Pennsylvania Department of Health
Facility Message Board Details
Date Posted:  3/12/2021 Subject: CMS QSO-20-39-NH revised 3/10/21


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Attached is the CMS QSO-20-39-NH revised 3/10/21.  The memo outlines revised guidance to nursing home related to visitation.  Nursing homes are required to follow the guidance as outlined in this memo from CMS. 
Key changes/notes:

  • CMS, in conjunction with the Centers for Disease Control and Prevention (CDC), is updating its visitation guidance accordingly, but emphasizing the importance of maintaining infection prevention practices, given the continued risk of COVID-19 transmission.
  • Facilities should allow responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor, unless certain scenarios arise that would limit visitation for:  
·       Unvaccinated residents, if the COVID-19 county positivity rate is greater than 10 percent and less than 70 percent of residents in the facility are fully vaccinated; 
·       Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated, until they have met the criteria to discontinue transmission-based precautions; or  
·       Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.  
Note – Page 3 under Indoor Visitation, provides a paragraph that contains information related to consideration of how the number of visitors per resident at one time and the total number of visitors in the facility at one time may affect the ability to maintain the core principles of infection prevention.  The paragraph further explains consideration of scheduling visits.

  • If/When a new case of COVID-19 among residents or staff is identified, a facility should immediately begin outbreak testing and suspend all visitation (except that required under federal disability rights law), until at least one round of facility-wide testing is completed. Visitation can resume based on the criteria outlined in the memo.
  • Although outbreaks increase the rise of COVID-19 transmission, as long as there is evidence that the outbreak is contained to a single unit or separate area of the facility, visitation can still occur.
  • Compassionate care visits should be allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak.  Compassionate care visits include visits for a resident whose health has sharply declined or is experiencing significant change in circumstances.
  • Visitor testing and vaccination can help prevent the spread of COVID-19, visitors should not be required to be tested or vaccinated (or show proof of such) as a condition of visitation. This also applies to representatives of the Office of the State Long-Term Care Ombudsman and protection and advocacy systems.
  • Federal and state surveyors are not required to be vaccinated and must be permitted entry into facilities unless they exhibit signs or symptoms of COVID-19. Surveyors should also adhere to the core principles of COVID-19 infection prevention, and adhere to any COVID-19 infection prevention requirements set by state law.
  • CMS and CDC continue to recommend facilities, residents and families adhere to the core principles of COVID-19 infection, including physical distancing.  This continues to be the safest way to prevent the spread of COVID-19.  If a residents is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after.  Visitors should physically distance from other residents and staff in the facility.
  • This guidance provides information on how visitation can occur but does not change any expectations for testing and adherence to infection prevention and control practices.

Questions can be directed to your local field office or
Attachments: QSO-20-39 updated 31021 (002).pdf 
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