COVID-19 Coronavirus and Impact on Nursing Homes, Long-Term Care Facilities and Senior Centers

Updated 6/19/2020 8:30 a.m.

Due to the COVID-19 coronavirus, the State of Vermont has placed prohibitions and restrictions on visiting nursing homes, residential care homes and assisted living residences. This is because older people are more likely to get seriously ill from the virus.  

Here’s a summary of the restrictions and prohibitions placed on visiting nursing homes, residential care homes and assisted living residences. 

New: Outdoor Visitation

1. Do the current prohibitions on indoor visits to long-term care (LTC) facilities — which took effect with the governor’s executive order on March 21, 2020 — remain in effect? 

Yes. The prohibitions on indoor visits to LTC facilities (nursing homes, residential care homes and assisted living) remain in effect. 

See our section about indoor visitation (including exceptions to the prohibition) below. Read the governor’s executive order concerning indoor visitation. 

2. What should I know about how visitation at LTC facilities has changed with Governor Scott’s announcement on June 17, 2020?  

LTC facilities (nursing homes, residential care homes and assisted living) can now offer outdoor visitation.  

3. Does a LTC facility have to offer outdoor visitation? 

No. Each LTC facility can decide whether or not to allow outdoor visitation.  

4. If a LTC facility decides to offer outdoor visitation, what must it do to help protect residents and visitors from COVID-19 (as well as to help prevent further spread of the virus)?  

Every LTC facility that chooses to allow for outdoor visitation must: 

• Develop facility specific polices about outdoor visitation.  

• Ensure that outdoor visitation polices are followed.  

• Include minimum guidelines for outdoor visitation.

• Note: A facility’s policies for outdoor visitation may be stricter than the minimum guidelines. 

• Suspend visits if a visitor is unable or unwilling to follow a facility’s policies for outdoor visitation.  

5. What are Vermont’s minimum guidelines for outdoor visitation for LTC facilities? 

A facility’s outdoor visitation policy must ensure that each of the following procedures are taken:  

• Schedule, in advance with the facility, each visit with a resident. 

• Screen every visitor for symptoms of COVID-19 immediately prior to any visitation with staff or residents of a facility.

• Note: Those with symptoms must be excluded from visitation.  

• Limit each visit to no more than two persons. 

• Allow each resident to receive scheduled visitors only once per day. 

• Document all visits (including maintaining a log of times and dates of all visitors, along with the visitor’s contact information).  

In addition to the above procedures, facilities must: 

• Adopt policies to ensure compliance with the governor’s current executive orders about out-of-state visitors to Vermont who intend to visit a resident.  

• Require that all visitors (with the exception of children 2 years old or younger) wear facemasks or cloth face coverings at all times during the visit.

• Note: The guidelines state that facilities will require that visitors provide their own facemasks to use during the visit.  

• Residents will also be encouraged to wear facemasks or cloth face coverings during visits if they can tolerate them.  

• Provide visitors with an alcohol-based hand rub/hand sanitizer prior to interaction with any staff members or residents.  

• Provide staff supervision, as needed, to ensure social distancing of at least six feet between people. Staff supervision may also be provided to ensure other infection prevention measures are maintained at all times during the visit.  

Note: Facilities will develop and provide advance notice about their facility-specific policies and procedures for safe visitation to scheduled visitors.  

6. What else should I know about a LTC facility’s policies about outdoor visitation?  

• Physical contact between visitors and residents, including the passing of items directly to the resident and vice versa, is prohibited.  

• Any gifts or items to be delivered to the resident must be handled according to a facility’s policy for receiving and sanitizing items.  

• Facilities may limit the times, dates, and lengths of stays by visitors 

• These limitations are to be based on available resources to ensure the proper care and safety of staff and residents.  

• Homes may place physical barriers or visual reminders/signage to ensure proper distancing during visits.  

• Residents under quarantine (due to being a new admission, recovering from a hospital stay, or for any other reason) should not be scheduled for visits until the quarantine period is successfully completed. 

7. Can residents visit with each other? 

• Yes. A LTC facility may develop an outdoor visitation policy specific for residents.  

• When a facility chooses to do so, up to three residents at a time may visit with each other outdoors.

• Note: A facility’s outdoor visitation policy specific to residents must follow the same minimum guidelines as for visitors.  

Read DAIL’s guidelines to LTC facilities for outdoor visitation, dated June 19, 2020. 

Note: Within the state’s guidelines on outdoor visitation is encouragement that LTC facilities (nursing homes, residential care homes, and assisted living residences) continue to explore and use creative strategies to encourage connection with families during this time of COVID-19. This includes telephone visits, video visits and calls. The goal is to combat isolation among residents and address families’ desire for communication and contact with loved ones. 

