After a grueling year of COVID-induced loss and loneliness in America's nursing homes, many residents finally are reuniting with their loved ones for hugs, hand-holding and indoor visits, thanks to recently revised nursing home guidelines from the federal government.
"It feels like a new day,” says Glen Lewis, executive director of the Edgewater senior living community in West Des Moines, Iowa. He opened his skilled nursing section to visitors March 11, the day after the Centers for Medicare & Medicaid Services (CMS) released the new guidance.
"It's definitely been a bright spot for our residents,” he says. “There's nothing like that sense of community and communication and companionship that comes from their own families.”
While the revisions represent the most dramatic steps toward reuniting residents with their family and friends since guests were first shut out of nursing homes in March 2020, many infection prevention protocols remain in place. Visitors must wear masks, the number of simultaneous visitors is capped, and the amount of time they can stay is limited.
Those restrictions continue to be challenging for some residents, says Maureen Cadwell, chief executive officer of Weston County Manor, a nursing home in Newcastle, Wyoming. Although the recent relaxations are “extremely welcome,” there are still struggles, she admits. “And they're wearing on everybody” — residents, staff and loved ones included.
Welcoming back families
"Facilities should allow indoor visitation at all times and for all residents [regardless of vaccination status],” the CMS guidelines say, citing widespread nursing home vaccinations and drops in COVID-19 infections among residents and staff.
Exceptions include residents in quarantine or with COVID-19. Also, residents who are not vaccinated and are living in a nursing home where fewer than 70 percent of residents are fully vaccinated, and whose county's rate of COVID-19 infections is greater than 10 percent, are advised against allowing visitors.
The agency also moved to permit “close contact,” which it had previously discouraged, if a resident is fully vaccinated and both the resident and visitor wear a “well-fitting face mask” and wash or sanitize their hands before and after the visit.
"We acknowledge the toll that separation and isolation has taken,” CMS officials said. “We also acknowledge that there is no substitute for physical contact, such as the warm embrace between a resident and their loved one."
America's 15,000-plus nursing homes, which are regulated by the CMS, can face penalties if they don't comply with certain requirements of the federal guidance, such as using face coverings or masks at all times during visits. Other sections of the guidance are less straightforward and may only be advisory, not required. For example, it says “facilities should consider scheduling visits for a specified length of time” to help ensure all residents are able to receive visitors. But no suggested time frame or penalty for not complying is mentioned.
Assisted living communities and other types of long-term care are not required to follow the CMS guidelines, as they are regulated by the state government rather than by the federal government. However, many states have reissued their long-term care guidance, closely following the recommendations put out by the CMS.
Birthday visit for 94-year-old husband
Thanks to the CMS’ changes, Sharon Peters-Bergen was able to visit her husband, Harold “Hal” Bergen, in person for his 94th birthday at the Selfhelp Home, a skilled nursing facility in Chicago. Last year she had to sing "Happy Birthday" to her husband through a window. This year she wasn't allowed to celebrate in the home's dining room with other residents — whom she brought birthday bagels and mini muffins for — but she still sees progress.