The following answer was provided by CMS on April 24, 2020 in QSO-20-28-NH:

Facilities should consider the necessity of the appointment to the resident’s health, and whether it is critical for the resident to attend the appointment. If the appointment is not critical, it is recommended that the appointment be deferred to a later date or be accomplished virtually, if the resident agrees. Decisions and any concerns about keeping or postponing the appointment should be discussed with the resident, resident representative, and the resident’s physician. If attending the appointment is necessary, the facility should help arrange for the resident to attend the appointment by taking precautions to minimize the risk of transmission of COVID-19 (e.g., giving the resident a surgical mask to wear while attending the appointment). Also, the facility should monitor the resident upon return for fever and signs and symptoms of respiratory infection for 14 days after the outside appointment (preferably in a space dedicated for observation of asymptomatic residents).

With regard to outside activities, the CMS memorandum (QSO-20-14-NH (Revised)) states that facilities should cancel “all group activities such as internal and external group activities.” This means there should be no group activities occurring outside or inside of the building, due to the risk of transmission.

CMS also encourages the use of telehealth, so residents can be seen virtually by their practitioner.

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