With most nursing home residents nationwide having received their COVID-19 vaccinations and recent data showing a dramatic decline in COVID-19 cases and deaths since winter, the federal Centers for Medicare & Medicaid Services (CMS) is urging states to ease restrictions on in-person visits at long-term care facilities.
Where visits have resumed, they remain different from those before the pandemic, which has taken the lives of more than 183,000 long-term care residents and staff. Nursing homes have had to take many steps to minimize the chance of further transmission, and some of those policies are likely to remain in place, even with residents having largely received their shots.
Though the vaccines “should considerably lessen risk” in long-term care facilities, “this does not mean that it is not important to practice diligence,” says Jennifer Schrack, an associate professor at the Johns Hopkins Bloomberg School of Public Health who specializes in the epidemiology of aging. “Precautions are still important. No visit is without risk."
Here is key information about the next steps toward reuniting with loved ones in long-term care.
Can I resume visiting my loved one?
State officials have generally followed CMS guidelines in restricting or opening up visitor access to nursing homes. If that pattern holds for the latest federal recommendations, you should be able to resume visits.
The updated federal guidance — which came after AARP and other advocates for older Americans called on the CMS to open up visitor access — urges nursing homes to allow indoor visitation in most circumstances, even if the facility or its community is considered to be in outbreak status for COVID-19. There would be a few exceptions — for example, if the resident you wish to see is infected, or if that person has not been vaccinated and community coronavirus spread in the surrounding area remains high.
For states that have adapted the guidelines, visitation continues to depend largely on whether there are active COVID-19 cases in your loved one's facility and, possibly, on case numbers in the surrounding community. The previous CMS guidelines, issued in September 2020 and largely adopted by the states, recommended allowing indoor visits if a facility has been case-free for 14 days and is located in a county with a positivity rate on coronavirus tests of less than 10 percent.
Check where your state stands on nursing home and long-term care visitors. But you should also ask your loved one's facility about its own regulations before you show up.
What about “compassionate care” visits? Can I see my loved one that way?
The CMS is calling on states to allow indoor “compassionate care” visits in all circumstances. Early in the pandemic, this was widely interpreted as meaning when a nursing home resident is near the end of life. But in its September guidance, the CMS spelled out other situations “consistent with the intent of compassionate care,” such as:
- A newly admitted resident is struggling with the change in environment and lack of physical family support.
- A resident is grieving for a recently deceased friend or family member.
- A resident needs prompting or encouragement to eat or drink, help previously provided by a loved one or other caregiver, and is experiencing weight loss or dehydration.
- A resident is showing signs of emotional distress from isolation; for example, speaking seldom or crying frequently.
The CMS says that the list of scenarios is not meant to be exhaustive and that compassionate care visits should not be limited to family members but “can be conducted by any individual that can meet the resident's needs, such as clergy or laypersons offering religious and spiritual support."