In coordination with the Centers for Disease Control and Prevention (CDC), the Centers for Medicare & Medicaid Services (CMS) is closely monitoring rapidly changing guidelines for detection and screening procedures for COVID-19 (commonly known as the coronavirus) and is issuing updated guidance for hospitals and hospice agencies. In the interest of limiting risk for COVID-19 infection among hospital and hospice populations, CMS recommends that these facilities identify volunteers, visitors and patients at risk for COVID-19 infection before or immediately upon each patient encounter and potentially implement patient visitation restrictions.

Providers should ask patients, volunteers, visitors and medical staff the following screening questions:

1. Have you traveled internationally within the last 14 days?
2. Do you have signs or symptoms of a respiratory infection, such as fever, cough or sore throat?
3. In the last 14 days, have you had contact with someone with or under investigation for COVID-19, or who was ill with respiratory illness?
4. [For hospice agencies] Do you reside in a community where community-based spread of COVID-19 is occurring?

Some hospitals and hospice agencies have opted to restrict or limit patient visitation to prevent the spread of COVID-19. Hospitals must have written policies and procedures discussing any “clinically necessary or reasonable restriction or limitation” on patient visitation and justification of those restrictions and limitations. CMS sub-regulatory guidance lists infection control as one situation that could justify such limitations. Hospitals must communicate any clinical restrictions or limitations on visitation to patients. Hospice agencies may implement policies restricting patient visitation rights to achieve their federally mandated directive to focus on infection control and prevention. If a different provider provides inpatient hospice, that provider may have additional visitation restrictions to address COVID-19 concerns.