Clarifications on New CMS Memos and CDC Guidance Released 4/27
The Maryland Department of Health has received many questions about the new CMS memos (QSO-20-38 and QSO-20-39) and CDC guidance released on 4/27/21- specifically about when this guidance may take effect. We hope the following summary is helpful as we all navigate the ever-changing regulations and guidance together. Please note this is all subject to change as new state directives are released. We will notify you as soon as that happens!
What may take effect immediately here in the state of Maryland:
1. Routine testing of fully vaccinated, asymptomatic staff is no longer recommended.
Continue to:
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test unvaccinated staff per Table 2 in CMS memo QSO-20-38.
- test (and exclude from work) all staff with signs or symptoms of COVID-19, regardless of vaccination status.
- test all staff during an outbreak, regardless of vaccination status.
2. Physical distancing is not required for fully-vaccinated residents during communal dining or group activities if all residents and healthcare personnel (HCP) present are fully vaccinated.
Continue to:
- distance unvaccinated residents from each other and from fully vaccinated residents (at least 6 feet apart)
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maintain physical distancing for all participants if unvaccinated HCP are present*, or if the vaccination status of participants cannot be determined (*note: MDH clarified this point with CDC directly)
- Facilities may choose to assign fully vaccinated HCP to work with residents for group activities and communal dining, if possible, so fully vaccinated residents would not have to sit with distancing.
3. Physical distancing is not required for fully vaccinated healthcare personnel (HCP) in break rooms or during in-person meetings.
Continue to:
- physically distance unvaccinated HCP from others
- maintain physical distancing for all participants if vaccination status cannot be determined
As of 5/3/21, the following restrictions still apply in Maryland LTC facilities (remember: state orders supersede federal guidance when more restrictive), regardless of vaccination status, and regardless of the CDC and CMS updates on 4/27/21:
1. Source control/masking:
- All staff, volunteers, vendors, and visitors shall wear the appropriate face covering at all times when they are inside the facility.
- To the extent possible, residents should wear face coverings in the following circumstances:
- if they leave their rooms or when they are within close proximity (under six feet) of others inside the facility; and
- for any trips outside of a facility (e.g. such as for a medical appointment)
2. Cohorting and New Admission Quarantine for Nursing Homes:
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Designate a room, series of rooms, unit, or floor of the nursing home as a separate observation area where newly admitted and readmitted residents are kept for 14 days on appropriate Standard and Transmission-based Precautions while being observed every shift for signs and symptoms of COVID-19 (Nursing Home Matters 2/11).
In summary:
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Source control/masking is still required for residents and HCP in Maryland long term care facilities, regardless of vaccination status, as long as the current MDH orders are in place.
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Quarantine/observation of new admissions or readmissions is still required for 14 days, regardless of vaccination status, as long as the current MDH orders are in place.
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Physical distancing and routine staff testing recommendations have changed, effective immediately, according to the new CDC guidance (as outlined above).
We hope this clarification is helpful! Please email mdh.ipcovid@maryland.gov if you have any further questions. We will notify you if new orders are released prior to the Thursday call.
