With the rapid spread of the omicron variant of the coronavirus and a spike in COVID-19 infections overall nationwide, nursing home advocates are asking the federal government to allow providers more discretion in restricting visitations.

The Centers for Medicare & Medicaid Services issued updated guidance last month that urged a more liberal visitation policy

“While CMS guidance has focused on protecting nursing home residents from COVID-19, we recognize that physical separation from family and other loved ones has taken a physical and emotional toll on residents and their loved ones,” the agency wrote in the Nov. 12 update.

In a Friday letter to CMS Administrator Chiquita Brooks-LaSure, however, leaders from AMDA – The Society for Post-Acute and Long-Term Care Medicine, the American Health Care Association and LeadingAge expressed “concerns regarding the unlimited, unrestricted access of visitation in nursing homes.”

Signed by AHCA Chief Medical Officer David Gifford, M.D., MPH; AMDA President Karl E. Steinberg, president of AMDA; and LeadingAge President and CEO Katie Smith Sloan, the letter asked the administrator to reconsider the “absolute, unconditional language” of the updated guidance, which they said “may pose a risk to nursing homes and their residents, placing skilled nursing facilities in precarious situations when outbreaks occur.”

The leaders said that, as written, SNFs appear not to be permitted to restrict visitation, regardless of staffing levels, community positivity rates or the severity of an outbreak within a facility. They expressed concern that that updated guidance could place nursing home staff members and residents at risk during a COVID-19 outbreak and asked for more flexibility in making decisions.

Friday, CMS said that although concerns still exist about visitation, including visitation with an unvaccinated resident while the level of COVID transmission is “substantial or high” in a county in which a nursing home is located, “adherence to the core principles of COVID-19 infection prevention mitigates these concerns.”

Each resident has “the right to make choices about aspects of his or her life in the facility that are significant to the resident,” the agency said.