The Michigan health department on Wednesday issued an order allowing indoor visitation by appointment at long-term care facilities if a facility has had no new cases within 14 days and is in a county where COVID-19 prevalence falls within permissible boundaries. 

Under state guidelines, more than 30 counties would still be barred from indoor visitations because of their ranking on the MI Safe Start Map. They include Washtenaw and Kent counties, some mid-Michigan counties and most of the counties in the Upper Peninsula.

Visits would be allowed in Metro Detroit but would be required to be tested for COVID-19 beforehand under the new state rules.

A sign at the Ingham County Medical Care Facility, one of the state's nursing homes, in Okemos is pictured on Friday, June 5, 2020.

In counties where visitation is allowed starting Oct. 26, the facility allowing the visit can limit the length of visits, and must prohibit more than two visitors at a time, conduct health screenings of visitors, and log arrival and departure times as well as contact information for the visitor.

Testing would be required prior to visits at facilities in counties with a higher risk level, C or D, on the MI Safe Start Map. Indoor visitation is not allowed in areas where the risk level is assessed at E.

Macomb, Oakland and Wayne counties have a D risk assessment, so testing would be required of visitors prior to visits. 

People unwilling to wear a face covering should instead use video or telephone. 

Visitors should not make physical contact with their loved one, unless the person is dying and the visitor is wearing appropriate protective gear. 

“This is a delicate balance of trying to prevent the further spread of the virus while still allowing for family members and friends to visit their loved ones in residential care facilities,” Chief Medical Executive Dr. Joneigh Khaldun said.

The announcement from the Michigan Department of Health and Human Services updates guidelines that had previously allowed only outdoor visitations. 

With cold weather approaching, long-term care facilities are worried about the continuation of visits under the previous order. 

Health and Human Services Director Robert Gordon acknowledged the change in seasons also has ushered in a higher caseload, presenting a challenge to increase visitations safely. 

“Visitation is a substantial source of risk,” Gordon said. “This order provides a plan for visitation that mitigates risk and continues necessary protections in facilities across the state.”

The Health Care Association of Michigan called the new order “a positive step toward carefully reuniting residents with their family and friends.”

“This is an important quality of life issue for our residents as safely reintroducing in-person visits with their loved ones is essential to their mental and physical well-being,” said Melissa Samuel, president and CEO of the association.​​​

The order continues to limit communal dining and group activities. It requires notification of employees and residents within 12 hours after a COVID-positive case is confirmed in the facility. 

The indoor visits will be allowed in areas where the risk level is assessed on the MI Safe Start Map as A, B, C or D, with locations in C and D requiring the testing of visitors. 

Most nursing homes now are able to provide rapid testing. But in cases where they are not, visitors must get a test within 72 hours of the scheduled visit. 

Currently, more than 30 counties are assessed at risk level E, where visitiation would be prohibited

eleblanc@detroitnews.com