Healthcare facilities in Virginia can expand visitation practices for residents and their families, the Virginia Department of Health (VDH) announced March 10, after the Centers for Disease Control and Prevention (CDC) released Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination for all healthcare settings, including but not limited to nursing homes and assisted living facilities.
At the same time, the Centers for Medicaid and Medicare (CMS) released updated COVID-19 Guidelines and Revised Visitation Recommendations for certified nursing homes in response to significant reductions in COVID-19 infections and transmission resulting from ongoing infection control practices and high vaccination rates in the nursing home population.
The number of new cases of COVID-19 reported in Virginia nursing home residents has been consistently decreasing since mid-January. The VDH is currently observing the lowest weekly case counts and has been since early summer 2020.
As of March 11, 279,969 vaccine doses have been administered to residents and staff in Virginia long-term care facilities. Relaxing current restrictions on indoor visitation might increase the risk for transmission of SARS-CoV-2 in post-acute care facilities. However, Virginia’s progress in the vaccination of residents and healthcare personnel can mitigate some of these risks, and public health officials understand that expanding visitation has substantial benefits to residents.
The health department recommends that per CDC’s updated guidance, indoor visitation could be permitted for all residents, except as noted below:
Indoor visitation for unvaccinated residents should be limited solely to compassionate care situations if the COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated.
Indoor visitation should be limited solely to compassionate care situations, for:
Vaccinated and unvaccinated residents with SARS-CoV-2 infection until they have met criteria to discontinue Transmission-Based Precautions.
Vaccinated and unvaccinated residents in quarantine until they have met criteria for release from quarantine.
Facilities experiencing outbreaks should continue to follow guidance from their local health department. Nursing homes should also follow guidance from CMS on when visitation should be paused.
Visitors should be counseled about their potential to be exposed to SARS-CoV-2 in the facility if they are permitted to visit.
Additional recommendations are outlined by CDC and CMS.
It is recommended that all long-term care facilities, including nursing homes, assisted living facilities, group homes, and other congregate healthcare settings adhere to these guidelines. Facilities should continue to regularly vaccinate new admissions and staff, and should adhere to CMS regulations and guidance for COVID-19 testing, including routine staff testing, testing of individuals with symptoms, and outbreak testing.
Since its inception in April 2020, the Virginia COVID-19 Long-Term Care Task Force has convened as least biweekly to ensure long-term care facilities have the resources they need to combat the virus; strengthen staffing, testing and infection control measures at long-term care facilities; and keep stakeholders informed about the impact of COVID-19 on long-term care facilities. The Task Force, led by VDH and composed of leadership from Virginia state agencies, Virginia’s long-term care and hospital associations, long-term care providers, and long-term care resident advocates, has been critical to the Commonwealth’s efforts to combat COVID-19 in long-term care facilities.
While VDH and the Task Force understands the milestone these updated recommendations represent, we remind Virginians that it is critical that facilities, healthcare personnel, residents and visitors remain vigilant by continuing to follow infection control recommendations such as wearing a well-fitted cloth mask or facemask, physical distancing (maintaining at least 6 feet between people), hand washing, staying home when sick, and wearing appropriate PPE. This continues to be the safest way to prevent the spread of COVID-19, particularly if either party has not been fully vaccinated.
For more information about Virginia’s efforts to support long-term care facilities, visit the Virginia Long-Term Care Task Force website.