Long-term Care Guidance for Outings - Minnesota Dept. of Health
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Long-term Care Guidance for Outings

Download for print:
Long-term Care Guidance for Outings (PDF)
Updated 9/8/21

On this page:
Background
Information for providers
Information for families
Resources

Background

On April 27, 2021, the Centers for Medicare & Medicaid Services (CMS) revised CMS guidance QSO-20-39-NH (PDF) to incorporate positive changes resulting from COVID-19 vaccinations. That same day, the Centers for Disease Control and Prevention (CDC) also released new guidance for reducing the spread of COVID-19 in health care settings after vaccination. Refer to Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.

On April 27, 2021, the CDC published revised guidance for preventing the spread of COVID-19 in nursing homes with updated recommendations for public outings: Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes.

CDC continues to evaluate the impact of vaccination and the emergence of COVID-19 variants on recommendations to prevent or control the spread of COVID-19 in health care settings. The Minnesota Department of Health (MDH) will update this guidance as new information becomes available.

Information for providers

Effective immediately, MDH will expect long-term care providers, including nursing homes and assisted living facilities, to comply with the new CMS and CDC directives and guidance. This MDH guidance replaces previous guidance for non-medically necessary outings.

This new guidance from CMS and CDC applies to all long-term care providers, regardless of vaccination status and level of vaccination coverage in the nursing home or assisted living facility, unless otherwise noted in the Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.

Key elements of the CMS and CDC guidance documents

  • Residents are considered fully vaccinated for COVID-19 two weeks after their second dose of a vaccine that requires two doses (like Pfizer or Moderna), or two weeks after they get a single dose of a vaccine that requires one dose (like Johnson & Johnson).
  • Residents who are living in the nursing home or assisted living facility and who are currently in isolation or quarantine for COVID-19 should not leave their long-term care settings to gather with others. This applies to all residents who are living in the nursing home or assisted living facility, regardless of whether they are fully vaccinated.
  • If residents who are living in the nursing home or assisted living facility choose to leave the building to gather with others, they should watch for symptoms of COVID-19 for 14 days after they return to the nursing home or assisted living facility. This applies to all residents who are living in the nursing home or assisted living facility, regardless of whether they are fully vaccinated.

Create a plan for leaving the nursing home or assisted living facility

Residents who choose to leave the nursing home or assisted living facility should follow the recommendations for preventing or controlling the spread of COVID-19:

  • Unvaccinated residents should wear a well-fitting mask. Fully vaccinated residents should wear a mask when recommended or required.
  • Unvaccinated residents should stay 6 feet apart from other people. Fully vaccinated residents should stay 6 feet apart from unvaccinated people.
  • Whether residents are fully vaccinated or not, they should wash or sanitize their hands often (alcohol-based hand rub is preferred).

People accompanying residents (e.g., transport personnel, family members) should also be educated about these infection prevention practices, should adhere to them, and should assist the resident with adherence.

For residents going to medical appointments, regular communication between the long-term care facility and the medical facility is essential to help identify residents with potential exposures or symptoms of COVID-19 before they enter the facilities, so that proper precautions can be implemented.

In most circumstances, quarantine is not recommended for residents who leave the nursing home or assisted living facility for less than 24 hours (e.g., for medical appointments, community outings with family or friends) and do not have close contact with someone with COVID-19 infection. Close contact is defined as spending 15 minutes or more in a 24-hour period within 6 feet of someone who has COVID-19.

Facilities may consider quarantining residents who leave the nursing home or assisted living facility if, based on an assessment of risk, uncertainty exists about their adherence or the adherence of those around them to recommended infection prevention and control measures.

Residents who leave the nursing home or assisted living facility for 24 hours or longer should generally be managed as described in CDC's guidance. Refer to the "Create a plan for managing new admissions and readmissions" section below.

Residents who want to exercise their right to leave their long-term care facility should take the following steps to lower the spread of COVID-19

Residents who leave the nursing home or assisted living facility may gather indoors or outdoors with other people. All persons in the group should follow the recommendations for preventing the spread of COVID-19 found at CDC: Interim Public Health Recommendations for Fully Vaccinated People.

If the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitors, in accordance with CDC: Interim Public Health Recommendations for Fully Vaccinated People.

If a resident chooses to attend a place of worship or other group event, or to shop or eat in public establishments, the resident should follow the core principles of COVID-19 infection prevention.

