Answers On Nursing Home Visitation

A few of the frequently asked questions we have received in the past 24 hours answered below. Please remember Texas HHSC emergency rules on expanded visitation must continue to be followed.

• How do I know my resident vaccination rate? Recall that in the updated guidance released yesterday, CMS stated that indoor visitation was restricted for unvaccinated residents if the county positivity rate was greater than 10% and the total resident vaccination rate at the nursing home was less than 70%. At this time, CMS has left this up to the discretion of the nursing home how this will be tracked. One suggested way to do this is by reporting aggregate vaccination rates through NHSN. This reporting tool is optional and is different from the reporting that the pharmacy does when they administer the vaccine. Using this reporting tool does not require SAMS Level 3 access because you are reporting aggregate data, not patient-level data. Learn more here. An added bonus of reporting through this module is that it will help CDC better track vaccination rates, which could translate into more freedoms sooner.

• Visitation is restricted for an outbreak, but what if the index case is a staff member and the initial round of outbreak testing reveals that no residents test positive? Good question. We’re following up with CMS on this one.

• Where does this leave us with activities and communal dining? CMS has not relaxed requirements here yet. Residents must continue to wear masks and social distance in activities and must be social distanced for dining regardless of vaccination status. We have shared this question with CMS and will follow up on our call next week.

• If everyone is now permitted visits, do I still need to supervise or enforce any limitations? CMS has not required supervision of visits. CMS does still recommend setting limits around visitation, such as limiting the number of visitors per resident or the total number of visitors in the building at once in order to ensure a safe environment and visitation experience. Visitors must also continue to adhere to core infection control principles such as masking, hand hygiene, and social distancing (though recall that fully vaccinated residents may now choose to engage in physical touch during a visit provided they remain masked and practice hand hygiene before and after contact).