CMS Issues Revised COVID-19 Guidance To Nursing Facilities

Effective March 13, 2020, the Centers for Medicare and Medicaid Services (CMS) revised its Guidance for Infection Control and Prevention of Coronavirus Disease 2019 (COVID-19) in Nursing Homes (Revised Guidance). The Revised Guidance states facilities “should restrict visitation of all visitors and non-essential health care personnel, except for certain compassionate care situations, such as an end-of-life situation.” Decisions regarding visitation in such situations should be made on a case-by-case basis. These visitors should be carefully screened for fever or respiratory symptoms; they must be asked to observe certain precautions (such as wearing a facemask); and they should be restricted to designated areas in the facility. Those with symptoms of a respiratory infection, however, should not be permitted to enter the facility at any time, even in an end-of-life situation.

There are exceptions for health care workers and for CMS and state agency surveyors. Facilities should follow CDC guidelines for restricting access to health care workers, and health care workers should be permitted in the facility so long as they meet the CDC guidelines. This also applies to outside health care workers that provide care to residents (e.g., hospice workers, EMS personnel, and dialysis technicians).  

In addition, facilities have been asked to:

• Identify staff who work at multiple facilities. Such individuals should be actively screened, and appropriate restrictions should be implemented to ensure they do not place facility residents at risk for COVID-19. This includes agency staff, as well as regional or corporate staff, among others.  
• Cancel communal dining and group activities. 
• Implement active screening of residents and staff for fever and respiratory symptoms, and screen all staff members at the beginning of their shifts for fever and respiratory symptoms.