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

It is unlawful for a facility to detain and stop a resident from leaving the facility if the resident wishes to leave. Because of the risks of transmission of COVID-19, facilities should strongly discourage residents from leaving the facility and follow the guidelines released by local or state jurisdictions. If a resident insists on leaving against medical advice, the facility must allow them to leave, should encourage them to wear a facemask while out in the community, discuss the importance of handwashing, offer hand sanitizer if available, and document in the resident’s medical record how the facility discouraged leaving and explained the risks of leaving to the resident and/or resident representative.

For a resident who leaves and intends to return, the facility should monitor the resident upon return for fever and signs and symptoms of respiratory infection for 14 days (preferably in a space dedicated for observation of asymptomatic residents), and implement the necessary Transmission-Based Precautions if the resident develops fever or signs and symptoms of respiratory infection. For residents the facility is considering discharging, the facility must follow the regulations at 42 CFR 483.15(c) (unless otherwise waived).

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