Restrictions in Nursing Homes

Today and Beyond

(March 17, 2020) There are at least 4,482 confirmed cases in the United States. COVID-19 has reached 49 states, Washington D.C., Guam, Virgin Islands, and Puerto Rico. New York has the most cases identified with 950 cases, followed by Washington at 787 cases and California at 583 cases.

President Trump declared a National Emergency on Friday. Thereby giving the Secretary of Health and Human Services the ability to waive restrictions to give all providers and hospitals maximum flexibility to respond to the Coronavirus. President Trump yesterday remarked that the Coronavirus may linger until July or August.

Currently the FFS qualifying 3-day hospital stay for skilled nursing facilities Medicare A stay is waived. There does not have to be a 60-day non-skilled stay in the facility to begin a new Medicare A episode for those who have exhausted their benefit and cannot have a 60-day break in skilled services due to the Coronavirus. The provider must document the change of condition and skilled status in the medical record.

President Trump has called for more waivers regarding the use of telehealth to allow providers to adequately care for their patients during this emergency.

On Friday CMS announced new measures, which supersede prior CMS guidance, constitute the agency’s most aggressive and decisive recommendations with respect to nursing home safety in the face of the spread of COVID-19. They include:

  • Restricting all visitors, effective immediately, with exceptions for compassionate care, such as end-of-life situations;
  • Restricting all volunteers and nonessential health care personnel and other personnel (i.e. barbers);
  • Cancelling all group activities and communal dining; and
  • Implementing active screening of residents and health care personnel for fever and respiratory symptoms.

The guidance directs nursing homes to restrict visitation except in certain compassionate cases, like end-of-life. In those cases, visitors will be equipped with personal protective equipment (PPE) like masks, and the visit will be limited to a specific room only.

President Trump asks Americans to:

  • avoid gatherings of more than 10 people;
  • avoid discretionary travel
  • avoid eating and drinking in bars, restaurants, and public food courts;
  • work on schooling from home whenever possible across the country.

Major cities are shutting down restaurants, bars, casinos, gyms and schools until at least March 31 to try to stop the spread of the coronavirus which has killed at least 86 people in the United States.

Currently there is one vaccine which has started phase one clinical trials in the U.S. while others are working to develop anti-virals that are effective against novel corona virus.

Please see link for more information on the Coronavirus from CMS:

CMS Fact Sheet for Providers

For further information contact us at 203-567-5260 or

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