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.
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.