February 24, 2021, Washington, DC—Following is a statement by Katie Smith Sloan, president and CEO of LeadingAge, the association of nonprofit providers of aging services, including nursing homes, on recommendations sent today to federal policymakers urging that they ease restrictions on nursing home visitation:

“COVID-19 vaccines are the most significant development of the pandemic and real progress has been made in vaccinating nursing home residents. It is time for nursing home visitation policies to catch up. As cases have declined, the balance between caution and isolation has tipped. We urge the federal government to revise guidance and reconnect nursing home residents with their loved ones.

While nursing homes have gone to extraordinary lengths to support residents and find creative ways to keep them connected with loved ones, there is no substitute for an in-person visit. With the right visitation policies, we can safely reduce isolation—and the physical, cognitive and emotional effects that accompany it—while continuing to fight this virus.

New visitation policies must include parameters—such as designated visitation spaces, controlled length of visit, and limits to the number of visitors—that ensure safety, since the coronavirus threat remains. We are not calling for a full return to pre-pandemic visitation. We expect that nursing homes would continue to screen all visitors for signs and symptoms of COVID-19 infection and that all visitors continue to practice core infection control principles including universal masking, hand hygiene, and social distancing. Nursing homes would also need to establish detailed visitation plans, educate residents and visitors on risks and benefits of visits, and work to increase staff vaccination rates.

The letter I sent today to the White House Domestic Policy Council, the Centers for Medicare and Medicaid Services, and the Centers for Disease Control and Prevention requests a series of policy changes designed to lower barriers to visitation and reduce the isolation that residents have dealt with for more than a year, including the preconditions and additional support needed to to proceed in a safe, smart fashion.

Even in an improving landscape, nursing homes will need federal leadership and support to safely adjust visitation policies. Providers need continued access to vaccines for new residents and staff, as well as ongoing support for testing, PPE supplies and financial support to make visitation safe—so that nursing home visitation does not become an unfunded mandate.”

Responsibilities for the Government & Nursing Homes in Easing Visitation Safely

To make indoor, in-person visits a reality, nursing homes, policymakers, residents and staff all have work to do. Specifically, the letter encourages nursing homes to do the following:

1. Establish a visitation plan. The plan should include core principles for COVID-19 infection prevention as outlined by CMS, as well as processes for disinfection of spaces, limiting visitor movement within the nursing home, visitor education on infection prevention practices and expectations, and how these processes will be staffed.
2. Encourage informed consent. Residents and families should understand and acknowledge the risks of expanded visitation and factors that may increase risk.
3. Increase rates of staff vaccination. Nursing homes should work aggressively to address issues of vaccine hesitancy through education and supportive policies such as paid time off for vaccination and recovery.

In turn, we ask federal leaders to do the following:

1. Ensure continued prioritization of nursing homes so they have access to vaccination through the Retail Pharmacy Program. New residents and staff should have easy access to vaccines, as should staff who declined vaccines during the initial Long-term Care Pharmacy Partnership.
2. Remove community prevalence-based restrictions to visitation. Allow indoor nursing home visitation regardless of county positivity rates.
3. Expand visitation in outbreak situations. Consider options such as allowing visitors to enter during an outbreak with full PPE or allowing visitors during outbreak who can provide proof that they are fully vaccinated against COVID-19.
4. Use all available resources to support expanded visitation. Continue to supply and increase allocations of point-of-care tests for nursing homes so they can test visitors. Eliminate the recommendations to only use point-of-care tests for symptomatic individuals and the requirement that a provider must have a physician serving as laboratory medical director in order to perform POC tests. Ease the reporting burdens of COVID testing. Permit the use of Provider Relief Funding to purchase additional stores of PPE and other protective supplies that reduce visitor to resident transmission.

We represent more than 5,000 aging-focused organizations that touch millions of lives every day. Alongside our members and 38 state partners, we address critical issues by blending applied research, advocacy, education, and community-building. We bring together the most inventive minds in our field to support older adults as they age wherever they call home. We make America a better place to grow old. For more information: www.leadingage.org