Last updated on June 15th, 2023
In March 2021, the Centers for Medicare & Medicaid Services (CMS) worked with the Centers for Disease Control and Prevention (CDC) to update nursing home visitation guidelines during the COVID-19 pandemic.
The guidelines changed after AARP and other organizations pleaded to CMS to open up visitor access in light of more and more vaccines being distributed across the country. The new guidelines allow for indoor visitation in most circumstances. The previous guidelines allowed for indoor visitation if a community was COVID-free for 14 days and was in a county with a positivity rate of 10% or less.
The new guidelines state that:
- Facilities should allow responsible indoor visitation at all times and for all residents, regardless of the resident or visitor’s vaccination status, unless certain scenarios arise that would limit visitation. See those certain scenarios here.
- Outbreaks increase the risk of COVID-19 transmission. However, facilities shouldn’t restrict visitation for all residents as long as there’s evidence that COVID-19 transmission is contained to a single area. Continue to adhere to CMS regulations and guidance for COVID-19 testing.
- When a new case of COVID-19 among residents or staff is identified, a community should immediately begin outbreak testing and suspend all visitation until at least one round of facility-wide testing is completed. Visitation can resume:
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- If the first round of outbreak testing reveals no additional COVID-19 cases in other areas of the community, then visitation can resume for residents in areas with no COVID-19 cases. But, visitation should be suspended in the affected unit until the community meets the criteria to discontinue outbreak testing.
- If the first round of outbreak testing reveals one or more additional COVID-19 cases in other areas of the community, then visitation should be suspended for all residents until the community meets the criteria to discontinue outbreak testing.
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- Visits for compassionate care should be allowed at all times for any resident regardless of the above scenarios.
- Federal regulations require that a Medicare and Medicaid certified nursing home provide representatives of the State Long-Term Care Ombudsman’s Office with immediate access to any resident.
What The New Guidelines Mean for Senior Living Communities
These new changes will affect how you continue to reopen your community and reinstate programs, like your dining program.
When it comes to screening visitors, those processes should remain unchanged. CMS still recommends that communities check visitor temperatures, ask about symptoms/exposure to COVID-19, and observe visitors for symptoms or signs of infection. Face coverings and physical distancing is also still recommended.
While CMS recommends that visits are conducted outdoors when possible, they now say that visitation can be conducted based on your community’s structure and residents’ needs. This means they can happen in resident rooms, visitation spaces, and outdoors.
What The New Guidelines Mean for Your Dining Program
At the beginning of the COVID-19 pandemic in spring 2020, the original CMS guidelines stated that communities should “cancel communal dining and all group activities, such as internal and external group activities.”
The new guidelines have updated dining rules. Dining and communal activities can occur again. The updated guidelines state that:
- Residents may eat in the same room with social distancing.
- Facilities should consider additional limitations based on the status of COVID-19 infections in the community.
- Group activities may be facilitated (for residents who have fully recovered from COVID-19 and those not in isolation for observation or with suspected or confirmed COVID-19 status) with social distancing among residents, appropriate hand hygiene, and use of a face covering (except while eating).
- Facilities may be able to offer a variety of activities while also taking necessary precautions. Book clubs, crafts, movies, exercise, and bingo are all activities that can be facilitated with alterations to adhere to the guidelines for preventing transmission.
To accommodate these guidelines and allow dining to feel “normal” again, one of the first things we recommend implementing is multiple dining areas. Previously you may have had one dining room for residents to gather in, but with social distancing rules, you probably can’t fit all of your residents in the same space at the same time. So get creative and turn other areas of your community into makeshift dining rooms for the time being, like the library, lobby, or even the garden. You can also stagger dining times to reduce the number of residents eating at once while still allowing for socialization.
We also recommend expanding your in-room dining options and schedule. Some residents may still be hesitant to enter the public spaces even if they are vaccinated. Allowing them to eat meals in their rooms with another resident or with loved ones and providing 24/7 dining options can keep them safe while allowing visitation and companionship.
With dining slowly getting back to “normal,” this also means that your team should be prepared for the return of state inspections. To ensure that your kitchen is ready to get a passing grade, check out our recent blog series about food safety and preparing your dining program for inspections.
What’s in Store for the Rest of 2021?
As more people get vaccinated and the world slowly moves back to its pre-COVID state, your dining team will likely have a lot to deal with during this transition. Throughout the pandemic, our team at Culinary Services Group helped communities across the country adjust their dining service plans in accordance with CMS, CDC, state, and local guidelines. We will continue to help senior living communities as guidelines loosen and life moves toward a new normal.
If you would like to learn how we can help your community transition to meet the new CMS guidelines, please contact us here.
