New MDHHS order will allow outdoor visits at residential facilities September 10, 2020

LANSING, MICH. People living in residential care facilities such as nursing homes soon will be able to see visitors outdoors under a new epidemic order signed today by Michigan Department of Health and Human Services (MDHHS) Director Robert Gordon that also requires precautions to protect against COVID-19.

The directive permits additional exceptions to Gov. Gretchen Whitmer’s order that temporarily restricts visits during the pandemic for the health and safety of residents, visitors and staff at health care, residential care, congregate care and juvenile justice facilities. Based in part on recommendations from Gov. Whitmer’s Nursing Home Preparedness Task Force, the new order is effective next Tuesday, Sept. 15.

“Limiting visitation has saved lives,” Gordon said. “And seeing loved ones in person is important for mental health. Allowing outdoor visits – with proper procedures such as requiring social distancing and masks – is good for residents and can keep everyone safe.”

In addition to the task force recommendations, other factors in the decision to expand visitation include a flattening of the COVID-19 curve and feedback from families and advocates about how the burden of the current restrictions has grown over time. On June 30, when MDHHS last expanded visitation, the epidemic curve was on the upswing. Viral spread has been stable for several weeks – and last week COVID-19 outbreaks in congregate facilities declined 19 percent from 83 to 67. To address areas with higher levels of risk, the order allows local health departments to stop visitation if necessary.

Prior to offering outdoor visits, facilities must assure that the visitation area allows for at least 6 feet separation between all people and provides adequate protection from weather elements. They must also assure someone trained in infection control will be within sight range to assure compliance with resident protection protocols.

Facilities must meet criteria specified in the order, including having had no new COVID-19 cases originate there within the previous 14 days.

To allow visitation, the facilities must, among other things:

• Permit visits by appointment only.
• Limit the number of visitors during each scheduled visit to two people or less.
• Exclude visitors who cannot or will not wear a face covering during the entire visit.
• Require visitors to maintain social distancing.
• Limit the number of overall visitors at the facility at any given time based upon space limitations, infection control capacity and other appropriate factors to reduce the risk of COVID-19 transmission.
• Prohibit visits to residents who are in isolation or under observation for symptoms of COVID-19.

Additional requirements can be found in the emergency order.

“The Michigan Long Term Care Ombudsman Program welcomes this cautious step forward to allow outdoor visits with residents of long-term care facilities,” said Salli Pung, the program ombudsman. “We also appreciate residents will now have access to medical and non-medical services that many residents have not received for nearly six months. By promoting these vital and basic visits and services, long term care facilities can better ensure and address residents’ quality of life.”

The order applies to residential long-term care facilities, which include nursing homes, homes for the aged, adult foster care facilities, hospice facilities, substance abuse disorder residential facilities, independent living facilities and assisted living facilities.

MDHHS previously eased visitation restrictions for residential care facilities in an emergency order issued June 30. The latest order further expands permissible visits in these settings. While the order permits outdoor visits, it does not require facilities to allow these visits. After reviewing experience and feedback around outdoor visitation, the department will consider additional changes to visitation rules.

Restrictions on visits don’t apply to medical service providers, resident physicians, and window visits when there is a barrier between the resident and visitor. Volunteers trained in infection control who supervise visitations also do not count as visitors. Additional non-medical services performed by visitors such as hairdressers can be provided under certain circumstances.

Information around the COVID-19 outbreak is changing rapidly. The latest information is available at Michigan.gov/Coronavirus and CDC.gov/Coronavirus.  

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