CMS issues new guidance for nursing home visits

Isolation kills signs
Posted at 11:16 PM, Mar 11, 2021
and last updated 2021-03-11 23:43:16-05

TAMPA, Fl.-- — The signs are hard to miss.

There are 300 of them. They’re bright yellow. And written on them in bold is the statement “Isolation kills, too.” Some include the names of long term care residents and those who have passed away in a facility.

“We’ve lost a lot of people due to the isolation, or the true diagnosis of failure to thrive and we need to learn form that lesson,” said Mary Daniel, the founder of the group Caregivers for Compromise.

The past week and a half, they’ve moved the signs across the state to bring attention to the battle long term care residents have faced during the pandemic.

“We need to let people back in the way they’ve always been let in especially those that are vaccinated,” Daniel said.

During the tail end of the tour, though, the Centers for Medicare and Medicaid Services, in collaboration with the CDC, issued updated guidance for nursing home visitation.

The guidelines still recommend physical distancing and outdoor visits when possible. However, it expands indoor visitation. In the event of a new COVID-19 case, it recommends allowing visits to resume as long as facility wide testing is complete and transmission is contained to a single area. If a resident is fully vaccinated, it says they can choose to have close contact with their visitor while wearing a mask.

It’s exciting news for Daniel, though she would still like to see guidance from the state.

“I believe that that would be helpful because it will give a clear foundation for us as caregivers to educate our facilities on what the rules really mean for all of us so that there’s no confusion,” she said.

The Agency for Health Care Administration in Florida is reviewing the guidelines.

“We’ve had visitation for a long time. We want them to do whatever’s best for their residents. So if there’s anything they need us to do we’re happy to do it,” said Governor Ron Desantis during a news conference Thursday.

Under the state’smost recent order, outdoor visitation is allowed even if the facility has had recent cases. General visitation is allowed with distancing so long as there is no new onset of resident COVID-19 cases in the previous two weeks. Only compassionate caregivers may have physical contact.

The Florida Health Care Association, an industry group representing skilled nursing facilities, is in communication with the state. It states:

“We all agree that the health and wellbeing of our residents has always been our priority. Our dedicated staff members have done a tremendous job adapting visitations during this difficult time, but nothing can replace face-to-face visits with loved ones. We’re in communications with the Agency for Health Care Administration to review the details of the guidance and how it compares to what’s currently required under Florida’s Emergency Order. In the meantime, we know that vaccinations are having a positive impact in our care centers. We remain committed to educating staff, residents and family members, and the general public, about the importance of the vaccine so they have the facts to make informed decisions about getting the shot so we can remain on track to getting our care centers back to normal.”

AHCA reports all of Florida’s licensed nursing homes and assisted living facilities have been offered the opportunity to have residents and staff vaccinated on site.
The agency reports 85 percent of residents and 37 percent of staff in assisted living facilities, 69 percent of residents and 34 percent of staff in nursing homes opted to receive the vaccine at the completion of its offering to long term care facilities for the first time.

“Now that you have the vaccines they need to live life. I mean let them make these decisions. And so we have no restrictions on that we want them to be able to do it,” said Governor Desantis.

Meanwhile, assisted living facilities are also waiting to see state guidance, since they do not fall under CMS regulation.

“Hugs have been here since September, hugs are here to stay. But there are some limitations on visitation we haven’t been able to throw the doors open completely but we’re making a lot of really good progress,” said Sandi Poreda.

She’s the spokesperson for the Florida Senior Living Association, which represents hundreds of owners and operators of assisted living facilities, memory and independent living communities. She said they’ve reached out to AHCA.

“We know that they’re working on it. They’ve told us that they are taking it very seriously, they’re working as quickly as they can,” said Poreda.

In the meantime, Daniel is hoping the signs don’t have to be used again.

“We’re going to move forward as a group to talk about the lessons learned here to be sure that we don’t make those same mistakes again. We need to review what’s happened and we need to look at what the isolation has done,” she said.