COVID-19 Guidance: Non-Medically Necessary Outings

Posted on January 27, 2021 by Kari Everson

Long-term care organizations work tirelessly to keep residents and staff as safe as possible during the pandemic. We know congregate living settings can have significant outbreaks when COVID-19 is brought into the building. These outbreaks impact the health and lives of our residents and staff. The CDC has long-reported small family gatherings increase the number of outbreaks in long-term care settings. 

Holiday guidance published on Dec. 24, 2020 provided information on how long-term care can respond as residents left the buildings for non-medically necessary outings and then returned to the building. Since that time, there are many questions about how to respond after a non-medically necessary outing.

The Minnesota Department of Health (MDH) published Long-Term Care Guidance for non-medically necessary outings on their website on Jan. 25, 2021 relating to those who leave the building for outings other than medically necessary appointments. MDH continues to strongly recommend against families taking their loved ones from long-term care settings and bringing them to gatherings or other places. For those that decide to do so, there are criteria for determining whether quarantine upon their return. 

Residents to NOT have to quarantine after a non-medically necessary outing IF:

• The resident tested positive for COVID-19 in the past 90-days
• The resident who tested positive received a positive WITH symptoms. The test can be a RT-PCR test or an antigen test.
• The resident meets criteria to discontinue transmission-based precautions

The symptom-based criteria to discontinue transmission-based precautions continues to be:

• At least 10 days have passed since symptoms first appeared (20 for severe immune compromised residents) AND
• At least 24 hours have passed without fever without the use of fever-reducing medications, AND
• Symptoms have improved
• Residents who have tested positive for COVID-19 within 90-days SHOULD be quarantined if:
  • Severely immune compromised
  • A member of the group with which the resident visited develops COVID-19 in the 48-hours after the visit.

While symptom-based criteria continue to be the recommendation by MDH, there is a less-used and less-recommended test-based approach for resident release from isolation. Those criteria continue to be:

• Two negative molecular tests from two consecutive respiratory specimens collected more than 24 hours apart; AND
• At least 24 hours have passed without fever without the use of fever-reducing medications, AND
• Symptoms have improved

Also within the guidance is information families may find helpful, including suggestions to contact the long-term care community prior to taking a loved one out of the building and the fact that there may not be an appropriate place for the resident to quarantine upon return to the building which may necessitate the family member caring for the resident themselves for a period of time. 

If you have questions, contact Kari Everson, Director of Clinical Care / Nurse Consultant at keverson@leadingagemn.org.