Update: CMS has released new guidance as of November 12, 2021. Read about it in our new blog post.

Over the past year, people in long-term care have been more affected by COVID-19 than almost anyone else. From staff to residents to families, we have seen people pivot and completely change how they work, live, and communicate. Over the past few months, we have seen vaccines get distributed, and the Center for Disease Control (CDC) update its recommendations, but we have had to wait for guidance specific to long-term care. VOYCE provides updates below on visitation guidance and recommendations.

On March 16, we shared some new guidance from the Centers for Medicare and Medicaid (CMS). While this new guidance made some important changes to visitation in long-term care, it didn’t apply to all levels of care. This meant that Assisted Living Facilities (ALFs) and Residential Care Facilities (RCFs) could choose not to follow CMS. They could still deny visitors.

As of March 24th, the Department of Health and Senior Services (DHSS) has released long-awaited updates to visitation guidance. This new guidance is almost the same as the CMS guidance, but all levels of care must follow this guidance.

What Does This Mean for Families?

The most significant change with this DHSS update is that, unlike before, this new guidance states that any long-term care community eligible for visits must allow visits. Before this update, ALFs and RCFs could choose to allow visits, but it was at their discretion.

Other important things to note:

  • Fully vaccinated residents can choose to be within 6 feet of their visitors and even choose to touch them.
  • Visits do need to be suspended if a new case of COVID-19 originates in the LTC community. They then need to begin outbreak testing.
  • After one round of outbreak testing, it is possible that visits could resume in the rest of the facility if there are no additional cases of COVID-19 in these other areas of the facility.
  • Even during outbreak testing, compassionate care visits should continue.
  • The definition of compassionate care visits has expanded beyond end-of-life situations. They include residents who have recently lost a friend or family member, residents who need assistance with eating or drinking and are experiencing weight-loss, residents with emotional distress, and residents living with family before being recently admitted into long-term care.
  • The DHSS guidance states that in-person visitation should be conducted based on CMS regulations, which means that they should be following the guidelines that we wrote about in our New CMS Visitation Guidance blog post. Read that blog post for even more information about this guidance, and read the guidance below:

What to Expect

This guidance is new, especially for ALFs and RCFs. Some LTC communities might not have policies in place that reflect this updated guidance. You should reach out to your loved one’s home to see what their updated visitation policy is. If they state that they are not allowing visits, ask them why they aren’t allowing them. Unless they are conducting outbreak testing, they should not be restricting visits. Try educating them about the new guidance. If you are still receiving pushback, contact your ombudsman.

How Visits Might Look

When you’re doing visits, they won’t be the same as before. LTC communities are still encouraged to limit the total number of visitors in the facility. As such, you can expect that you will need to call ahead to schedule your visit. However, you shouldn’t be told that they can only accommodate you once a week. As long as they meet the criteria to allow visits and as long as they are not at capacity, they need to allow you to visit any time.

You won’t be able to walk around the building with the same freedoms you had pre-COVID. You also won’t be able to visit your loved one’s room if they have a roommate. Instead, expect to go straight to wherever the visit is taking place, either their room if they live alone or a designated visitation area.

Most importantly, the limitations of social distancing that have been placed on residents for the last 12 months have been lifted. As long as a resident is fully vaccinated, that resident can choose to get within 6 feet of their loved one and even touch them.

Things have changed this past year. Visits look different than they used to. You might be required to wear a mask, practice proper handwashing, and be asked to schedule your visits, but for the first time in a year, you can sit next to your loved one, hold their hand, and hug them.

If you have more questions about these guidelines, reach out to your ombudsman or contact the state ombudsman office at 1-800-309-3282.

Comments

  1. 1

    […] UPDATE: DHSS has released new guidance. Read more about it in our newest blog post. […]

  2. 2
    C. Darris on April 7, 2021

    ST. Sophia health & rehabilitation center is NOT allowing resident who are fully vaccinated to be within 6 feet of loved ones and strictly no touching. Regardless if resident is vaccinated or not. My loved one is vaccinated as I am to yet we still have to visit behind a huge piece of plexiglass outside for max of 45minutes. To my knowledge no visitor is not allowed inside facility. I have copy of St. Sophia visiting rules Mon – Sun 10am – 7pm ( though this is not on the written statement informed today no visits between 3pm -5pm visits resume at 6pm) I am also fully vaccinated but aware not a requirement to visit. Resident has the decision who they can visit with, touch regardless if visitor is fully vaccinated or not is at choice of the resident that is fully vaccinated. This is not currently being allowed. Then Written instructions do not mention six feet guidelines or strictly no touching though it is repeatedly reinforced when you arrive to visit your loved one. We have to visit behind very tall plexiglass. Did ditto hear loved one when another family is visiting on front of entrance. My initial visit this barrier was not in place the resident was positioned by staff six feet away from me. We both wear mask, hand hygiene and no touching . The letter the facility mailed out with the new outdoor visitation guidelines went into effect March 15. Since resume visits have had total two covid cases informed first was an employee approx 2-3wks ago. The most recent was announced via robo call April 5th approx 5pm one new covid case. Visitations have not been restricted but again since they have resumed visits this facility’s is NOT allowing residents to sit next to loved ones. Repeatedly tells you NOT to be near resident or attempt to touch them only staff can bring resident outside in wheelchair. If we are allowed to hold hands & hug our loved ones the facility should allow / follow guidelines placed. Have had two separate covid positive cases in last 3 wks last being announced April 6 one case. Visits are not restricted just we never been allowed to give our loved ones a long overdue hug. Have suffered enough w the isolation, loneliness and depression. Now finally be able resume visits without looking through an old window screen just to still be alienated from giving our loved ones a warm hug and hold hands. Feels like what I imagine visiting someone in prison through plexiglass . Residents still endure cold, detached visits from loved ones due to this barrier & facility not allowing physical contact still leaves our loved ones feeling isolated & lonely and depressed mood.

    1. 3
      lsykes on April 7, 2021

      Thank you for reaching out. The Regional Ombudsman Coordinator for St. Sophia Health and Rehabilitation Center is Katie Morrison. You can reach her by calling 314-919-2409 or emailing kmorrison@voycestl.org. She will be able to help you with this concern.

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