Relaxed Guidelines for Nursing Home Visitation Give Relief to Many

Hook Law News | Apr 7, 2021 | Letha Sgritta McDowell

While the past year has been one of isolation and uncertainty for all Americans, no group has felt the isolation more than those in long term care facilities. For more than a year now, long term care facilities have allowed almost no in-person visitation with residents. Unfortunately, the population of long-term care facilities are at high risk for infection being that the residents have co-morbidity factors which could result in a higher likelihood of death from COVID-19, and living quarters are close, which increases the likelihood that infection would spread. In fact, it is estimated that 40% of all COVID-19 deaths were residents of long-term care facilities. For all these reasons, it seems smart to limit contact with outside persons who may unknowingly be infected and spread the disease. However, the separation from family and friends has left an already vulnerable population feeling even more alone and isolated.

The emergency approval of vaccines in late 2020 gave many hopes of returning to normal and recently the Center for Medicare and Medicaid Services issued updated guidelines urging states to relax the visitation policies for long term care facilities. On March 10, 2021, CMS, in collaboration with the Center for Disease Control, stated that long term care facilities should allow “responsible indoor visitation at all times and for all residents, regardless of vaccination status of the resident, or visitor, unless certain scenarios arise.”

Allowing visitation again is a result of vaccination rates of both residents and health care workers as well as reduced cases reported daily in the United States. This news is welcomed by residents and visitors alike as many have spent the last year lonely and separated from family during what is already a stressful time. However, certain guidelines like social distancing and mask wearing remain in place and the requirement to distance may add additional complications for facilities since it is unlikely that in-room visitation will be allowed.

CMS and the CDC included the caveat that visitation can and should be limited if certain scenarios arise. Those include:

  • Unvaccinated residents of long-term care facilities where less than 70% of the residents are vaccinated and the community positivity rate exceeds 10%
    • Residents with a confirmed case of COVID-19
    • Residents who are required to quarantine based on other CDC quarantine requirements

CMS has also encouraged compassionate care visits regardless of vaccination status, community positivity rates, or other factors. Compassionate care visits include visitation at the end of a resident’s life or in other circumstances or times of extreme stress.

While we have not yet returned to normal, the recent CMS guidelines are evidence of moving toward normalcy and provide a great sense of relief for many families.

Ask The Attorney

Client: Do I need to change my will if I wish to give certain items to specific friends or family members?

Letha McDowell: No. A list of the tangible personal property you wish to give can be incorporated by reference into your will. For example, if you wish to leave your silverware collection to your daughter, you do not need to specifically change your will. You can prepare a separate memorandum referenced in your will that leaves your silverware, or any other tangible personal property, to your daughter. The memorandum must be dated and signed. If you later change your mind, you can destroy or change the memorandum without signing a whole new will.

Ask Dan: Pandemic Pets

Hook Law Center: Hey Dan, what is a pandemic pet and who gets one?

Dan: Pandemic pets are pets that were acquired after March 2020. Many people found as they were working from home and students were learning virtually, that they had time for a pet which they had not had before the pandemic. For many, a pandemic pet was a cure for isolation. While much of the country was shut down and people were shut in their homes by themselves, many people decided to get a pet. Those who felt isolated reported that having a pet helped reduce the feelings of stress and anxiety caused by isolation and even lessened the physical symptoms which are manifested because of loneliness and isolation. While much of the talk about pandemic pets has been about families who are at home more now than ever, it is estimated that 1 in 10 seniors have also gotten a pandemic pet. Perhaps the statistics are evidence that you are never too old to teach a human new tricks – including pet care.

Letha Sgritta McDowell

Attorney, Shareholder, CELA
757-399-7506 | 252-722-2890
[email protected]

Letha Sgritta McDowell is a Shareholder of Hook Law practicing in the areas of estate planning, elder law, special needs planning, estate and trust administration, asset protection planning, long-term care planning, personal injury settlement consulting, guardianships & conservatorships, and tax law. Ms. McDowell’s clients range from high-net-worth individuals with over $75 million in net worth to families with limited assets.

Ms. McDowell is a past President of the National Academy of Elder Law Attorneys and was named as a Fellow of the prestigious American College of Trusts and Estates Council (“ACTEC”) in 2020. She is certified as an elder law attorney by the National Elder Law Foundation (“CELA”) and Board Certified as a specialist in Elder Law by the North Carolina State Bar Board of Legal Specialization. Furthermore, McDowell is accredited to prepare and prosecute claims with the Department of Veterans Affairs.

Ms. McDowell is currently the chair of NAELA’s strategic planning committee, a member of the Board of Directors for the North Carolina Chapter of NAELA, and a member of the Board of Directors for the Purdue Center for Cancer Research. She is the former Chair of the North Carolina State Bar’s Elder Law Specialization Committee and is the former Editor-in-Chief of “Gray Matters”, the newsletter for the Elder Law Section of the North Carolina Bar Association. She is a consultant for InterActive Legal and has worked on several law and technology initiatives including IBM’s Watson project. Along with her experience practicing as an attorney, she has dedicated much of her time writing for national publications including, but not limited to: Wolters Kluwer,, the NAELA Journal, Trust & Estates Magazine and many more.

Practice Areas

  • Elder Law
  • Estate & Trust Administration
  • Estate Planning
  • Asset Protection Planning
  • Long-Term Care Planning
  • Special Needs Planning
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