State releases new COVID-19 guidance to allow more visitors in long-term care

Signs that say 'heroes work here' in a yard in front of a building.
The Lyngblomsten Care Center in St. Paul has signs outside its facility recognizing the workers. The Minnesota Department of Health released new guidance Monday that gives long-term care residences a framework for setting up policies to allow more visitors.
Peter Cox | MPR News file

After months of strictly limited visitation policies, Minnesota's long-term care facilities will soon be allowed to cautiously open their doors a little wider — but only if they meet strict criteria laid out by the state.

The Minnesota Department of Health rolled out new guidance Monday that gives long-term care residences — which include assisted living facilities, nursing homes and memory care units — a framework for setting up policies to allow visitors more broadly than at any other time during the coronavirus pandemic. 

The guidance, which goes into effect Aug. 29, gives facilities a road map for opening based on a matrix of several factors: The latest COVID-19 case numbers in the surrounding community; the number of active, confirmed cases among the facility’s residents, staff and visiting service providers; and whether staff are working at other long-term care homes.

In March, as outbreaks began spreading through Minnesota’s long-term care facilities, visitors were banned from residences in all but the most dire circumstances. As of Monday, 1,250 people who lived in long-term care or assisted living facilities have died from COVID-19.

After access to testing became more widespread, safety protocols improved and the state implemented a system for backing up facilities that were experiencing staffing shortages, the crush of COVID-19 cases — and deaths — among long-term care residents began to ease. 

Since then, the state has begun allowing outdoor, socially distanced visits among residents and their family and friends. More recently, the state has implemented rules allowing residents to identify one essential caregiver — a designated family member, friend or other caregiver — who is allowed to visit them inside their long-term care facility.

Number of daily COVID-19 deaths in and out of long-term care facilities.

New rules based on local data

Under the latest rules announced Monday, a long-term care facility will be permitted to enact a tailored policy that will open their doors to visitors beyond the essential caregivers and outside visits that are currently allowed.

The Health Department’s new framework requires facilities to base their policies on whether anyone in the facility — resident, staff or visiting service provider — has been exposed to the coronavirus in the previous 28 days. Facilities should also be looking at the 14-day case rate for their county to determine whether to open to visitors. “If that number is greater than 10, you may consider the county at elevated risk of disease transmission,” the state guidance indicates.

“We will be dealing with COVID-19 for a long time, and it is important to find a way to allow residents to interact with their loved ones safely,” Health Commissioner Jan Malcolm said in a press release Monday.

“Residents have been isolated for months, and that presents significant risks for their emotional and social well-being. This guidance helps facilities keep their COVID-19 guard up while taking cautious steps toward ensuring residents have more social connections and interaction.”

Facilities will also have to monitor several other risk factors in making visitation decisions — including rates of COVID-19 in the surrounding community, facility size and the extent to which staff has been working at other long-term care facilities as well.

"Let's put the choice of whether to reunite in the hands of people who live in long-term care and their families,” said Aisha Elmquist with the state’s Office of Ombudsman for Long-Term Care. “Let's trust that they can make the right decisions for themselves and for their families."

MPR News reporter Tim Nelson contributed to this story.

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