Statement on update to LTC outing and visitation guidance

Effective immediately, MDH is updating guidance for long-term care facilities related to non-medical outings. MDH has posted new guidance documents for Minnesota’s long-term care facilities, including nursing homes and assisted-living-type facilities, following the March 10 update from the federal Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC).

This is an important next step for the overall health and well-being of our long-term care residents. Minnesota’s focus on vaccinating our long-term care residents now allows these residents who are vaccinated to travel and go out for activities, visits and worship without having to quarantine upon returning home.

The updated guidance includes the following recommendations related to outings:

• Residents who are fully vaccinated do not have to quarantine after non-medically necessary outings unless they spend 15 minutes or more in a 24-hour period within 6 feet of someone who can spread COVID-19.

• Residents who are fully vaccinated may gather indoors or outdoors with other people who are fully vaccinated.

• Residents who are fully vaccinated can visit indoors or outdoors with unvaccinated people from a single household who are at low risk for severe COVID-19 infection.

• If the resident is fully vaccinated, they can choose to have close contact (including touch) with the people they are visiting.

• If a resident who is fully vaccinated chooses to attend a place of worship or other group event, or to shop or eat in public establishments, the resident should follow the core principles of COVID-19 infection prevention. MDH strongly encourages attending places of worship or other group events only when the 14-day county percent positivity rate is below 5%.

• Unvaccinated residents who leave the building to gather with others may be required to quarantine when they return. At this time, quarantine recommendations remain unchanged for an unvaccinated resident, regardless of the vaccination status of those with whom they gather.

The updated guidance includes the following recommendations related to facility visits:

• Residents should be able to have private visits.

• If a resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitted face mask (if tolerated) and performing hand hygiene before and after.

• While taking a person-centered approach, outdoor visitation is preferred even when the resident and visitor are fully vaccinated against COVID-19, because outdoor visits generally pose a lower risk of spreading the disease. Visits should be held outdoors whenever feasible.

• Compassionate care visits, essential caregivers, and visits required under state and federal disability rights laws should be allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak.

• Facilities in medium or high positivity counties are encouraged to offer testing to visitors as feasible. Visitors should also be encouraged to get vaccinated when they have the opportunity. While visitor testing and vaccination can help prevent the spread of COVID-19, neither testing nor vaccination should be required of visitors as a condition of visitation, nor should proof of such be requested.

• Screening questions must now include whether the visitor has had close contact in the prior 14 days with someone who is infected with COVID-19 (regardless of whether the visitor is vaccinated). If the visitor answers yes, the visitor should not be allowed to enter.

• Vaccinations and the slowing of coronavirus infections are allowing us to safely expand visitation and allow indoor visits that bring families and residents together. Minnesotans can help continue the positive momentum by taking the right steps to prevent spread of COVID-19. These include masking up, keeping social distance, staying home when sick, and getting tested when appropriate.

Minnesota Commissioner of Health Jan Malcolm provided the following statement in response to the guidance update.

“Residents of long-term care facilities need the opportunity to see and spend time with their friends and loved ones as much as possible. As we continue to make progress in the effort to defeat COVID-19 it’s great to take steps like this to ensure residents have those connections and support. We thank all those who have helped make this step possible by doing the little things that help minimize the spread of COVID-19. Those little steps – masking, social distancing, staying home when sick and getting tested when appropriate – will help us get back quicker to all those things we have missed in the last year.”

The updated MDH documents are at Long-term Care: COVID-19, under the heading visitors and outside services.

• Long-term Care Guidance for Non-medically Necessary Outings

• COVID-19 Guidance: Long-term Care Indoor Visitation for Nursing Facilities and Assisted Living-type Settings (PDF)

• Long-term Care Visitation Guidance Flowchart for Outbreak Status (PDF)

• Long-term Care Visitation Guidance Flowchart for Exceptions (PDF)