Guidance for residential care facilities outdoor visitation

Downloadable version: English

Available languages (last updated 09/10/20): Español | Tiếng Việt | 中文 | Soomaali | العربية | नेपाली 

While COVID-19 continues to present a substantially increased risk of mortality among older adults and individuals with underlying medical conditions in the State of Colorado, isolation of individuals in nursing homes, group homes, assisted living communities, and other congregate settings impose substantial physical and mental health consequences for these residents. Social distancing and use of electronic means of communication remain strongly recommended; however, the State of Colorado, in an effort to promote the health and well-being of Colorado’s residents, will allow for visitation in facilities under the following policy guidance.

Outdoor visitation criteria

Family and friends

Residential Care Facilities may opt to allow outdoor visits under written policies and implementation plans that include all of the following restrictions and minimum requirements. 

1. Visitors

Visitors should call ahead to arrange or schedule a visit. Prior to arrival for the scheduled meeting, the visitor should be provided information on the terms of the visit through a means provided by the facility (web, email, etc.). The information must contain: 

  • Information on COVID-19 and how the spread of the virus is minimized. 

  • Instructions for self-screening along with information as to when the results of the screening would require a cancellation of the visit. 

  • Information on COVID-19 and how the spread of the virus is minimized including instructions for how to properly wear a mask

    • For the purposes of facility visitation, masks with exhalation valves cannot be worn by visitors, residents or staff members as they cannot be used as a form of preventing the spread of respiratory droplets/secretions to others. 

  • Instructions for social distancing and requirements for wearing a mask.

  • Instructions on where to arrive and wait at the facility for staff accompaniment to the designated meeting area. This information must include a notice that the visitor will be restricted from entering the building and may not leave the designated visiting area to interact with any other residents or staff. 


2.  Visitor Arrival 

The visitor must be greeted outside at a designated area by facility staff, and the staff member must: 

  • Perform temperature check and symptom screening in accordance with symptom screening guidelines. Visitors with symptoms in the previous 14 days should not be allowed to visit.

  • Collect and verify name and contact information of the visitor for the purposes of contact tracing using the COVID-19 Visitor Health Screening Form

  • Ensure the visitor has a face mask or cloth covering, and is wearing it appropriately as described here.


3. Visitation Area

As a part of the facility's existing resident outdoor area, the separate designated meeting area should be isolated. The facility should ensure that residents not participating in visits, continue to have access to separate outdoor space. 
 
The designated outdoor area must be monitored to ensure it remains separated from the facility population and from facility staff. 

The number of visitors should be determined by using the outdoor social distance calculator, which will provide the allowable number based on the square footage of the area that will be designated for outside visits. The allowable number of persons (resident, staff, and visitors) is either the calculated number or 8, whichever is smaller. Any codes, regulations, or ordinances requiring a smaller number of people must be followed. This number of maximum visitors allowed must be documented in the visitation plan.

Furniture used for external visits should be appropriately disinfected between visits.  


4. Visitation Process

The facility must: 

  • Escort the visitor to the designated outdoor visiting area and escort the visitor out of the designated visiting area at the conclusion of the visit through the same path they arrived.  

  • Not be experiencing a current COVID-19 outbreak. 

The visitor must wear a face mask or covering for the duration of the visit. All staff and the resident must wear a surgical or cloth mask unless medically contraindicated. 


5. Restrictions 

Facilities may NOT offer or allow outdoor visitation on the premises if: 

  • The resident participating in the visit has symptoms of COVID-19 or an active COVID-19 infection.

  • The resident participating in the visit is on transmission-based precautions (e.g., COVID-19 isolation, droplet or contact precautions). This includes residents on observation following admission. 

  • The facility has an active outbreak of COVID-19 which is defined as two or more probable COVID-19 cases (or one confirmed COVID-19 case and one or more probable COVID-19 cases) in residents with onset in a 14 day period.

  • The county or the city where the facility is located is under the Stay-at-Home orders related to COVID-19. 

  • Statewide restrictions are implemented due to increased cases of COVID-19. 

This guidance is for:

  • Long-term care facilities 

  • Skilled nursing facilities 

  • Nursing facilities 

  • Assisted living facilities 

  • Intermediate care facilities 

  • Group homes 

Additional resources and guidelines: 

Each facility must document their outdoor visitation policies and add them to their isolation plan. Resubmission of the isolation plan to CDPHE is not required. For nursing facilities, the medical director must sign off on the visitation plan. The facility must also document evidence of staff training regarding the visitation policy. These documents must be made available for review by public health officials (e.g., CDPHE, local public health). 


Access to outdoor visitation should not be viewed as a permanent relaxation of COVID-19 precautions. The State of Colorado continues to monitor infection rates across the state and may further relax or restrict visitation policies as the COVID-19 emergency evolves. Furthermore, nothing in the guidance should be seen as limiting visitation that is already allowed including but not limited to: essential external health care providers (e.g. Home Health, Hospice, etc.), compassionate or supportive care situations, essential vendors, LTC Ombudsman, etc.