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

Updated 9/2/2021

Need help? Call us!

The Vermont Long-Term Care Ombudsman Project promotes the rights of people getting long-term care services. If you have questions or concerns, contact us. Long-Term Care Ombudsmen are working and available by phone during the COVID-19 crisis. Call us at 1-800-889-2047 or fill out our online form.

Due to the COVID-19 coronavirus, the State of Vermont 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.

On June 29, 2021, the Vermont Department of Disabilities, Aging and Independent Living (DAIL) put out updated guidance to long-term care facilities. The new guidance can be found here on the DAIL website.

The effective date of the revised guidance is July 2, 2021.

Below we highlight parts of the current guidance and restrictions. 

1. ARE VISITORS REQUIRED TO TESTED OR VACCINATED FOR COVID-19 (OR SHOW PROOF OF TESTING OR VACCINATION) AS A CONDITION VISITATION?

No. Visitors not required to be tested or vaccinated (or show proof of such) as a condition of visitation.

2. ARE LONG-TERM FACILITIES REQUIRED TO SCHEDULE VISITS IN ADVANCE AND LIMIT THE DURATION OF VISITS?

No. Scheduling visits in advance and limiting the duration of visits is not required by the guidance.

NOTE: Facilities may consider scheduling visits in advance, and/or limiting the duration of visits, if doing so is necessary to help ensure all residents are able to receive visitors.

3. WHEN I VISIT A LONG-TERM CARE FACILITY WILL VISITATION BE OUTDOORS OR INDOORS?

Visitation may be outdoors or indoors.

The state’s guidance states the following:

  • “Outdoor visits pose a lower risk of transmission due to increased space and airflow. Therefore, visits should be held outdoors whenever practical even when the resident and visitor are fully vaccinated against COVID-19. Facilities should create accessible and safe outdoor spaces for visitation, such as in courtyards, patios, or parking lots.”
  • “When outdoor visits are not feasible, facilities should allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission. (Note: Compassionate care visits should be permitted at all times.) These scenarios include limiting indoor visitation for:
    • Unvaccinated residents, if the facility’s COVID-19 county positivity rate is greater than 10% and less than 70% of the residents in the facility are fully vaccinated.”

4. WHAT CAN I EXPECT AS A VISITOR OF A LONG-TERM CARE FACILITY?

  • Long-term care facilities must screen visitors for symptoms of COVID-19 before any visitation with staff or residents. Person with symptoms must be excluded from visitation.
  • Visitors must follow the core principles of COVID19 infection prevention (including face coverings/masks).
  • Long-term care facilities may require that physical distancing be maintained at all times.
  • Staff may end visits if visitors demonstrate an unwillingness or inability to comply with the core principles of COVID19 infection prevention.
  • Long-term care facilities may document and track visits (including keeping a log of times and dates of all visitors with their contact information).
  • Unvaccinated residents will be encouraged to wear facemasks or cloth face coverings during visits if they can tolerate them.

5. WHEN IS PHYSICAL TOUCH ALLOWED DURING A VISIT?

  • If a resident of a long-term care facility is fully vaccinated, the resident can choose to have close contact (including touch) with their visitor in accordance with the CDC’s Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.
    • If both the resident and visitor are fully vaccinated, they may choose to forego source control (which means masks and/or faceshields).
    • A fully vaccinated resident may choose to have close contact, including touch, with their unvaccinated visitor(s), however it is recommended both resident and visitor wear well-fitting source control (which means masks and/or faceshields).
  • For unvaccinated residents receiving visitors, CDC continues to recommend physical distancing and wearing well-fitting source control (which means masks and/or faceshields).
  • When the resident is not able to communicate their choice, a facility can decide (on a case-by-case basis) when physical touch is allowable. In making the decision, a facility must take a resident-centered approach and consult with the resident’s legal responsible party.

6. WHO IS CONSIDERED FULLY VACCINATED?

  • “Fully vaccinated” = means greater than, or equal to, two weeks following administration of the second dose in a two-dose series, or greater than or equal to two weeks following administration of one dose of a single-dose vaccine.
  • “Unvaccinated” = refers to a person who does not fit the definition of “fully vaccinated,” including people whose vaccination status is not known.

7. WHAT HAPPENS WITH INDOOR VISITATION DURING A NEW COVID-19 OUTBREAK (I.E., A NEW COVID-19 CASE IS IDENTIFIED FOR A RESIDENT OR STAFF)?

The facility should immediately begin outbreak testing AND suspend all visitation (except compassionate care visits and end-of-life visits) UNTIL at least one round of facility wide testing has been completed. Decisions on resuming visitation will be made in consultation with the Vermont Department of Health and based on Centers for Medicare and Medicaid (CMS) guidance.

8. WHAT HAPPENS WHEN STAFF REFUSES TO PARTICIPATE IN COVID-19 TESTING?

Facilities must have procedures in place for staff who refuse testing.

According to the guidance:

  • Facilities should ensure that staff who have signs or symptoms of COVID-19 and refuse testing are not allowed to enter the building until the return-to-work criteria are met.
  • When outbreak testing has been triggered and a staff member refuses testing, the staff member should be restricted from the building until the procedures for outbreak testing have been completed.

9. WHAT ABOUT WHEN A RESIDENT REFUSES TO PARTICIPATE IN COVID-19 TESTING?

  • Residents (or resident representatives) may exercise their right to decline COVID-19 testing.
  • Facilities must have procedures in place for residents who refuse testing.

10. SHOULD GROUP ACTIVITIES AND COMMUNAL DINING BE HAPPENING AT LONG-TERM CARE FACILITIES?

Communal activities and dining should be taking place (while following the core principles of COVID-19 infection prevention) for all residents except those not in quarantine, or in isolation with suspected or confirmed COVID-19 status. In addition, group activities should be taking place.

NOTE: Long-term care facilities can follow additional guidance from the Centers for Disease Control (CDC) based on the vaccination status of residents.

11. IS A COVID-19 VACCINATION OR NEGATIVE COVID-19 TEST REQUIRED FOR NEW ADMISSIONS?

No.

  • A new resident is not required to be vaccinated for COVID-19 prior to admission to a long-term care facility. 
  • A new resident is not required to have a negative COVID-19 test prior to admission to a long-term care facility.

NOTE: There are quarantine recommendations for new admissions.

12. WHEN IS QUARANTINE RECOMMENDED?

  • New facility admissions to a long-term care facility are generally recommended for 14-day quarantine by the Centers for Disease Control (CDC) with exceptions. The exceptions are:
    • The new admission is fully vaccinated.
    • The new admission is within 90 days of a PCR confirmed infection of the virus that causes COVID-19 (SARS-CoV-2)
    • The facility is in an area with minimal to no community transmission and elects a utilization of a risk-based approach for determining whether the resident requires quarantine upon admission.
  • Fully vaccinated residents who meet the definition of close contact exposure to a known case of the virus that causes COVID-19 (SARS-CoV-2) are still recommended for quarantine, with an option to test out on or after day seven (7).
    • Quarantined residents should not participate in communal dining, group activities, or non-medically essential services like salon services for the duration of their quarantine.
    • Quarantined residents may be able to safely participate in outdoor visitation, if visitation can take place while maintaining quarantine (examples include visiting without coming in close contact with other residents or staff; outdoor visits through an entrance directly to the quarantine area; or window visits).

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

Updated: Sep 02, 2021