COVID-19 Nursing Home Visitation Restrictions – Revised QSO Memo

In accordance with the end of the COVID-19 Public Health Emergency (PHE), the Centers for Medicare & Medicaid Services (CMS) revised QSO-20-39-NH, “Nursing Home Visitation – COVID-19.” The QSO Memo, initially published on September 17, 2020, provided guidance on visitation guidelines for nursing homes. Here’s what to know about the revisions.

  • Two bullet points were added to the Memo to reflect the end of the PHE. The first is that visitation is allowed for all residents at all times. The second notes that the guidance has been updated to reflect the end of the PHE.
  •  In the body of the Memo, CMS states that even though the PHE is ending, the Agency still expects facilities to adhere to infection prevention and control recommendations (via the CDC and other agencies).
  • The Core Principles of COVID-19 Infection Prevention and Control now includes posting visual alerts at the facility entrance and other strategic locations that include current IPC recommendations and instructions. Staff and resident testing remain as a core practice, but now states that testing should be conducted per accepted national standards, such as the CDC. The CDC updated its recommendation on May 8, and CMS guidance now aligns with those changes – we’ll cover those in another CMSCG Blog post.

Indoor Visitation during an Outbreak Investigation

  • During an outbreak investigation, if in-person, indoor visitation is preferred by the resident/ representative, then this should “ideally” take place in the resident’s room.
  • The resident (if tolerated)/ representative should wear well-fitting source control during the visit.
  • If possible, the resident and visitor should be physically distanced.

Nursing Home Visitation FAQs

The Frequently Asked Questions associated with this QSO Memo were also updated. Updates include:

  • Clarification that visitors may share a meal with, or feed, a resident while they are visiting
  • Recommendations for conducting visits to reduce the risk of COVID-19 transmission have been updated to include offering visitors face coverings or masks and posting visual alerts that include instructions about current infection prevention and control recommendations.

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