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Who Makes the Rules?

Updated: Oct 6, 2022

This last year had a real impact on all of us, but none more so than our elders who live in long-term care facilities. Residents have gone for months on end without seeing their loved ones. Now, we’re turning a corner and visitation is opening up. However, it seems that each facility has their own rules for when and how you can visit. It’s a bit confusing for those of us who just want to be able to visit loved ones. Who is responsible for setting the visitation guidelines at the facility where your loved one lives?

Not all long-term care facilities are alike. A nursing home is not the same as an assisted living facility. The main difference is in the level of care they provide. People in nursing homes generally have a greater need for services and are more dependent on others for their daily needs to be met. Assisted living facilities are as the name states; they provide assistance to residents to help them meet their daily needs.

An assisted living facility is regulated by the state and there is no federal oversight. Nursing homes, on the other hand, are regulated by state and federal regulations. The Centers for Medicare and Medicaid Services (CMS) is the agency that oversees and enforces nursing home regulations. CMS works with the state to ensure regulations are followed.

CMS is the agency responsible for setting visitation guidelines for our nursing homes. Assisted Living facilities follow some of those guidelines but, because they are not mandated to follow CMS guidelines, they can set their own policies on how they want to reopen their facility for visitors. Most of the assisted living facilities in our area are open. They may have set hours you can visit, or you may be able to visit whenever you want. Nursing homes, though, must follow the guidelines set by CMS. However, CMS left enough “wiggle” room to allow facilities to set their own policies for how they will reopen facilities to visitors. Some have designated visiting hours. At others, you have to schedule your visit. Some have a designated spot to visit. Others allow you to go to your loved one’s room.

As much as we would like to be able to tell you what the guidelines are and when you can go see your loved one, we can’t. The only thing you can do is call your loved one’s facility and find out what their policies are. It never hurts to ask questions so, if you still can’t see your loved one or you believe that their policies are too restrictive, ask when their visitation restrictions will loosen. If visiting hours are a set time, ask about accommodations for your schedule. Always remember, you are your loved one’s best advocate.

The latest federal requirements issued by CMS state, “Facilities should allow indoor visitation at all times and for all residents regardless of vaccination status of resident, or visitor, unless certain limited scenarios arise that would limit visitation” due to high risk of COVID-19 transmission.

It is important to know that Compassionate Care Visits are “allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak.” These visits include 1) visits for a resident whose health has sharply declined, and  2) visits for a resident who is experiencing significant changes in circumstances, such as grieving a recent death of a loved one.

If you have questions about care coordination and advocacy for your loved one, give our office a call at (615) 824-2571.

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