Changes to Nursing Home Visitation COVID-19 (Revised) and COVID-19 Survey Activities

The Centers for Medicare & Medicaid Services (CMS) is continuing to promote health and safety and address the impacts of the COVID-19 public health emergency (PHE) on nursing home residents and their families by issuing memos that revise guidance for nursing home visitation and address the backlog of complaint and recertification surveys.

The first memo, Nursing Home Visitation – COVID-19 (Revised), issues revised visitation guidance in nursing homes. Together with infection prevention safeguards, including the recent staff vaccination regulation, this guidance will promote resident health and ensure continued safety as facilities continue to open. Early in the pandemic, visitation restrictions were implemented to mitigate the risk of visitors introducing COVID-19 to the nursing home. Today’s guidance update reflects that, while visitors, residents, or their representatives should be made aware of the risks associated with visiting loved ones, visitation should now be allowed for all residents at all times. CMS has consistently updated its visitation guidance through the COVID-19 PHE, and this update represents our most comprehensive action to bring residents and loved ones closer together. CMS continues to strongly encourage that everyone get vaccinated against COVID-19.

The second memo, Changes to COVID-19 Survey Activities, includes steps to assist State Survey Agencies (SAs) to address the backlog of facility complaint and recertification surveys. This backlog was the result of the temporary suspension and reprioritization of survey activity nationwide in the early days of the pandemic as CMS and states focused their efforts on infection prevention and control and controlling the spread of COVID-19. In recent months, states have made strong concerted efforts to resume recertification surveys, and we want that to continue.

Steps to assist SAs include:

  • Revising the criteria for conducting COVID-19 Focused Infection Control (FIC) Surveys;
  • Guidance for resuming recertification surveys; and
  • Temporary guidance and minor flexibilities related to complaint investigations.

In addition, CMS is increasing oversight in nursing homes to provide a more focused review of quality-of-life and quality-of-care concerns. For example, the memorandum instructs surveyors to specifically review and focus additional attention to the competency of nursing staff, the use of any potentially inappropriate antipsychotic medications, and other areas of care, such as unplanned weight loss, loss of function/mobility, depression, abuse/neglect, or pressure ulcers.

To view the Nursing Home Visitation COVID-19 (Revised) memo, please visit:

To view the Changes to COVID-19 Survey Activities and Increased Oversight in Nursing Homes memo, please visit: