{"id":"FED-156","kind":"order","level":"federal","jurisdiction":"United States (Medicare and Medicaid nursing homes)","state":"","metro":"","industry":"","agency":"","eco":"","issuer":"CMS, Quality, Safety \u0026 Oversight Group","authority":"42 C.F.R. § 483.10(f)(4) (resident right to visitors), § 483.80 (infection control), § 483.80(h) (testing); F-tags F563, F880, F886","instrument":"QSO-20-39-NH REVISED Apr. 27, 2021, Nursing Home Visitation - COVID-19 (the text in force throughout 2021Q3)","title":"QSO-20-39-NH, Nursing Home Visitation - COVID-19 (REVISED 04/27/2021)","dateIssued":"2021-04-27","effective":"2021-04-27","end":"revised Nov. 12, 2021 (date verified_secondary; not saved), Sept. 23, 2022 and May 8, 2023 (FED-167)","startDate":"2021-04-27","endDate":"2021-11-12","quarters":["2021Q2","2021Q3"],"types":["HC","GATH","MASK","QUAR","EMP"],"addressees":["all Medicare/Medicaid certified nursing homes","every visitor, vendor, contractor and non-essential worker entering a nursing home"],"clause":"Core Principles of COVID-19 Infection Prevention: Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions about and observations of signs or symptoms), and denial of entry of those with signs or symptoms or those who have had close contact with someone with COVID-19 infection in the prior 14 days (regardless of the visitor\u0027s vaccination status)... Face covering or mask (covering mouth and nose) and social distancing at least six feet between persons, in accordance with CDC guidance... Resident and staff testing conducted as required at 42 CFR § 483.80(h) (see QSO-20-38-NH Revised). These core principles are consistent with the Centers for Disease Control and Prevention (CDC) guidance for nursing homes, and should be adhered to at all times.... Facilities should allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission... These scenarios include limiting indoor visitation for: Unvaccinated residents, if the nursing home\u0027s COVID-19 county positivity rate is \u003e10% and \u003c70% of residents in the facility are fully vaccinated; Residents with confirmed COVID-19 infection...; or Residents in quarantine... Visitors who are unable to adhere to the core principles of COVID-19 infection prevention should not be permitted to visit or should be asked to leave.... During indoor visitation, facilities should limit visitor movement in the facility.","enforcement":"Survey enforcement under F563 (visitation) and F880 (infection control); civil money penalties","functions":["VS visitation and access (home-care-senior-living; hospice; clergy CR; families)","IC screening and masking of every entrant regardless of vaccination","DN communal dining and activities (conducted under the core principles)","HR/WF and vendor access (staffing PL; personal services SL in-facility salons; physician CL on-site visits)","RS cohorting and quarantine"],"notes":"It compelled screening, denial of entry, masking and six-foot distancing for every person entering every certified nursing home in the country on every day of the quarter, and limited indoor visits where county positivity exceeded 10 percent (which, during the Delta wave of August-September 2021, was most counties).","sourceUrl":"https://web.archive.org/web/20210801id_/https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf","snapshot":"https://web.archive.org/web/20210801id_/https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf","fileExists":true,"fileBytes":346996,"grade":"primary","character":"","description":"","collection":"FED-A","url":"/library/FED-156","exhibitUrl":"/exhibit/FED-156","citation":"CMS, Quality, Safety \u0026 Oversight Group, QSO-20-39-NH REVISED Apr. 27, 2021, Nursing Home Visitation - COVID-19 (the text in force throughout 2021Q3) (Ex. FED-156)","stateName":"","related":["FED-167","FED-154","FED-155","FED-163"]}