ST PAUL, Minn. — The Minnesota Department of Health (MDH) on Monday released a new set of guidelines designed to strike a balance between the physical safety of long-term care residents in the era of COVID-19, and their social and emotional well-being as the pandemic stretches on.
Long-term care and assisted living facilities have borne the brunt of the state's coronavirus fatalities, accounting for 1,250 of 1,660 total deaths. MDH has previously said they are prone to outbreaks due to the proximity of residents, their compromised physical health, and exposure from the outside world in the form of workers and visitors.
Most facilities stopped in-person visitations altogether in March in an attempt to slow the spread of COVID-19 in long-term care settings, but the policy also had a major impact on the emotional health and well-being of residents.
The guidance offered Monday by MDH, which will take effect on Aug. 29, 2020, lays out a "cautious and measured" process long-term care facilities can use to determine the most appropriate visitation policy to protect residents and staff, and whether an existing policy can safely be relaxed.
“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,” Commissioner Malcolm said. “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.”
The primary consideration laid out in MDH's new guidance policy is whether there has been an exposure in the facility from a COVID-19 case in a resident, staff or visiting service provider within the past 28 days. Among the other factors that play into the decision on whether to relax visitation policies are:
- Case incidence in the surrounding community
- The size of the care facility
- The number of staff who are working at multiple long-term care facilities
The guidance issued Monday says facilities should develop testing plans with baseline facility-wide testing, and the type of facility should play a key factor in those plans. MDH says nursing home residents are considered to be at a higher risk of contracting and dying from COVID-19, which is why they must conduct facility-wide testing. Assisted living type-facility residents are still at high risk, and so facility-wide testing is recommended.
In addition to supporting residents’ connections with family and friends, MDH says allowing safe visits can help reveal any potential maltreatment or abuse of residents. According to MDH regulators, the number of maltreatment reports coming in since March has dropped by 20% compared to a similar period from 2019 – a drop that would not be expected to have happened by coincidence during a major pandemic.
The Office of Ombudsman for Long-Term Care says it has been responding to many calls both from long-term care residents who feel hopeless and helpless while cut off from family and friends, and from family members who worry about the health and safety of their loved ones.
"Most people understand the importance of restricting visitors from an infection control perspective, but it is very distressing for residents who are lonely and isolated, sick and dying, to not have their families there," said State Long-Term Care Ombudsman Cheryl Hennen. "This visitor guidance recognizes how long-term care facilities can balance the protection of residents with their needs for family and friend connection.”
For more on the guidance policy and other subjects like testing plans for long-term and assisted living facilities, access the MDH website.