RNCohortJournal of the American Medical Directors Association2025

Lifting Federal Visitation Restriction and COVID-19 Infections in Nursing Homes.

John R Bowblis, Shuang Li, Yong-Fang Kuo and 3 others

PMID 40383139

WHAT IT FOUND

Lifting federal nursing home visitation restrictions did not increase resident COVID-19 infections.

Infection rates tracked community spread, not visitation policy. Clinicians can reassure families that allowing visits, with proper infection control, is unlikely to drive outbreaks.

Key findings

01There was no statistically significant increase in nursing home infection rates associated with lifting the federal visitation restriction.

02Nursing home infection rates were more influenced by community spread than by the lifting of the federal visitation restriction.

03Community-adjusted nursing home infection rates did not increase after the federal restriction was lifted.

STILL TO COME

How it was doneWhat they foundWhat it means for RNs

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What it does not show

The study relied on self-reported data from nursing homes, which may be inaccurate. Community infection rates were measured at the county level, which may not reflect the specific local exposure risk for each facility. The researchers could not verify whether facilities actually adhered to the federal guidance or if visitation occurred as intended. The analysis assumes that states in the control group had parallel trends in infection rates, which may not hold if they experienced different early pandemic dynamics.

Declared interests

Dr. Bowblis receives funds from state and federal agencies for nursing home research and policy advice, and has served as an expert witness in healthcare legal matters. Other authors declared no conflicts of interest.

The easy way to misread this

Do not conclude that visitation is completely safe without controls. The study found no increase in infections after restrictions were lifted, but this occurred alongside community spread and with existing infection protocols. It does not prove that unrestricted, unmasked visitation is safe, only that the specific federal ban on visitors was not the primary driver of infections compared to community transmission.

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