CMS announced new guidance for state and local officials to ensure the safe reopening of nursing homes across the country.
Because COVID-19 poses an elevated threat to vulnerable elderly nursing home residents, CMS recommends additional criteria for nursing homes advancing through phases of reopening, to complement the Trump Administration’s broader Opening Up America Again framework. CMS is recommending that nursing homes do not advance through any phases of reopening or relax any restrictions until all residents and staff have received results from a baseline test. In addition, CMS recommends that state survey agencies inspect nursing homes that experienced a significant COVID-19 outbreak prior to reopening. Finally, CMS recommends that nursing homes remain in the current state of highest restriction even when a community begins to relax restrictions for other businesses, and should be among the last to reopen within the community, to ensure safety of the residents. Nursing homes may receive visitors during phase three, which is when there has been a sustained decrease in COVID-19 cases. A variety of factors must go into making this decision, including states not only relying on case count, but assessing the individual nursing home and other local factors. Visitors must be screened and wear a cloth face covering at all times.
The guidance encourages state leaders to collaborate with the state survey agency and local health departments to decide how these criteria should be implemented. Given the critical importance in limiting COVID-19 exposure in nursing homes, CMS recommends that decisions on relaxing restrictions be made with careful review of the following facility-level, community, and state factors:
- Status of COVID-19 cases in the local community
- Status of COVID-19 cases in nursing homes
- Adequate staffing
- Baseline test of all residents, weekly testing of all staff, practicing social distancing, and universal source control for residents and visitors (e.g., face coverings)
- Access to adequate personal protective equipment (PPE)
- Local hospital capacity