MDH strongly encourages attending large group events only when the county percent positivity rate is below 5%. The positivity rate is the percentage of people who test positive for COVID-19 among all the people in the county who are tested.

Fully vaccinated residents should continue to do the following:

  • If residents living in the nursing home or assisted living facility are fully vaccinated, they should follow the recommendations for visiting friends or family in a private setting outside the nursing home, as described in CDC: Interim Public Health Recommendations for Fully Vaccinated People. If vaccination status cannot be determined, the safest practice is for all participants to follow all recommended infection prevention and control practices.
  • Comply with any current local or business-level mandates or restrictions on group size at the time of the outing.
  • Get tested if they have CDC: Symptoms of COVID-19.
  • Get tested if they have been exposed to a person with COVID-19. They should get tested three to five days after exposure, even if they do not have symptoms. They should also wear a mask indoors in public until they get a negative test result or for 14 days following exposure.
  • Follow CDC and Protect Yourself & Others: Traveling requirements and recommendations.
  • Continue to follow current guidance inside a nursing home, including staying 6 feet apart from others.

Create a plan for managing new admissions and readmissions

  • Residents with confirmed COVID-19 infection who have not met criteria for discontinuation of Transmission-Based Precautions should be placed in a designated COVID-19 care unit, if possible.
  • In general, all other new admissions and readmissions should be placed in a 14-day quarantine, even if they have a negative test upon admission.
    • Exceptions include residents within three months of a COVID-19 infection and fully vaccinated residents, as described in CDC: Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.
    • Facilities located in areas with minimal to no community transmission might elect to use a risk-based approach for determining which residents require quarantine upon admission. Decisions should be based on whether the resident had close contact with someone with COVID-19 infection while outside the nursing home or assisted living facility and if there was consistent adherence to infection prevention practices in health care settings, during transportation, or in the community prior to admission.

Information for families

Plan ahead

Take steps to lower the risk COVID-19

If you are unvaccinated:

  • Follow current CDC recommendations at How to Protect Yourself & Others.
  • Wear a well-fitting mask when you are inside places other than your home. Vaccinated people should continue to wear a mask when recommended or required. For more information on when vaccinated people should wear masks, visit CDC: When You’ve Been Fully Vaccinated.
  • Wear a well-fitting mask at outdoor events where you cannot stay at least 6 feet away from others. Visit CDC: Improve How Your Mask Protects You.
  • Stay at least 6 feet from others who live outside your household, whenever you can.

Regardless of vaccination status, wash your hands regularly and thoroughly and ask people coming into your home to do the same.

Create a safe setting

Create a safe setting for visitors

  • Before anyone enters your home, ask if they have had a fever, cough, body aches, fatigue, runny nose, or other symptoms of COVID-19. People with symptoms should stay home and away from all others. They should be tested for COVID-19 as soon as possible, regardless of vaccination status.
  • Before anyone enters your home, ask if they have recently been near someone with COVID-19. Unvaccinated people who have spent time near a person with COVID-19 should stay home and away from others. Regardless of vaccination status, people who have spent time near a person with COVID-19 should be tested for COVID-19. For more details on what to do after an exposure, refer to Close Contacts and Tracing: COVID-19.
  • Before bringing someone who is a resident of a long-term care facility into your home, get yourself and your household members tested for COVID-19.
  • Before anyone who is not fully vaccinated enters your vehicle or home, wear a mask that covers your mouth and nose completely, especially if the person is at-risk for more severe illness. If unvaccinated people are staying with you, wear a mask and ask them to do so as well.
  • Before anyone who is not fully vaccinated enters your home, set up your house so people can stay 6 feet apart from each other. Refer to Indoor Air Considerations: COVID-19.
  • For current recommendations about creating a safe space for visitors, refer to Protect Yourself & Others: COVID-19.

Contact the nursing home or assisted living facility

Nursing homes and assisted living facilities follow strict regulations and guidelines to prevent the spread of COVID-19 in their buildings. Before taking someone out of a nursing home or assisted living facility, make sure you understand the current guidelines.

Vaccination for COVID-19 is ongoing. We look forward to the day when more restrictions can be removed. At the same time, we also continue to learn more about whether people who are fully vaccinated can transmit the virus, and we continue to adjust our recommendations based on up-to-date science and CDC recommendations. Refer to CDC: Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination.

Resources

Updated Wednesday, 08-Sep-2021 10:36:13 CDT