2020 changed the way the family celebrated the holidays. This was especially true for families with relatives in skilled nursing facilities (SNF). However, the 2021 holidays appear to be brighter and visiting loved ones in SNFs will be easier thanks to new federal and state guidelines.

On November 12, 2021, the Centers for Medicaid & Medicare Services (CMS) released revised visiting guidelines for SNFs. The New York State Department of Health (DOH) released revised visitation guidelines for NFCs on November 16, 2021.

Under the revised guidelines, SNF residents can now attend family gatherings outside the facility.

SNF visit

SNFs must now authorize interior visits for all residents, without limit the number of visitors per inhabitant, at any time, and without requiring proof of vaccination or a negative COVID-19 test. SNFs should continue to maximize social distancing and masks should be worn when visiting communities with high COVID-19 infection rates. For added security, room visits are not recommended for unvaccinated or immunocompromised residents.

Compassionate visits are now permitted even when circumstances require an institution to restrict other types of visits.

Health precautions

SNFs in communities with high COVID-19 infection rates are encouraged to offer or recommend COVID-19 testing for visitors. SNF staff can ask visitors if they are vaccinated, but visitors are not required to be vaccinated or tested. Masks are recommended for visitors who do not disclose their immunization status.

Routine testing of unvaccinated SNF personnel is still part of CMS guidelines. Additionally, SNFs should continue to follow CMS guidelines for testing people with symptoms and should continue epidemic testing.

Visitors are allowed during an outbreak investigation, but they should be made aware of the risk of the visit and they should use PPE when visiting, regardless of their immunization status.

Off-site visits

SNFs must allow residents to leave the establishment. SNF staff are advised to remind the person accompanying the resident to follow all recommended infection prevention practices, including face covers / masks, physical distancing, and hand hygiene. Residents who leave an SNF for 24 hours or more should be treated as a new admission / readmission according to CDC interim recommendations on infections. An SNF reserves the right to test residents returning from an outing who 1) have symptoms, (2) have had close contact with an infected person, or (3) are ambiguous about their adherence to safety measures.

2021 celebrations

While it’s tempting to have a big, old-fashioned party this year, COVID-19 has not been eradicated. Large gatherings can increase the risk of exposure of vulnerable guests. Guests who are residents of SNF may have underlying health conditions that put them at a higher risk for serious illness. Exposure to an infected guest can also impact their return to their SNF.

Some families have added new precautions to their celebrations:

• Limit the number of guests
• Notify guests that a vulnerable guest will be present
• Increase ventilation
• Encourage social distancing
• Ask about possible exposures to COVID-19
• Vaccination verification
• Require negative test results

This year, we are all grateful for the opportunity to return to a glimmer of normalcy even with the extra precautions necessary to ensure peace of mind and the chance to enjoy the vacation together.