to monitor for signs or symptoms of respiratory infection for at least 14 days after exiting the nursing home. If symptoms occur they should self-isolate, call health care provider and immediately inform the nursing home.

NURSING HOME OPERATIONS

The guidance also advises nursing homes to:

• cancel communal dining and all group activities, internal and external
• remind residents to practice social distancing and perform frequent hand hygiene
• actively screen residents and staff for fever and respiratory symptoms, documenting screening process and outcome
• immediately screen individuals who have had contact with visitor with reported respiratory symptoms

[View source.]