Visits to nursing-home residents will be allowed soon

A nursing-home resident in Kirkland, Wash., who had tested positive for the coronavirus, blew a kiss to her son-in-law and daughter early in the pandemic. (Photo by Ted Warren, The Associated Press) 

By Melissa Patrick

Kentucky Health News

After nearly a year of keeping visitors out of long-term-care facilities, Kentucky allowed visitation at some, but has been waiting on federal guidance for nursing homes regulated by the federal Centers for Medicare and Medicaid Services. On Wednesday, that guidance finally dropped. 

CMS said it was relaxing its indoor visitation rules in response to "significant reductions" in infections and transmissions resulting from infection control practices and high vaccination rates in such facilities. 

Visits won't begin right away.

“We urge our residents, family members, and everyone involved to be patient as facilities review the guidance, develop policies, and operationalize the guidance to ensure that residents, family members, and staff are kept safe,” the Kentucky Association of Health Care Facilities said in a press release.

“2020 was a dark time for our most vulnerable population in isolation from their friends and daily activities and we are glad we are able to lift restrictions safely,” said Betsy Johnson, president of the group. 

State Cabinet for Health and Family Services Inspector General Adam Mather said March 1 that the federal program to vaccinate residents and staff was ending and the state would have a "maintenance" program to ensure new residents, new staff and reluctant residents and staff would be able to get a shot. 

As of Feb. 1, more than 70 % of nursing-home residents and 45% of employees had been vaccinated as part of the federal program, according to data from the state. The numbers did not reflect employees that may have been vaccinated elsewhere. 

Coronavirus cases in long-term care facilities hit their peak in mid-December, just as residents began getting the Covid-19 vaccine, with 4,133 cases on Dec. 11, according to an analysis by the Lexington Herald-Leader. Since, cases have plummeted, with only 264 active cases reported on Wednesday. 

Nursing home advocates have long been calling for nursing-home residents to have visitors, saying that the isolation they have experienced has been devastating. 

“At this point, residents are becoming more likely to die of isolation and neglect than covid,” Jocelyn Bogdan, program and policy specialist at the National Consumer Voice for Quality Long-Term Care, told Kaiser Health News for a March 4 article about the pleas of advocates for federal officials to open up visitation in these facilities. 

CMS continues to recommend social distancing and conducting visits outdoors, but has expanded its guidance to allow "responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor," and compassionate-care visits should be allowed at any time for any resident, vaccinated or unvaccinated, with no exceptions. 

For normal situations, there are exceptions, such as no visits for: unvaccinated residents if the county's positivity rate is greater than 10% and less than 70% of residents in the facility are fully vaccinated; residents with a confirmed case of the virus, whether vaccinated or unvaccinated until they are out of quarantine; or residents who are in quarantine, whether vaccinated or unvaccinated. 

The guidelines also address the continued need for testing and how to manage visitation if a new case of the coronavirus is identified.

Beshear has noted several times that his administration has been waiting on these guidelines in order to relax visitation in Medicare-certified nursing homes. 

In mid-February, the state relaxed some of the visitation restrictions at assisted-living homes, personal-care homes, intermediate-care facilities for individuals with intellectual disabilities, and independent-living facilities whose residents are fully vaccinated to allow "group activities, communal dining and visitation among vaccinated residents."