Steps are being taken to allow visitors again at nursing homes across the country. The Centers for Medicare and Medicaid Services has issued new guidance for visitation.

Outdoor visits are encouraged. Indoor visitation is allowed if there are no new cases in the previous two weeks and if certain core principals — like screening, resident and staff testing, hygiene, social distancing, and cleansing — are put into effect.

A memo sent out to state survey directors makes clear that visitations can be made for more than pure end-of-life reasons, and can even include physical touching in some instances. Communal dining and activities may take place as long as six-foot distancing and other precautions are observed.

According to the memo, examples of other types of compassionate care situations include, but are not limited to:

• A resident, who was living with their family before recently being admitted to a nursing home, is struggling with the change in environment and lack of physical family support.

• A resident who is grieving after a friend or family member recently passed away.

• A resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), is experiencing weight loss or dehydration.

• A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).

Home facilities will continue to use that COVID-19 county positivity rate to determine the degree to which indoor visitation can take place.

Virtually in every nursing home in America, there is a Point of Care test.  Point-of-care testing allows physicians and medical staff to accurately achieve real-time, lab-quality diagnostic results within minutes rather than hours. Medical experts say this type of testing enables staff to make timely and important treatment decisions when diagnosing a patient’s condition.

The memo says some of the “Core Principles of COVID-19 Infection Prevention” are:

-Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions or observations about signs or symptoms), and denial of entry of those with signs or symptoms

-Hand hygiene (use of alcohol-based hand rub is preferred)

-Face covering or mask (covering mouth and nose)

-Social distancing at least six feet between persons

Facilities that have not had any positive COVID-19 cases in the last 14 days and are in a county with a low or medium positivity rate may not restrict visitations “without a reasonable clinical or safety cause” consistent with regulations, CMS noted. Doing so could subject a provider to the threat of citation and penalties.