New CMS Guidance Will Help Residents Stay Connected

March 22, 2021
Louise Ryan, Regional Administrator for Region X and National Ombudsman Program Coordinator

Since March 2020, Long-Term Care Ombudsman programs have heard the voices of residents and their loved ones: 

“I thought that you had forgotten about me!”

“I think about dying.”

“I look through the window at my husband and can see that he has lost weight; I’m not sure if he recognizes me.”

The goal of keeping residents safe from COVID-19 created problems that deeply affected residents – the physical separation from family, loved ones and neighbors and the loss of shared meals and activities created risk for anxiety, depression and feelings of isolation. Ombudsmen have listened to their heartbreak and worked to find solutions and foster connections to ease the worry and pain of isolation.

Ombudsmen also have provided ACL the front-line information we need to advocate for older adults and people with disabilities. With real-time awareness of the most pressing needs and concerns, ACL is better able to work with partners like the Centers for Medicare & Medicaid Services (CMS) to find solutions and protect the rights of the people we serve.

Recently, CMS issued updated guidance on visitation in America’s nursing homes that will make it easier for residents to connect to their loved ones. The new guidance also will make it easier for Ombudsmen, protection and advocacy (P&A) systems and others working to support the rights of people with disabilities and older adults to perform their critical roles.  

Over the course of the public health emergency, CMS issued several updates to visitation within nursing homes based on science and evidence.  Millions of COVID-19 vaccinations have been administered to nursing home residents and staff, and these vaccines have been shown to help prevent symptomatic COVID-19. CMS, in conjunction with the Centers for Disease Control and Prevention, has updated its visitation guidance accordingly, while still emphasizing the importance of maintaining infection prevention practices, given the continued risk of COVID-19 transmission.

The recent update guidance encourages nursing homes to allow indoor visitation at all times and for all residents, and only limit visitation in certain scenarios. The guidance:

  • Recommends continuation of outdoor visits when possible.
  • Recommends that facilities allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission.
  • Emphasizes that compassionate care visits (which are not limited to end-of-life situations) and visits required under federal disability rights law – such as when in-person assistance is necessary to ensure effective communication – should be allowed at all times, for any resident.
  • Provides specific guidance to allow for indoor visitation during an outbreak.
  • Clarifies that visitors should not be required to be tested or vaccinated (or show proof of such) as a condition of visitation. This clarification also applies to representatives of the Office of the State Long-Term Care Ombudsman and protection and advocacy systems.
  • Emphasizes that State Long-Term Care Ombudsman and P&As have legal rights to access facilities and meet with residents. 
  • Includes recommendations to encourage social distancing, but to allow fully vaccinated residents to choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after.

The Long-Term Care Ombudsman program and other ACL programs such as the Protection and Advocacy systems will continue to advocate for the needs of people with disabilities and older adults.  ACL will continue to share information from federal partners and our grantees, as well as resources we think may be useful to the aging and disability networks, and the people we all serve. Watch ACL.gov/COVID-19 for the latest information and be sure to sign up for ACL Updates.


Last modified on 03/22/2021


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