November 18, 2020

CMS issues formal alert on how nursing homes should manage Thanksgiving visits

McKnight’s LTC News – Danielle Brown – November 18, 2020

The federal government is recommending that nursing home residents do not leave their facilities during the ongoing public health emergency as the Thanksgiving holiday approaches. 

The Centers for Medicare & Medicaid Services late Wednesday issued an alert to providers, residents and their family members or representatives on how they should manage residents and workers who may want to visit loved ones during the Thanksgiving holiday. 

CMS pointed to its COVID-19 visitation guidance for nursing homes that was issued in September. The agency said that providers should follow the guidelines for visitation and adhere to core principles of infection prevention this holiday season. 

“[Nursing home residents] have already endured loss and loneliness to a degree that would have been unthinkable before this year began, but they and their families — along with facilities themselves — must not let their guard down over the holiday season, especially with a safe and effective vaccine so close to reality,” CMS Administrator Seema Verma said in a prepared statement. 

The agency noted that although it knows residents may want to leave the nursing home temporarily to visit family and friends for the holidays or other outings, it’s imperative that all parties “work together to take extra precautions to help reduce the spread of COVID-19, which can pose an elevated danger to the health of nursing home residents.” It called on facilities to find innovative ways of to celebrate the holidays without having parties or gatherings that could increase the risk of COVID-19 transmission. 

Specifically, the alert calls on providers to supply  information to residents and their families about the risks they face if they do leave the facility during the public health crisis. If a resident does decide to leave in spite of the risks, the alert suggests that providers give them educational materials on how they and their families can mitigate and reduce the risk of COVID transmission. 

Upon a resident’s return, CMS suggested providers screen and monitor them for signs and symptoms of the disease and consider placing them on transmission-based precautions if they do show signs of COVID-19.

The alert also calls for nursing home staff members to use extra caution, especially during the holidays. 

“Staff should follow the same recommendations for residents and families regarding gathering with their families and friends outside of work to protect the vulnerable residents they care for,” Verma wrote in the document.  

Evan Shulman, director of CMS’ Division of Nursing Homes, announced the alert ahead of its release earlier Wednesday in a call with providers. 

“We think our visitation guidance is sound and allows for the appropriate way to conduct visitation when there are or aren’t cases, but [during] the holidays, as you all know, the virus does not take off for the holidays. We need to be just as vigilant,” Shulman said during the call. 

“This year’s going to be different around holidays, unfortunately, but it needs to be different because of the position we’re in. That said, with the vaccine on the horizon, there’s a light at the end of the tunnel. Hopefully in a few months, even shorter perhaps, we’ll all be celebrating all of the holidays together,” he later concluded.  

Earlier this month, Shulman hinted that the agency was considering providing additional guidance to providers regarding the holidays.

Katie Smith Sloan, the president and CEO of LeadingAge, an association comprising nonprofit providers, said each “provider, resident and family” should inform their approaches to holiday visits in the weeks and months ahead based on COVID-positivity rates in the surrounding county. Research has shown that community COVID-19 infection rates directly impact rates within nursing homes, she explained.

“The sad truth is that surges of COVID around the country mean that many nursing homes will have to curb or restrict family visits and in-house meals and celebrations,” she said. “This Thanksgiving could have been different. If community spread had been contained, older adults and the people who care for them wouldn’t be far from the people they love this holiday. 

“The sadness and pain of so many families this Thanksgiving should be a call to action,” she added. “We need national leadership on masks, closures of public places, and other protections against spreading COVID infections.”

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