Indoor Visitation 

1. Nursing homes

Indoor visitor access is prohibited.

Exemptions to the prohibition are:

• Medically Necessary Personnel
• Visitors for residents receiving end-of-life care

2. Residential Care Homes & Assisted Living Residences

Indoor visitor access is prohibited.

Exemptions to the prohibition are:

• Two designated visitors for each resident
• Medically Necessary Personnel
• Visitors for residents receiving end-of-life care

Note: Any visitor to a nursing home, residential care home or assisted living residence will be screened using the recommendations issued by the Vermont Department of Health.

Do not go to a facility if you are sick or may have been in contact with someone with the virus. Consider using the phone or the internet to visit with a loved one.

Adult Day and Senior Centers & Food Delivery

On June 17, 2020, the State of Vermont announced that Senior Centers may begin to reopen. Senior Centers serve Vermonters over the age of 50 who are independent and can physically distance and follow infection control guidance. 

The announcement does not mean Adult Day programs can resume.  

In order to reopen, Senior Centers must follow the technical guidance provided by Vermont Department of Health and Department of Disabilities Aging and Independent Living. 

Even if they are closed, the providers may offer and provide alternative services by phone or essential in-person services to adult day participants in their own homes. You can contact the Adult Day Center in your area to ask if services are being offered. 

If they are closed, home delivered meals are an option for those who need them. Contact the local Area Agency on Aging for more information about nutrition services at 1-800-642-5119. 

COVID-19 testing and prevention in nursing homes, residential care homes or assisted living facilities

What is being done about COVID-19 in long-term care (LTC) facilities?

The Vermont Health Department (VHD) is contacting all long-term care facilities proactively to review strategies to prevent COVID-19 infection and develop plans to respond immediately if an infection is identified.

VDH also provides COVID-19 testing at admission, discharge, and for certain residents who require regular care outside of the long-term care facility.

Survey and Certification, the state agency regulating long-term facilities, is examining long-term care facilities to determine if requirements related to implementing proper infection control practices to prevent the development and transmission of COVID-19 are being followed properly.

What steps can LTC facilities take to prevent and control COVID-19?

Staff should:

• Wear personal protective equipment, such as facemasks and gloves.
• Wash their hands or use hand sanitizer before and after contact with each resident, after using medical equipment, and after taking off masks, gowns, and/or gloves.
• Place alcohol-based hand sanitizer in all resident-care areas, including both inside and outside resident rooms.
• Practice cough etiquette/hygiene.
• Stay home when sick.
• Clean residents’ hands after toileting or eating.
• Clean and disinfect medical equipment between residents and areas of the facility.

 What should the administrations of LTC facilities be doing in response to COVID-19?

• Complete a self-assessment designed to determine if the LTC facility’s infection control plan and protections are adequate to address COVID-19.
• Communicate frequently with the Vermont Department of Health and Survey and Certification to share facility conditions, obtain the most up-to-date information and resources, and ask for help as needed.
• Put a plan in place for frequent communication with residents and families about facility conditions and individual resident updates.

What can you do if you have concerns about the facility’s infection control practices or other issues?

• Talk to the director of nursing or administrator about your concerns and ask what they will do to address them.
• Contact the Vermont Long-Term Care Ombudsman program for assistance. Ombudsmen advocate for residents and can help resolve your concerns.
• File a complaint with Survey and Certification.
  • Survey and Certification is currently focusing only on complaints classified as “Immediate Jeopardy.” This means that the problem/concern has caused or could cause serious harm, injury, impairment or death. If you believe your concern rises to that level, make sure to indicate that in your complaint.
  • File a complaint even if you don’t think it is Immediate Jeopardy. The complaint will still be entered into the system. The federal government will be issuing guidance about how these complaints will be handled.

What happens if a resident or staff person at a long-term care facility tests positive for COVID-19?

• If a case of COVID-19 is identified within a long-term care facility, VHD contacts the facility to provide recommendations and infection control support. VHD also begins contact tracing to try and determine the source of the infection and how the infection may be spreading.
• When a resident or staff member tests positive for COVID-19 at a long-term care facility, testing is offered to all staff and residents at the facility. In addition to the initial test, residents and staff are re-tested at 3 days, 7 days, 10 days and 14 days after the initial test. Staff and residents may decline testing, and facilities may decline universal testing. When it comes to any symptomatic or exposed residents or staff who refuse testing, they should be treated as presumptive positive (treated as if they have the virus).

More information: The Department of Disabilities, Aging and Independent Living (DAIL) website and Vermont Health Department (VHD) website.