CMS, CDC Update Nursing Home Visit Guidelines for Hospices, Other Visitors

The U.S. Centers for Medicare & Medicaid Services (CMS) and the U.S. Centers for Disease Control and Prevention (CDC), have revised their previous guidance for visitors accessing nursing homes, including service providers such as hospices. The availability of vaccines was a key factor in the update. 

The agencies now indicate that facilities can 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.

“CMS recognizes the psychological, emotional and physical toll that prolonged isolation and separation from family have taken on nursing home residents, and their families,” said CMS Chief Medical Officer Lee Fleisher, M.D., “That is why, now that millions of vaccines have been administered to nursing home residents and staff, and the number of COVID cases in nursing homes has dropped significantly, CMS is updating its visitation guidance to bring more families together safely.”


Scenarios that could limit visitation include the following according to CMS:

  • Unvaccinated residents, if the COVID-19 county positivity rate is greater than 10% and less than 70% 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
  • Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine

The new guidance specifically indicates that facilities should permit “compassionate care” visits at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak. The agency defines compassionate care to include visits for a resident whose health has sharply declined or is experiencing a significant change in circumstances.

The agencies continue to recommend adherence to COVID-19 infection prevention protocols such as social distancing and conducting visits outdoors whenever possible.


“There is no substitute for an in-person visit, even in nursing homes that have gone to extraordinary lengths to support residents and find creative ways to keep them connected with loved ones throughout the pandemic,” said  Katie Smith Sloan, president and CEO of LeadingAge. “COVID-19 vaccines are the most significant development of the pandemic. With today’s announcement, federal policy now reflects the real progress that has been made in vaccinating nursing home residents and staff.”

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