Feds Say Nursing Homes Should Ease Restrictions on Indoor Visits

Residents should also be able to hug and hold hands with visitors, officials say

womin medical mask is visited by another woman

Inside Creative House/Getty Images

Andrew Soergel

En español

Published March 11, 2021

Federal officials on Wednesday issued new recommendations to nursing homes that are aimed at making it easier for residents to visit, hug and hold hands with their loved ones after almost a year of isolation.

Citing widespread nursing home vaccinations and plummeting infection and death rates among residents and staff, the Centers for Medicare & Medicaid Services (CMS) said facilities should allow indoor visits “regardless of vaccination status of the resident or the visitor.”

There are some exceptions, including for residents who are quarantined, who have a confirmed COVID-19 infection or who are unvaccinated and living in a county with a high rate of COVID-19 transmission. But the guidance represents the most dramatic step toward indoor visits since long-term care facilities were first shuttered to guests in March 2020.

The new guidance also recommends that facilities move away from completely shutting down indoor visits if new infections crop up. If a facility finds that an outbreak is limited to a certain ward or unit, indoor visits should be allowed for other residents, the new guidelines say.

They also open the door to hugging, hand-holding and “close contact” if a resident consents, is fully vaccinated, is wearing a face mask and washes or sanitizes his or her hands before and after the visit. Such interactions had previously been discouraged. CMS officials said they “acknowledge that there is no substitute for physical contact."

"With today's announcement, federal policy now reflects the real progress that has been made in vaccinating nursing home residents and staff. This is the right thing to do,” Katie Smith Sloan, president and CEO of LeadingAge, an association of nonprofit aging services and nursing home organizations, said in a statement on Wednesday.

COVID-19 infections in nursing homes have fallen dramatically in recent months as federal officials partnered with CVS, Walgreens and other pharmacies to vaccinate residents and staff of nursing homes, as facilities battered by COVID-19 achieved some herd immunity and as many facilities and local and state governments imposed restrictions to curb the virus's spread.

Almost all nursing homes, which were given first priority in the national vaccine rollout, have completed their vaccination clinics. Most assisted living and other long-term care facilities are conducting their final clinics.

AARP had been calling for federal officials to update the long-term care visitation guidance that was last issued in September. “As we enter a new phase of this pandemic with the ongoing rollout of vaccines and growing knowledge about public health needs — including the safety, mental health and social well-being of nursing home residents — it is vital that these vulnerable seniors are able to safely visit with their loved ones,” Nancy LeaMond, AARP executive vice president and chief advocacy and engagement officer, said in a statement on Thursday.

An AARP analysis of federal data found that new COVID-19 cases and deaths in nursing homes have plummeted from their winter peaks, but the numbers are still higher than during last summer’s surge. One in 100 nursing home residents died from COVID-19 between mid-January and mid-February, the analysis found, roughly half the rate that was recorded over the prior four weeks.

Residents and staff in long-term care have accounted for nearly 175,000 deaths over the course of the pandemic, according to the COVID-19 Tracking Project, that's nearly 35 percent of all COVID-19 related deaths recorded in the U.S.

The new recommendations come two days after the CDC said people who have been fully vaccinated for COVID-19 can safely visit indoors with other fully vaccinated people without wearing masks or social distancing.

Still, CMS officials repeatedly noted that the threat of COVID-19 infection hasn't evaporated. They encourage facilities, residents and loved ones to conduct visits outside when possible and to keep family members and their guests distanced from other residents and staff members.

"This continues to be the safest way to prevent the spread of COVID-19,” according to CMS guidance.

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