On April 27, 2021, the CDC provided updated Healthcare Infection Prevention & Control Recommendations in Response to COVID-10 Vaccination and CMS updated guidance related to COVID-19 testing and visitation.
Revisions to QSO-20-38-NH related to facility testing requirements include:
- Definitions to clarify “fully vaccinated” versus “unvaccinated” status
- Clarification that symptomatic staff and residents should be tested for COVID-19 regardless of vaccination status and outbreak testing should continue for all staff and residents, regardless of vaccination status.
- Fully vaccinated staff do not have to be routinely tested according to county positivity rates, but previous guidance related to routine testing still applies for unvaccinated staff.
- CMS updated the Infection Prevention, Control & Immunization Pathway (CMS-20054) to reflect the updated testing requirements. . The current Survey/Infection Prevention, Control & Immunization Pathway (CMS-20054) can be found in the LTC Survey Pathways zipfile located at https://www.cms.gov/Medicare/Provider-Enrollment-andCertification/GuidanceforLawsAndRegulations/Downloads/LTC-Survey-Pathways.zip.
Revisions to QSO-20-39-NH related to Nursing Home Visitation include:
- Clarified that face covering or mask and social distancing should occur in accordance with CDC guidance
- References to see the current CDC guidance Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination for information on indoor visitation and fully vaccinated resident close contact with visitors
- Notes that the CDC has provided additional guidance on activities and dining based on resident vaccination status. For example, residents who are fully vaccinated may dine and participate in activities without face coverings or social distancing if all participating residents are fully vaccinated; if unvaccinated residents are present during communal dining or activities, then all residents should use face coverings when not eating and unvaccinated residents should physically distance from others. See the CDC guidance Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination for information on communal dining and activities.
Revisions to CDC Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination, that applies to all staff while at work and residents, include:
- In general, healthcare facilities should continue to follow the infection prevention and control recommendations for unvaccinated individuals (e.g., quarantine, testing) when caring for fully vaccinated individuals with an immunocompromising condition.
- Updated SARS-CoV-2 testing recommendations (see CMS guidance noted above)
- Updated visitation guidance to include recommendations to describe circumstances when source control and physical distancing are not required during visitation
- Permits visitations and close contact among residents and visitors who are fully vaccinated without masks and without social distancing as long as they are both fully vaccinated and they are alone in their room or in a visitation area without unvaccinated individuals
- Visitors should wear source control and physically distance from other healthcare personnel and other patients/residents/visitors that are not part of their group at all other times while in the facility.
- Added guidance for communal activities and dining in healthcare settings
- Allows fully vaccinated residents to resume dining activities and group activities without masking or social distancing restrictions (If unvaccinated resident is participating, social distancing and mask wearing is still required)
- Eased guidance for fully vaccinated staff, allowing for fully vaccinated staff to dine and socialize together in break rooms and conduct in-person meetings without source control or physical distancing, as long as unvaccinated individuals are not present.
- Quarantining is no longer recommended for new residents if they are fully vaccinated and have not had prolonged close contact with someone with COVID infection in past 14 days
Blog by Shelly Maffia, MSN, MBA, RN, LNHA, QCP, CHC, CLNC, Proactive Medical Review
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