The COVID Project
The record
- Jurisdiction
- United States (Medicare and Medicaid nursing homes)
- Level
- Federal
- 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
- Issued
- 2021-04-27 Apr. 27, 2021
- Effective
- 2021-04-27
- End
- revised Nov. 12, 2021 (date verified_secondary; not saved), Sept. 23, 2022 and May 8, 2023 (FED-167) (read as 2021-11-12)
- In force
- Apr. 27, 2021 to Nov. 12, 2021
- Quarters
- 2021 Q22021 Q3
2020 Q22020 Q32020 Q42021 Q12021 Q22021 Q3
- Limitation types
- Gathering capFace-covering requirementHealth care ordersWorkplace rulesQuarantine and isolation
- Addressees
- all Medicare/Medicaid certified nursing homes
- every visitor, vendor, contractor and non-essential worker entering a nursing home
- Functions reached
- 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
- Collection
- Federal health, safety and transport layer FED-A
Operative words
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's 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's COVID-19 county positivity rate is >10% and <70% 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
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).
Retrieval noteRetrieved from the Wayback Machine's raw capture nearest Aug. 1, 2021 of cms.gov/files/document/qso-20-39-nh-revised.pdf; header reads 'DATE: September 17, 2020... REVISED 04/27/2021'.