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Hospice NewsVisitation resumes amid COVID in Michigan nursing homes — with limits | #hospice | #elderly | #seniors

Visitation resumes amid COVID in Michigan nursing homes — with limits | #hospice | #elderly | #seniors


Under the order signed by Elizabeth Hertel, director of the Michigan Department of Health and Human Services, the level of COVID risk in a given county — outlined on the MiStart dashboard — is stripped from the state’s formula for determining whether a facility reopens. 

Now, visitation is allowed in all counties as long as nursing homes and a range of care facilities have not had a new COVID-19 case in the prior 14 days.

The order also: 

  • Encourages — but does not require — communal dining and group activities for residents.
  • Requires visitors 13 years and older to be tested for COVID before visiting. Facilities should provide rapid testing “whenever possible.” When such testing is not available, the visitor must find an alternative test within 72 hours of the visit, and provide proof of a negative result before they enter the facility.
  • Requires visitors to wear face masks or other personal protective equipment in nearly all circumstances. 
  • Requires visitors to maintain a social distance of at least six feet in all but the most extreme circumstances, such as end-of-life visits.

The order, effective immediately, opens up visitations to long-term care facilities — nursing homes, adult foster care homes, homes for the aged, substance use disorder residential programs, and hospice care.

Many have banned indoor visitation altogether since March 14, first under an executive order signed by Gov. Gretchen Whitmer and later under orders, extended and tweaked, by the MDHHS after Whitmer lost some of her emergency powers.

While those state orders had prohibited indoor visitation based on the risk level assigned on the state’s MiStart map, even nursing homes in counties  with safer risk levels have sometimes continued to keep their doors locked, multiple advocates and family members have told Bridge. 

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Nursing homes have said they are not only at the mercy of MiStart map levels but also could only open after being been COVID-free for 14 days. They also said they have faced confusing layers of guidance and requirements from the state and the U.S. Centers for Medicare and Medicaid Services.

For example, the state has allowed visitation since April for residents “in serious or critical condition or in hospice care,” but even that has not always happened.

“Providers weren’t clear in probably —  in some cases still aren’t clear — what ‘end-of-life’ visits really mean. Some interpreted that to mean that residents had to be actively dying,” David Gehm, president of Wellspring Lutheran Services, which operates several facilities around Michigan, told lawmakers last week during a Michigan House Oversight Committee.

Under the new order signed Tuesday, facilities “must support and accommodate” indoor visitations in nearly all circumstances.

“Due to the trends that we’re seeing, we’re taking a step forward, but a cautious one,” Hertel, the MDHHS director, said Tuesday in announcing the changes.

At the same time, Hertel and Whitmer loosened restrictions on restaurants, retail, casinos, gymnasiums and other recreational facilities. Whitmer also announced a new task force to study the return to in-person work.



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