What Are the Rules for Nursing Home Visits? FAQ for Facilities

Nursing homes are responsible for the health and safety of their residents, but they also have a duty to facilitate interactions with outside visitors. These aren’t mutually exclusive, as socialization and visits with family members are crucial to residents’ wellbeing. So, what are the rules for nursing home visits, and how do these rules account for infection prevention and other health concerns?

The COVID-19 Public Health Emergency (PHE) tested many aspects of healthcare, resulting in the emergence of new infection prevention strategies that included visitor restrictions in nursing homes. While visitation guidelines have since stabilized, the need to balance visitation with health and safety concerns remains. We’ll go over the most frequently asked questions about CMS visitation policies so that you can understand how they may affect your facility.

Overview of Infection Prevention in Nursing Homes

So, what are the rules for nursing home visits? Before we answer that important question, let’s look at the other infection prevention regulations that are in place. CMS collaborates closely with the CDC to ensure the most current practice standards are available for Medicare and Medicaid facilities.

Primary prevention is crucial to preventing transmission of respiratory viruses in nursing homes. The CDC outlines all influenza vaccination laws that should be applied in healthcare settings. Facilities should also provide updated information and resources on the COVID-19 vaccine to both providers and staff. Vaccination requirements within nursing homes can vary by state, so facility administrators are expected to keep up with state regulations through their local health department.

Additionally, facilities must adhere to the CDC’s core principles of infection prevention, which include guidance covering topics like:

• Hand washing.
• Staff personal protective equipment (PPE) use.
• Cleaning and disinfecting, particularly surfaces that are used at a high-frequency.
• Displaying visitor education about infection control policies, such as mask use or hand hygiene, throughout the facility.

Overview of Quarantine Guidelines in Nursing Homes

The CDC and CMS support quarantining nursing home residents if they test positive for highly contagious viruses like COVID-19. Facilities may adjust their quarantine guidelines based on recommendations from their state or local health departments. Here are the CMS quarantine guidelines for nursing homes:

• If a nursing home resident contracts an infectious illness, they shouldn’t participate in communal activities. They may be placed on transmission-based precautions or quarantine.
• Residents testing positive for certain infections (such as COVID-19) should be placed in a single-person room when possible. If single-person rooms are limited, or if multiple residents are infected, residents should remain in their current locations.
• Residents are not required to quarantine after leaving the facility for less than 24 hours.
• If an outbreak occurs in a facility, residents in the affected area may be required to quarantine. The CDC recommends testing residents every 3-7 days until there are no new cases for two weeks.

What Are the Rules for Nursing Home Visits? FAQ

CMS visitation guidelines for nursing homes recognize the psychosocial impact of allowing visitors. Nursing home residents benefit from socialization — it improves mood, promotes activity, and supports healthier overall well-being. Visitation also promotes patient-and-family-centered care, which can improve patient satisfaction at your facility.

This consideration, while ensuring a sufficient number of nursing home residents are vaccinated against COVID-19 and other contagious pathogens, allows facilities to relax their visitation policies. Other considerations that may impact your facility include the following.

Can a nursing home deny visitors?

According to CMS, facilities may no longer restrict the number of visitors and the length or frequency of their stay. CMS says nursing home residents have the right to make choices about their life in the facility that are significant to them, such as seeing their loved ones. They may also make their own choice to deny visitors. Facilities that violate CMS regulations may be subject to citation.

Facilities may enforce visitor restrictions for high-risk residents (for example, someone who is severely immunocompromised). However, restrictions can be overridden for compassionate care visits, such as an impending death. In the event of an infectious disease outbreak, facilities may consult with their local health department for assistance with visitation guidelines.

Do visitors need to wear masks?

Mask mandates depend on community transmission rates of a given pathogen. If a community is experiencing high transmission rates (or if the facility has an outbreak), CMS recommends everyone in the facility wear masks. If community transmission is not high, it’s up to the facility to implement the appropriate infection prevention measures. Decisions can be informed by CDC recommendations or consultation with state or local health departments.

Can facilities restrict indoor visits?

CMS regulations allow visitors at all times, even during an infectious disease outbreak. Outdoor visitation is preferred during an infectious disease outbreak, but facilities may not restrict indoor visits. Facilities should follow these guidelines for indoor visitation:

• Visitors should keep to the resident’s room during a visit, and avoid going to other parts of the facility during an outbreak.
• Physical contact is allowed, but residents and visitors should be made aware of their risk during the visit.
• Visitors may choose to take off their masks in a resident’s room unless a roommate is present.

Can family members stay overnight in nursing home facilities?

Some facilities may have a suggested nursing home visiting hours policy, but CMS does not specify restrictions for families who wish to stay overnight. If visitors are staying overnight at your facility, it’s important to ensure that all other aspects of their stay adhere to visitation guidelines.

Can facilities restrict visits from service providers?

Traffic in a nursing home isn’t limited to healthcare staff and residents’ families. Facilities must allow entry to all visitors, such as vendors and service providers, to be compliant with CMS guidelines covering nursing home visitation policies.

Anyone with an active infection should avoid entering the facility. Visitors should take precautions when visiting a resident with an infection. CMS says nursing home residents have the right to meet with a healthcare ombudsman, regardless of infection status.

Healthcare surveyors, who suspended operations during the pandemic, should proceed as usual. They are expected to take proper precautions to conduct surveys. Facilities should not deny entry to surveyors based on their vaccination status.

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