ACL Advocacy: Visitation in Congregate Settings

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From the ACL Blog
ACL Advocacy: Visitation in Congregate Settings
February 24, 2021
by Vicki Gottlich, Director, ACL’s Center for Policy and Evaluation

Throughout the COVID-19 pandemic, ACL has worked with the HHS Office for Civil Rights, the Centers for Medicare & Medicaid Services and other partners to protect the rights of people with disabilities and older adults. One issue on which we have been heavily engaged is visitation for people who live in a range of congregate settings, and we wanted to make sure our networks were aware of the latest guidance on this crucial topic. 

On Feb. 10, CMS issued guidance on visitation in Intermediate Care Facilities (ICF) for Individuals with Intellectual Disabilities and psychiatric residential treatment facilities (PRTF). This complements CMS’ guidance for visitation in nursing homes, which was issued in September.

The new guidance includes a number of provisions that are important for ACL’s partners in the aging and disability networks to be aware of. For example, although it allows facilities to restrict visitation in order to prevent the spread of COVID-19, it makes clear that visitation may not be restricted without a reasonable clinical or safety cause.  It further says that even if a facility is otherwise limiting in-person visitation, it should allow visits – with appropriate safety measures — by the following:  

-Protection and Advocacy systems
-People who provide in-person supports necessary for equal access to care and communication under disability rights laws
-Long-Term Care Ombudsmen (for ICFs licensed as nursing facilities and certified under section 1919 of the Social Security Act)
-Outside healthcare and service providers, including providers assisting with transition from a facility to the community
-People providing support in a compassionate care situation.  

The guidance further clarifies that compassionate care situations are not limited to end-of-life. The guidance offers several examples in which visitation by family and caregivers could be considered compassionate care and makes clear that the list should not be considered all-inclusive.   The guidance also includes descriptions of key federal disability rights laws and P&A programs and provides best practices for allowing visitation safely. This new guidance augments the guidance CMS issued in December on infection control for ICFs, psychiatric hospitals, and PRTFs (which included strategies for transition to the community, where appropriate). 

As always, the HHS Office for Civil Rights stands ready to assist if in-person supports or visitation are being denied in violation of federal disability rights laws.  Complaints can be filed through OCR’s portal. If you have questions or need help filing a complaint, you can email OCR at [email protected] or call toll-free at: 1-800-368-1019, TDD: 1-800-537-7697. OCR also provides materials in alternative formats (such as Braille and large print), auxiliary aids and services (such as a relay service), and language assistance.

ACL will continue to advocate for the needs of people with disabilities and older adults, and we’ll continue to share information from federal partners and our grantees, as well as resources we think may be useful to the aging and disability networks, and the people we all serve.

Watch for the latest information and be sure to sign up for ACL Updates.
Related links: National Strategy for the COVID-19 Response and Pandemic Preparedness ACL’s COVID-19 Information for older adults, people with disabilities, and the aging and disability networks Back to top