New guidelines from the Centers for Disease Control and Prevention (CDC) and the Centers for Medicare and Medicaid Services (CMS) eased some testing requirements and social distancing measures for nursing home facilities in light of a large number of residents and employees being fully vaccinated. These changes should alleviate some of the burdens that nursing homes have faced during the COVID-19 pandemic with respect to testing programs, masking, and social distancing within facilities.

Last week, the CDC and the CMS issued two key updates on COVID-19 guidance for nursing homes. On April 27th, the CDC updated its guidelines for testing residents and staff, including those who are vaccinated and those who are unvaccinated. The CDC also issued revised guidance for indoor visitation, communal activities, and dining in nursing homes. CMS also issued memos with the same guidance for testing procedures and visitation.

Testing for Residents and Staff

Last week, the CDC eased COVID-19 testing requirements for fully vaccinated nursing home residents, nursing home workers, and other healthcare personnel.

The updated guidance recommends that vaccinated workers and residents who are either symptomatic or in close contact with a person who tests positive for COVID-19 should still have a series of two viral tests, including one immediately and a second 5-7 days after exposure.

The CDC still recommends that facilities continue with routine testing for unvaccinated employees. Under the current guidelines, facilities should test unvaccinated staff on a monthly, weekly, or twice-weekly basis depending on the positivity rate in the county.

Despite these changes, the CDC did not revise its testing recommendations for nursing home workers at facilities experiencing an active COVID-19 outbreak. In facilities with an outbreak of COVID-19, facility workers and residents, both vaccinated and unvaccinated, should continue to have a viral test every 3-7 days until no new cases are identified for 14 days.

Indoor Visitation, Communal Activities, and Dining

The CDC issued major changes to its guidance on indoor visitation, communal activities, and dining at nursing homes.

To start, the CDC’s new guidance allows for in-person, indoor visitation, and personal contact among residents and visitors who are fully vaccinated. Under this change, facilities may allow for visitors and residents who are both fully vaccinated to visit without masks and without social distancing as long as they are alone in their room or a visitation room without unvaccinated individuals.

However, the new guidance does not change how facilities should handle communal activities and dining when unvaccinated residents are present. When any unvaccinated resident is participating in a communal activity or in-person dining, the CDC recommends that facilities should keep social distancing measures in place and require that residents wear masks.

In addition, the CDC’s new guidance allows fully vaccinated nursing home residents to resume in-person dining without masking or social distancing restrictions. Facility residents can now sit at the same table as other fully vaccinated residents without masks and social distancing measures.

Similarly, the CDC advised that healthcare workers at nursing homes can dine together in break rooms and conduct in-person meetings without masks or social distancing as long as all workers present are fully vaccinated. However, all workers should continue to wear masks while working with residents. Additionally, all workers should wear a mask and physically distance if unvaccinated workers are present, including in break rooms.