Visitation must be allowed ‘with very few occasional exceptions’
As the highly transmissible Omicron variant fuels the winter surge of COVID-19, the Centers for Medicare and Medicaid Services (CMS) has launched additional guidance about nursing home visitation during this climate.
“Recent CDC data has shown a spike in COVID 19 cases among nursing home staff members. CMS is concerned about this trend, and we expect staff to follow CDC and CMS guidance for preventing transmission,” said a CMS Spokesperson.
The CMS clearly states that visitation must be permitted at nursing home facilities with very few occasional exceptions. But in light of rapid rises in COVID-19 infections due to the Omicron mutation, the CMS released two new informational tools to help keep residents, visitors, and staff safe during visits at nursing homes.
Of course, the best tool to protect nursing home residents and prevent severe outcomes from COVID-19 is getting vaccinated and boosted against the virus, but regardless of one’s vaccination status, visits are allowed, states the CMS.
According to their new infographic tool, nursing homes should create dedicated outdoor and indoor visitation spaces to make visitations safer. In-room visits should also be allowed when the resident’s roommate is not present. If that’s not an option, visitation can occur as long there is adequate space for physical distancing, says the CMS.
Additionally, visitors should follow the same health guidelines to prevent the spread of COVID-19, including wearing a well-fitted mask at all times inside the nursing home and washing hands frequently with soap and water.
Further still, the CMS recommends that nursing home staff offer visitors surgical masks or KN95 masks, prohibit visitors from meeting in communal areas, sanitize the visitation area after each visit, and urge visitors to remain in the location of the visit.
In addition to the infographic, the CMS updated its Nursing Home Visitation Frequently Asked Questions memorandum. The resource addresses a dozen COVID-19 visitation questions, including whether visitors can share a meal with the resident and how nursing homes should handle a COVID outbreak.
With regard to sharing a meal or feeding the loved one they are visiting, the CMS said visitors are allowed to eat a meal with the resident so long as both parties are aware of the risks and follow the core mitigation strategies that help prevent infection.
“Eating in a separate area is preferred, however if that is not possible, then the meal could occur in a common area as long as the visitor, regardless of their vaccination status, is physically distanced from other residents and wears a mask, except while eating or drinking,” states the memorandum. “If the visitor is unable to physically distance from other residents, they should not share a meal with the resident in a common area.”
The CMS recognizes that even when COVID-19 cases are increasing, the resident still has the right to receive visitors. The only circumstance in which a resident would not be allowed to receive a visitor is if the visit increases the risk of spreading COVID-19 for other residents.
“Therefore, if the resident is aware of the risks of the visit, and the visit is conducted in a manner that doesn’t increase the risk of COVID-19 transmission for other residents, the visit must still be permitted in accordance with the requirements,” states the FAQs.
Here in Platte County, the positivity rate is at 31.8%. Platte County health officials said the latest seven-day average infection rate is 702.7 new cases per 100,000 residents. That’s a pandemic high for Platte County, local health officials said Wednesday.
While health officials continue to warn the public that the risk remains highest for the unvaccinated, current vaccination rates among health care personnel in a number of Platte County nursing homes is less than 75 percent.
At the Riverside Nursing and Rehabilitation Center, only 64.66 percent of health care personnel and 87.34 percent of residents have received a completed COVID-19 vaccination.
Similarly, at the Tiffany Springs Rehabilitation & Health Care Center merely 66.67 percent of health care workers and 83.17 percent of residents have received a completed COVID-19 vaccination.
This may come as a suprise to some as nursing homes have every opportunity to partner with retail pharmacies, like CVS or Walgreens, or coordinate with local health departments to arrange COVID-19 vaccination for residents and staff. Some people do not relish the thought of their loved one being exposed to COVID-19 by the health care workers who ought to be providing them assurance. Not surprisingly, there is a cause of concern that nurses and aides often spend more time with patients but have relatively lower rates of vaccination coverage.
In facilities that receive Medicare and Medicaid funding, this will no longer be the case.
On Thursday, the United States Supreme Court voted to uphold the CMS’ vaccine mandate on health care workers at Medicare and Medicaid-certified nursing homes, hospitals, and health care facilities, clamping down on the unvaccinated.
“The Centers for Medicare & Medicaid Services is extremely pleased the Supreme Court recognized CMS’ authority to set a consistent COVID-19 vaccination standard for workers in facilities that participate in Medicare and Medicaid,” said Chiquita Brook-LaSure, administrator of the CMS. “CMS’ vaccine rule will cover 10.4 million health care workers at 76,000 medical facilities. Giving patients assurance on the safety of their care is a critical responsibility of CMS and a key to combatting the pandemic.”
“Vaccines are proven to reduce the risk of severe disease. The prevalence of the virus and its ever-evolving variants in health care settings continues to increase the risk of staff contracting and transmitting COVID-19, putting their patients, families, and our broader communities at risk. And health care staff being unable to work because of illness or exposure to COVID-19 further strains the health care system and limits patient access to safe and essential care,” Brook-LaSure said Friday.
The decision puts an end to a block on the mandate in 24 states, including Missouri, by federal judges who issued a preliminary injunction temporarily halting the mandate until the higher court’s ruling. Generally, a preliminary injunction serves as a fast provisional remedy from the court to address the time lapses between filing a lawsuit and the trial.
“CMS is already implementing its health care worker vaccination rule in 25 states and territories that were not covered by preliminary injunctions,” added Brook-LaSure. The court’s 5-4 decision will allow the CMS to move forward with fully implementing the vaccine mandate. “We will continue our extensive outreach and assistance efforts encouraging individuals working in health care to get vaccinated,” said Brook-LaSure.
A spokesperson for the CMS added: “As a result of the January 13, 2022, Supreme Court decision, health care providers subject to the Omnibus COVID-19 Health Care Staff Vaccination rule in the 24 states (Alabama, Alaska, Arizona, Arkansas, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Mississippi, Missouri, Montana, Nebraska, New Hampshire, North Dakota, Ohio, Oklahoma, South Carolina, South Dakota, Utah, West Virginia, Wyoming) covered by this decision will now need to establish plans and procedures to ensure their staff are vaccinated in place within 30 days from the issuance of forthcoming guidance and to have their employees receive the shots needed for full vaccination by March 15, 2022.”
The Supreme Court blocked the mandate for businesses with 100 or more employees. The case argued the Occupational Safety and Health Administration (OSHA) had the authority to mandate the vaccine in the workplace.
“CMS is disappointed in the decision on the Occupational Safety and Health Administration (OSHA) Emergency Temporary Standard, and agrees with President Biden and Secretary Walsh: This is a major setback for the health and safety of workers across the country,” said Brook-LaSure.
The CMS emphasized that vaccines reduce hospitalizations and deaths from the infection.
“The bottom line is that vaccine requirements work and are an important tool to protect patients – and also to keep our health care workers healthy. We’ve already seen many health care providers successfully implement requirements for their staff. We look forward to working with health care providers to get their workers vaccinated. Protecting vulnerable patients across the country from the devastating effects of COVID-19 remains a top priority for the Biden-Harris Administration and CMS,” said Brook-LaSure.
