Centers for Medicare & Medicaid Services and Administration for Community Living Guidance, Resources & Action

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The Centers for Medicare & Medicaid Services (CMS) and the Administration for Community Living (ACL) have issued and revised guidance and resources throughout the COVID-19 pandemic. See these documents and Consumer Voice's summaries below.

CMS rescinded emergency waivers, including of training and certification requirements for nurse aides (QSO-22-15-NH & NLTC & LSC) on April 7, 2022. Read Consumer Voice's summary.
CMS updated its Nursing Home Visitation Guidance (QSO-39-NH Revised) on uses of face coverings during visitation and quarantine and guidance on testing (QSO-20-38-NH Revised) on March 10, 2022.
CDC updated its Infection Prevention and Control Recommendations for Healthcare Personnel and provided updated definitions for "fully vaccinated" and being "up to date" on your vaccinations on February 2, 2022.
CMS updated its Nursing Home Visitation Frequently Asked Questions on February 2, 2022. Read Consumer Voice's summary of these updates.
CMS published Frequently Asked Questions regarding its November 12th visitation guidance on January 6, 2022. Consumer Voice provided an update on nursing home visitation in regards to this guidance on January 14, 2022.
CMS released guidance and survey procedures (QSO-22-07) on December 28, 2021 to ensure compliance with nursing home staff vaccination requirements. Read Consumer Voice's summary of this guidance.
CMS updated their Nursing Home Visitation Guidance (QSO-20-39) on November 12, 2021 making visitation allowed at all times, including indoor visitation. Read Consumer Voice's key takeaways from the guidance.
On November 12, 2021, CMS updated its guidance related to the state survey process (QSO-22-02). Read Consumer Voice's summary.
CMS updated its guidance regarding COVID-19 staff testing and outbreak testing (QSO-38-NH Revised) on September 10, 2021.
CMS updated their visitation (QSO-20-39-NH Revised) and testing (QSO-20-38-NH Revised) guidance (4/27/21) to reflect the guidance from the Centers for Disease Control & Prevention (CDC) regarding lifting restrictions on dining and other activities for vaccinated nursing home residents.
CMS rescinded three emergency waivers of regulations in place since the beginning of the pandemic - QSO-21-17-NH (4/8/2021). Read Consumer Voice's summary.
CDC updated their guidance (3/29/21) regarding infection prevention and control to prevent COVID-19 spread in nursing homes. It includes important information about when nursing home residents are required to quarantine. Read Consumer Voice's summary of the guidance.
CMS updated its guidance on visitation in nursing homes - QSO-20-39-NH REVISED (3/10/21). Read Consumer Voice's summary, key takeaways and concerns about the guidance.
On March 8, 2021, the Centers for Disease Control & Prevention (CDC) released new recommendations for fully vaccinated individuals.
On January 4, 2021, CMS revised a June 1, 2020 memo to State Survey Agency Directors regarding survey activities and issued a set of Frequently Asked Questions (FAQs) about the resumption of survey activities (QSO-20-31-ALL). Read Consumer Voice's summary of the revision.
CMS published Nursing Home COVID-19 Testing FAQs (December 2020)
CMS published a memo, QSO-21-06 (12/4/2020), on updates to the Nursing Home Compare website and Five Star Quality Rating System.
CMS issued an alert (November 2020) with Holiday Leave Recommendations for residents, their families, and representatives in the nursing home.
- See Consumer Voice's fact sheet summarizing the recommendations.
CMS updated its Nursing Home Reopening Recommendations for State and Local Officials, QSO-20-30-NH (9/28/20).
- The 9/28/20 guidance revises the original guidance from 5/18/20 - CMS Guidance, QSO-20-30-NH and Frequently Asked Questions. See Consumer Voice's Statement in Response.
CMS released a memo (9/17/2020) significantly easing visitation restrictions in nursing homes. CMS notes that this guidance replaces all previous guidance. See Consumer Voice's summary. Prior to the release of this memo, Consumer Voice and other advocates provided recommendations:
- Recommendations to Allow Nursing Home Residents to Have Increased In-Person Contact with Family and Friends During the COVID-19 Pandemic (9/4/20)
- Initial Recommendations to Address Resident Isolation and Decline by Allowing Residents to Have Increased In-Person Contact with Family Members and Friends (8/20/20)
CMS Interim Final Rule (8/25/20) on COVID-19 testing requirements for nursing home residents and staff and accompanying guidance. See Consumer Voice's summary.
