The COVID-19 public health emergency has been very difficult on residents of long-term care facilities. Not only are residents at particular risk of illness and death from the coronavirus itself, they may also be experiencing loneliness and isolation due to the restrictions on visitation in the facilities.

The Sixth Amended Director's Order to Limit Access to Ohio's Nursing Homes and Similar Facilities, with Exceptions outlines opportunities for residents and their families and loved ones to visit safely when possible. Even if facilities are restricting visits due to outbreaks or widespread community spread, compassionate care visits are still possible. Examples of compassionate care situations include, but are not limited to:

• A resident who was living with their family before recently being admitted to a home, is struggling with the change in environment and lack of physical family support.
• A resident who is grieving after a friend of family member recently passed away.
• A resident who needs cueing and encouragement with eating or drinking, previously provided by family or caregiver(s), is experiencing weight loss or dehydration.
• A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).

The Centers for Medicare & Medicaid Services (CMS) issued new guidance March 10, 2021 for visitation in nursing homes during the COVID-19 public health emergency. Revised QSO memorandum 20-39-NH updates guidance last issued September 17, 2020 and can be accessed here.

According to the updated guidance, facilities should allow indoor visitation at all times and for all residents, regardless of vaccination status of the resident or visitor. However, visitation should be limited in certain scenarios due to the high risk of COVID-19 transmission for:

• Unvaccinated residents, if the COVID-19 county positivity rate is greater than 10 percent and less than 70 percent of residents in the facility are fully vaccinated;
• Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated, until they have met the criteria to discontinue transmission-based precautions; or
• Residents in quarantine, whether vaccinated or unvaccinated, until they have met the criteria for release from quarantine.

The memorandum describes how visitation can occur when there is an outbreak, but there is evidence that the transmission of COVID-19 is contained to a single area. It also emphasizes that compassionate care visits should be allowed at all times, regardless of a resident’s vaccination status, the county’s CMS COVID-19 positivity rate, or an outbreak.

Long-Term Care Ombudsmen stand ready to assist residents and their loved ones navigate the visitation opportunities in long-term care facilities such as nursing homes and assisted living facilities. The order requires homes to work with residents, families, caregivers, resident representatives, clinicians, and the Office of the State Long-Term Care Ombudsman program to identify the need, length, and frequency for compassionate care visits.

Long-term care facilities must notify families and caregivers of all residents when an employee or resident tests positive for COVID-19. This notification must be completed within 24 hours. Additionally, the names and addresses of all long-term care facilities and nursing homes that have a minimum of one resident or employee case of COVID-19 are posted on the state's coronavirus.ohio.gov dashboard. Call 1-833-4-ASK-ODH if you have other questions about COVID-19.