Visitation, Indoor and Outdoor, in Residential Care Facilities per MDHHS

By Jeanne E. Murphy posted 14 days ago


In the wake of Michigan Supreme Court’s opinion in Midwest Inst of Health, PLLC v Governor of Michigan (In re Certified Questions from the United States Dist Court)No 161492, ___ Mich ___, ___ NW2d ___ (Oct 2, 2020), Governor Whitmer’s COVID-19 executive orders promulgated under the Emergency Powers of the Governor Act of 1945, including orders governing visitation in residential care facilities, may become a nullity by the end of month. On October 6, 2020, the MDHHS issued an emergency order, effective immediately and until October 30, 2020, under the Public Health Code setting out protocols for visitation to address the threat to public health caused by COVID-19. Here are the highlights of the emergency order.

Indoor visitation. The order generally prohibits visitors from entering facilities but allows the following visitors:

  • those necessary for the provision of medical care;
  • those necessary for the support of activities of daily living under certain circumstances;
  • those necessary for the exercise of power of attorney or court-appointed guardianship for an individual under the facility’s care;
  • a parent, foster parent, or guardian of an individual who is 21 years of age or under and who is under the facility’s care;
  • those visiting an individual under the facility’s care who is in serious or critical condition or in hospice care;
  • those visiting under exigent circumstances; and
  • those visiting for the performance of official government functions.

There must be a health evaluation of all individuals entering the facility which include tests for fever and other symptoms for COVID-19 as well inquiry regarding to exposure to someone with COVID-19.

Outdoor visitation. Outdoor visits may take place if (1) the facility has no new COVID-19 cases within the prior 14 days (admission of a COVID-19-positive resident is not included in this assessment) and (2) there has been no determination by the local health department that the facility is unsafe for visitation based on local epidemiological conditions.

Some additional requirements for the visits include the following:

  • The outdoor visitation area must allow for six feet of distance between people and must provide protection from weather.
  • An employee/volunteer trained in infection control must be near enough to observe and ensure compliance with patient protections.
  • Visitation must take place by appointment only, and the facility may set reasonable time limits on the visit.
  • Visitors must log arrival and departure times, provide contact information, and state in writing that they will inform the facility if they develop COVID-19 symptoms within 14 days of the visit.
  • There is a maximum of two visitors per visit.
  • Visitors must use a face covering and must follow hand hygiene requirements.
  • Visitors must use designated entrances that allow for COVID-19 screening.
  • Visitors must follow social distancing requirements and abstain from physical contact.

Note that the order provides that the visitation restrictions do not apply to medical, certain non–medical service providers, resident physicians or other clinical students and volunteers trained in infection control measures who are serving as facilitators of outdoor visits.      

Residential care facilities include homes for the aged, nursing homes, adult foster care facilities, hospice facilities, substance use disorder residential facilities, independent living facilities, and assisted living facilities.