- Consumer Voice submitted comments to CMS regarding this rule. Read Consumer Voice's comments.
CMS Frequently Asked Questions on Nursing Home Visitation (6/23/2020)
CMS COVID-19 Nursing Home Data includes data reported by nursing homes to the Centers for Disease Control and Prevention (CDC).
- Nusing Home COVID-19 Data Release FAQs (6/4/2020)
CMS Memo - Posting of Nursing Home Inspections, QSO-20-33-NH (6/4/2020) Download the infection control survey reports from the Nursing Home Compare website.
State Nursing Home COVID-19 Data (6/1/2020), chart that provides facility-reported information for each State under CMS’s new reporting requirements.
Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes (June 2020)
CMS Memo - COVID-19 Survey Activities, CARES Act Funding, Enhanced Enforcement for Infection Control deficiencies, and Quality Improvement Activities in Nursing Homes, QSO-20-31-All (6/1/2020) See Consumer Voice's summary of the memo, data, and letter to Governors.
Letter to Governors from CMS and CDC (5/31/2020), summarizing the information in the memo (QSO-20-31-All), describing the data chart, and calling on Governors to submit a comprehensive plan for testing and submit it to HHS.
CMS Toolkit on State Actions to Mitigate COVID-19 Prevalence in Nursing Homes (May 2020)
CMS Interim Rule (5/8/2020) mandating that nursing homes report COVID-19 related data to CDC as well as residents and families. See Consumer Voice’s summary (5/5/2020) and Consumer Voice's summary with comments (6/2/2020).
Press Briefing (4/30/20) at which President Trump made a number of announcements regarding steps the federal government is taking related to nursing homes and COVID-19. See Consumer Voice’s Summary and Statement in Response.
CMS Waivers for Health Care Providers (3/30/20, revised 4/21/20), including waivers of select Nursing Home Requirements of Participation. See Consumer Voice’s Summary.
Civil Money Penalty (CMP) Application for Communicative Technology Requests - April 24, 2020 application template, and application approval letter, CMP Application for Communicative Technology Requests Frequently Asked Questions (FAQs) for State Medicaid Agencies.
CMS Guidance, QSO-20-28-NH (4/24/20) – updates to Nursing Home Compare, nursing home staff counts, and frequently asked questions. See Consumer Voice’s Summary.
CMS Guidance, QSO-20-26-NH (4/19/20) – nursing homes will be required to report COVID related information to CDC, residents, and families. See Consumer Voice’s Summary.
CMS Guidance, QSO-20-25-NH (4/13/20) – supplemental information for transferring or discharging residents between facilities based on their COVID-19 status. See Consumer Voice’s Summary.
CMS Guidance (4/2/20) - CMS & CDC Recommendations to mitigate the spread of COVID-19. See Consumer Voice’s Summary.
CMS ‘Flexibilities’ for Long Term Care Facilities (3/28/20, revised 4/29/20) –regulatory waivers and new rules. See Consumer Voice’s Summary.
HHS Secretary Azar letter to Governors calling to expand capacity of healthcare workforce (3/24/2020)
CMS Guidance, QSO-20-20-ALL (3/23/20) – limiting activities of the survey agencies. See Consumer Voice’s Summary.
CMS Guidance, QSO-20-14-NH (3/4/20, revised 3/9/20 and 3/13/20) – suspended non-emergency inspections, restricts visitation and entry to facilities, suspends communal activities. See Consumer Voice’s Summaries of the March 4th version, March 9th revision, March 13th revision. *Note that this guidance has been replaced as of the memo dated 9/17/2020.*
The Administration for Community Living published FAQs for long-term care ombudsman programs regarding COVID-19 (3/16/2020).
Administration for Community Living COVID-19 Information Page
The Centers for Disease Control and Prevention (CDC) has issued specific guidance to long-term care facilities for strategies for preventing the spread of COVID-19.
CMS COVID-19 Partner Toolkit
CDC: Coronavirus Disease 2019 (COVID-19) Preparedness Checklist for Nursing Homes and other Long-Term Care Settings
CDC: Strategies to Prevent the Spread of COVID-19 in Long-Term Care Facilities