AMDA: Interim Recommendations for Communal Activities and Visitation in PAC and LTCFs

Mary Madison, RN, RAC-CT, CDP 
Clinical Consultant – Briggs Healthcare

AMDA (The Society for Post-Acute and Long-Term Care Medicine) has released their final Interim Recommendations for Communal Activities and Visitation in Post-Acute and Long-Term Care Facilities.  These recommendations carry a date of February 25, 2021.  To be clear – this is NOT guidance from CMS but rather recommendations from an extremely engaged and knowledgeable entity.   See Recommendation #6 below as well as in the document. 

The 3-page document begins with this statement:

“Residents of post-acute and long-term care (PALTC) settings have suffered inordinately from the COVID19 pandemic. The effects include not only the morbidity and mortality caused by infection with SARSCoV-2, but also the devastating impacts of social isolation as a consequence of communal activity and visitor restrictions. With the availability of an effective vaccine against SARS-CoV-2, optimism is mounting about the possibility of opening PALTC settings to resuming group activities including communal dining and visitation. PALTC settings will need to carefully consider potential risks and benefits as they take steps to resume group activities and visitation. We offer recommendations to begin opening post-acute long-term care settings, based on our current understanding of the COVID-19 pandemic, and recognizing that more evidence will become available and the situation will continue to evolve.”

AMDA’s six (6) recommendations are:

  1. AMDA recommends that PALTC settings adopt a measured, stepwise approach to resuming visitation and group activities.
  2. AMDA recommends that PALTC settings continue to encourage all staff, residents, and visitors to be vaccinated against COVID-19 and seasonal influenza.
  3. AMDA recommends that visits with residents be scheduled and supervised by facility staff.
  4. AMDA recommends that all visitors should continue to be screened for COVID-19 infection each day they visit.
  5. AMDA recommends that all visitors be required to wear a medical-grade mask issued by the PALTC facility throughout their visit, to wear the mask properly, to practice effective hand hygiene frequently during their visit, and to only visit one resident a day.
  6. AMDA recommends that each PALTC setting develop policies and procedures that align with guidance from their local and state health departments, CDC, and CMS.

There are additional comments beneath all but #5 which speaks for itself.

“NOTE: This is interim guidance and will be updated as more evidence on vaccine effectiveness in post-acute long-term care settings becomes available.”

CMS has updated visitation guidelines for ICF/IIDs and PRTFs but not for nursing homes or assisted living communities.  In February 2021, Evan Shulman (CMS Director of Nursing Homes) addressed LeadingAge members during a call on visitation to nursing homes, stating “For the current time, all existing recommendations and guidance for visitation need to be adhered to.”  For more on Director Shulman’s comments, reference the McKnight’s Long-Term Care News article found beneath the addressed hyperlink in the previous sentence.