Michigan loosens testing requirements for nursing home visitors

Beth LeBlanc
The Detroit News

Michigan's nursing homes don't have to require visitors to get tested for COVID-19 prior to allowing them into the facility under changes state health officials made Wednesday to its visitation policy. 

The state still is strongly encouraging testing for indoor visitors, but has removed a mandate that nursing homes require such a test to reflect changes in guidance from the federal Centers for Medicare and Medicaid Services, which updated guidance March 10. The federal guidance also notes visitors are not required to be vaccinated to visit loved ones in nursing homes.

The new policy is a change from March 2 that required facilities in the state to use point-of-care rapid tests on indoor visitors or, when that option isn't available, to require regular testing 72 hours ahead of a visit. Testing still is recommended by the state and some individual facilities can still require them for visitors.

A sign at the Ingham County Medical Care Facility points to the "COVID entrance & exit" on Friday, June 5, 2020.

The new policy also loosens restrictions requiring appointments for visits and capping visitors at two people. Instead, federal guidance asks facilities to limit the length of each visit and restrict the number of people based on the size of the size of building.

“While we are still very much fighting this pandemic and seeing some concerning trends in new cases and hospitalizations, these new changes align with CDC guidance and support families being able to visit their loved ones in nursing facilities,” Chief Medical Executive Dr. Joneigh Khaldun said in a statement.

The policy notes that nursing homes should still require health screenings, mask usage and social distancing. There is an exception to social distancing rules for vaccinated individuals.

"... We acknowledge the toll that separation and isolation has taken," the new federal CMS guidance said. "We also acknowledge that there is no substitute for physical contact, such as the warm embrace between a resident and their loved one. Therefore, if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after."

The order still requires facilities to provide safe communal dining and group activities for residents, and give notice to employees, residents and guardians when someone tests positives. About 35% of Michigan's COVID-19 deaths have occurred among nursing home residents and employees. 

If a new case of COVID is discovered at a facility but found to be contained within a single unit, visitation may proceed in units not affected by the COVID case, according to the March 10 federal guidance. 

“Throughout the pandemic we have focused on protecting vulnerable long-term care residents from COVID-19, which has required physical separation from family and other loved ones,” Department of Health and Human Services Director Elizabeth Hertel said in a statement. “The new CMS guidance provides reasonable ways these facilities can safely facilitate in-person visitation to address the needs of residents.” 

The revised order applies to all residential care facilities, including adult foster care homes, nursing homes, assisted living locations, hospice facilities and substance use disorder locations.

The state has administered about 270,000 vaccinations for nursing home residents and staff and provided more than 1.3 million antigen tests since the start of the pandemic.

But Khaldun said Wednesday the state remains "at risk" of COVID-19 infection spikes despite increasing vaccination rates. While the state reported no new deaths Wednesday for the first time since Aug. 7, it reported its highest daily infection total in more than two months at 3,164 cases. 

Hospitalizations and case rates have been increasing for three weeks in Michigan.

“We continue to monitor the data closely and urge Michiganders to continue doing what works to slow the spread of the disease by wearing a mask, washing their hands, avoiding crowds and making a plan to get the safe and effective COVID-19 vaccine when it is their turn," Khaldun said.

On March 2, the state lifted several restrictions on nursing home visitation policies, marking the first time since early in the pandemic that nursing homes statewide could allow visitors. Visitations prior to the March 2 order were allowed depending on whether metrics indicated a given county was at low risk for the virus.

Staff Writer Craig Mauger contributed.