WASHINGTON – The Biden administration published revised guidelines on Wednesday for visits to nursing homes during the coronavirus pandemic, allowing guests to come in to see residents, regardless of whether they or the residents have been vaccinated.
The recommendations, released by the Centers for Medicare and Medicaid Services with comments from the Centers for Disease Control and Prevention, are the first revision of the federal government’s guidelines for nursing homes since September. And they arrived when more than three million doses of vaccine were administered in nursing homes, the agency said.
Federal officials said in the new guideline that outdoor visits are still preferable because of the lower risk of transmission, even when residents and visitors have been fully vaccinated.
The guidance was also the latest indication that the pandemic in the United States was decreasing, with coronavirus cases continuing to decline across the country, although the seven-day average remains at more than 58,000. The CDC on Monday released the long-awaited guidance for Americans who have been fully vaccinated, telling them that it is safe to meet in small groups at home, without masks or social detachment.
About 62.5 million people received at least one dose of the Covid-19 vaccine, including about 32.9 million people who were fully vaccinated by the Johnson & Johnson single dose vaccine or the two-dose series made by Pfizer -BioNTech and Moderna.
In a statement setting out the reasons for updating the recommendations, Dr. Lee A. Fleisher, medical director of the Centers for Medicare and Medicaid Services, cited the millions of vaccines administered to residents and asylum workers and a decline in coronavirus cases in homes of elderly people.
“The CMS recognizes the psychological, emotional and physical price that prolonged isolation and separation from the family has affected nursing home residents and their families,” he said.
At the start of the pandemic, the coronavirus ran through tens of thousands of long-term care facilities in the United States, killing more than 150,000 residents and employees and accounting for more than a third of all virus deaths since the end of spring. But since vaccines arrived, new cases and deaths in nursing homes have dropped dramatically, overtaking national declines, according to an analysis of federal data from the New York Times.
The eight pages of recommendations, which are not legally binding, came with suggested limits, saying that “responsible internal visitation” should be allowed at all times, unless a guest is visiting an unvaccinated resident in a county where the rate of Covid-19 positivity is more than 10 percent and less than 70 percent of nursing home residents have been fully vaccinated. The guidance also says to limit visits if residents are Covid-19 or quarantined.
So-called compassionate care visits – when a resident’s health has seriously deteriorated – should be allowed regardless of the county’s vaccination status or positivity rate, the guideline said.
When a positive case is identified in a nursing home, visits should be stopped and residents and staff tested, the guidance said. Visits can be resumed in other parts of the facility if there are no positive tests there, but if cases are found in other areas, nursing homes must suspend all visits.