During last Thursday's press conference, Director of Aging Ursel McElroy announced that the DeWine Administration will allow indoor visitation for residents of Ohio’s nursing homes and assisted living beginning October 12. This comes after months of LeadingAge Ohio-led advocacy efforts to resume indoor visitation with winter fast approaching.
“The prolonged loss of connection is critical,” said the Director, noting that they had consulted with aging advocates, including LeadingAge Ohio, to develop the guidelines for indoor visitation.
LeadingAge Ohio and other provider associations worked hand-in-hand with the Administration to craft considerations for indoor visitation. Similar to outdoor visitation, providers should consider the following before opening indoor visitation:
• Case status in the surrounding community;
• Case status in the facility;
• Staffing level;
• Access to adequate testing for residents and staff;
• Personal protective equipment supplies; and
• Local hospital capacity.
Director McElroy noted that nursing homes cannot limit access to the building to other healthcare providers, including hospice staff. The Director of the Ohio Department of Developmental Disabilities noted that visitation will begin for intermediate care facilities (ICF-IDD) on September 28, setting up a space in each home that would allow visitation to occur in a space isolated from other residents.
The state has recently sought to align Ohio's testing and visitation guidance with federal guidance from the Centers for Medicare & Medicaid Services (CMS) to streamline the process. CMS, the federal body which regulates nursing homes, recently released QSO-20-38-NH
, which provides new guidance for testing and visitation in nursing homes during the COVID-19 pandemic.
For months, state and federal guidance surrounding visitation and testing have been at odds with one another, with providers having to follow two distinct and contradicting county color coding systems and sets of requirements. The state has recently sought to align Ohio's guidance with federal guidance to streamline the process. Confusion still exists, however, particularly around the county positivity color designation. LeadingAge Ohio continues to work with association partners and the Administration on this issue.
The CMS guidance relies on core principles of COVID-19 infection prevention, which include:
- Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions or observations about signs or symptoms), and denial of entry of those with signs or symptoms
- Hand hygiene (use of alcohol-based hand rub is preferred)
- Face covering or mask (covering mouth and nose)
- Social distancing at least six feet between persons
- Instructional signage throughout the facility and proper visitor education on COVID19 signs and symptoms, infection control precautions, other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene)
- Cleaning and disinfecting high frequency touched surfaces in the facility often, and designated visitation areas after each visit
- Appropriate staff use of Personal Protective Equipment (PPE)
- Effective cohorting of residents (e.g., separate areas dedicated to COVID-19 care)
- Resident and staff testing conducted as required at 42 CFR 483.80(h) (see QSO-20-38-NH)
CMS will also only permit indoor visitation for a facility if there has been no new onset of COVID-19 cases in the past 14 days and the facility is not conducting outbreak testing. “Outbreak” is defined as any new case within a facility.