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Long-term care facilities move to restrict visits from family members

Citing new federal guidance, nursing homes and assisted living facilities nationally will start to screen all visitors.

In-person visits at the Life Care Center of Kirkland, are not allowed, as the nursing home is at the center of the outbreak of the coronavirus in Washington state.Grant Hindsley/The New York Times

Skilled nursing and assisted living homes across the nation will begin screening all visitors and restricting entry to all but essential health care workers in an effort to prevent new outbreaks of coronavirus, operators of the facilities said Tuesday.

Citing new guidance from the federal Centers for Disease Control and Prevention, trade groups representing long-term care residences housing 2.5 million older Americans said they’ll screen all family members, employees, contractors, and government officials before permitting them to enter ― and telling family and friends to stay away.

The action is being taken to protect residents because the Covid-19 mortality rate for people over 80 with serious underlying medical conditions ― a common demographic in long-term care facilities ― looks to be "shocking,” said Mark Parkinson, president of the American Health Care Association and the National Center for Assisted Living.


While he wouldn’t give a precise number, other association officials estimated it could be as high as 15 percent of those infected. That’s based on data from countries and regions where the virus has spread widely, including China and Kirkland, Wash., where dozens of residents at the Life Care Center nursing home ― considered the US epicenter for the virus ― have died and 70 workers have been sickened over the past few weeks.

"We face one of the most significant challenges, if not the most significant challenge in our history,” Parkinson said in a teleconference Tuesday morning.

In a Boston news conference Tuesday afternoon, Massachusetts officials echoed a call for visitor restrictions already given by some other states.

Marylou Sudders, the state secretary of health and human services, said Massachusetts would offer new guidance Wednesday. Nursing homes will be directed to actively screen and restrict access to visitors to ensure safety and health of residents, she said.

There will be no access for visitors with Covid-19 symptoms or those who’ve had contact in the last two weeks with someone infected or suspected to be, she said. People who’ve traveled overseas in the past 14 days or live in a community where the coronavirus has spread will also be restricted. Long-term care facilities will be required to actively screen employees and vendors.


In place of social visits, senior living operators will be advising loved ones to deploy technology and helping find "alternative ways for family members to stay in touch” with residents, Parkinson said.

Association officials hastened to say they were not imposing a complete ban. But they cited guidance issued by the CDC late Monday noting the heightened risk to older adults with chronic medical conditions such as heart disease, diabetes, and lung disease. It urges them to stock up on supplies, avoid contact with anyone who is sick, and stay home as much as possible to reduce the risk.

Tim Brown, marketing and communications director at Athena Health Care Systems, said it’s already greatly limited visits to its 20 nursing homes and assisted living facilities in Massachusetts, stretching from the Boston area to Cape Cod and the Berkshires. Brown said most contractors are being restricted to designated delivery areas.

Family members who are feeling sick have been asked not to visit residents, he said. If they insist, the residences require they and the residents wear protective masks, gowns, and gloves during the visit.

Brown said he’s not surprised by the new policy of the national trade associations and expects the restrictions to become more stringent. Public health officials in Connecticut, where Athena is based, have already required long-term care facilities to restrict all social visits, he said. The company is awaiting similar official guidance from health officials in Massachusetts and Rhode Island, where it also operates long-term care centers, he said.


One exception to the no-visits policy, he said, is that family members who want to visit their loved ones at the end of life are still permitted entry.

Operators said most residents and their families appreciate the vigilance despite the inconvenience, recognizing the threat posed by coronavirus.

"We have canceled all activities coming in from the outside,” said Debbie Meade, board chair at the health care association and chief executive of Health Management, a Georgia company that runs skilled nursing and assisted living properties. But she said, staff will run more bingo games for residents.

Meade said her long-term care facilities have been calling and sending letters to family members explaining the need for the new policy. Almost everyone supports the restrictions, she said.

"My parents have told me not to visit them,” said Dr. David Gifford, chief medical officer for the associations, saying long-term care residents are bowing gracefully to the new reality. "So this is how we operationalize this going forward.”

Robert Weisman can be reached at