White House moves to increase nursing home visits

Nothing is more precious than time spent with loved ones. This is true at any age, but for older Americans, a personal connection with family and friends transcends mere entertainment — it’s almost life-sustaining. Yet over these past seven months, connections with loved ones have been perverted — warped into potential hazards: a grandchild’s embrace or kiss from a spouse now brings worry about serious illness or even death for those at high risk.

That’s why, though President Trump directed nursing homes to restrict visitors indefinitely soon after the pandemic began, as of today, the Trump administration expects all nursing homes to provide residents a means of visitation. That’s why we’re directing our network of inspectors to cite any Medicare or Medicaid nursing home that limits visitation without reasonable clinical or safety cause. Nursing homes that fail to facilitate visitation under the regulations could be subject to enforcement actions.

The Trump administration has released clear guidance to nursing homes laying out core principles for visits in various situations — indoor, outdoor, compassionate care and for resident advocates, such as ombudsmen. These principles are rooted in longstanding infection control practices, like handwashing and use of personal protective equipment like masks, as well as social distancing and staff testing — as outlined in our new requirements for nursing homes. Additionally, nursing homes now have a new ability to rapidly test, so there’s no reason nursing homes can’t facilitate more visitation.

As demonstrated by the numbers, testing is a top priority for the Trump administration: on average, over 800,000 tests are conducted each day and 97% of lab tests turned around within three days. Recently, President Trump directed that point-of-care testing devices be sent to each of the nation’s 15,500 Medicare and Medicaid certified nursing homes, along with a supply of testing kits and supplies. These shipments are ongoing and will be complete in the coming weeks. This announcement was paired with $2.5 billion of funding to nursing homes to defray testing costs. In the meantime, we’ve encouraged nursing homes to facilitate virtual communication between residents and their loved ones.

From my vantage point as head of the agency that oversees nursing homes’ compliance with Medicare health and safety rules, I’ve seen it all too often over these past eight months: COVID-19 is insidious when introduced into congregate care settings like nursing homes. It spreads like wildfire, devastating residents, who are particularly susceptible because they often suffer from multiple health conditions. That’s why as soon as we learned just how vulnerable nursing homes are to the virus, President Trump directed nursing homes to restrict visitors indefinitely. But keeping nursing home residents safe wasn’t as easy as closing facilities to visitors. In fact, visitation is critical to residents’ mental, physical, and spiritual well-being. We knew that indeterminately long visitor restrictions, however necessary to prevent COVID-19 outbreaks, could result in unbearable isolation for these vulnerable people.

Prolonged social isolation can result in sadness and despair and the attendant mental health issues. Nursing home staff care deeply for their residents, yet it’s impossible to replicate the benefit of visits from loved ones. No medical professional can prescribe a hug from a spouse or the joy of a routine Saturday family visit. So the Trump administration identified ways to ensure nursing home residents have access to the most meaningful, fulfilling contact with loved ones possible under these unprecedented circumstances.

In May, for example, the administration unveiled guidance to state and local governments, as well as nursing homes themselves, laying out phased reopening protocols. This May guidance provided for increased visitation with each phase. In June, the administration expanded its visitation guidance, explaining how to facilitate visitation in ways that are safe for residents, visitors, and staff alike. This included guidance on the use of outdoor visitation spaces, combined with masks. It also discussed safe ways to facilitate communal activities like book clubs, crafts, and bingo inside the facility, again with masks and social distancing.

Seven months on, we are learning more about the virus every day. We’ve also come to truly appreciate that prolonged visitor restriction takes a profound emotional and mental toll on aged nursing home residents. Additionally, we know some parts of the country will soon turn too cold to allow for outdoor visitation. So we’ve redoubled our efforts to provide clear guidance and robust resources for nursing homes to facilitate in-person visitation.

No one should be forced to weather this pandemic alone so we’re using every lever at our disposal to ensure America’s seniors in nursing homes can continue seeing loved ones in a safe way.