If you were planning to visit mom or dad in the nursing home, think again.

Following guidance from the federal government and recommendations from a national industry group, nursing homes in Minnesota and across the nation on Tuesday began taking unprecedented measures to limit, discourage, and outright ban visitors from nursing homes, long-term care facilities, hospice centers and many assisted-living facilities as a result of the serious risk the spreading coronavirus poses to the elderly.

“It’s the largest sort of lockdown I’ve ever seen,” said Doug Beardsley, vice president of member services for Care Providers of Minnesota. The group represents about 160 nursing homes and hundreds of assisted living centers across the state. Beardsley noted it’s not a true lockdown — residents’ movements are not affected — but his statement underscores the seriousness of the situation.

“With what we’ve seen and what we’re learning in Seattle, our long-term care facilities are in a perfect storm,” he said, referring to the West Coast city where, as of Tuesday, five nursing homes were grappling with outbreaks.

The measures were first pressed Monday by the American Health Care Association and National Center for Assisted Living, which felt that national guidance from the CDC might not be strong enough to gird its residents against the disease COVID-19, which is proving itself to be especially lethal in such facilities.

“The mortality rate is shocking,” Mark Parkinson, president and chief executive officer of the American Health Care Association, told the New York Times. He told the paper that the death rate might well exceed the 15 percent that has been reported in China for people aged 80 and older. The challenge of the virus “is one of the most significant, if not the most significant” issues the industry has ever faced, he said.

As of Tuesday, Minnesota had reported three cases, none of which were in nursing homes. But a number of health experts said that instituting stringent restrictions across the country was wise.

The national industry groups made their case in a footnote to their recommendations, which included this statement referring to a nursing home outside Seattle that had recorded 18 deaths as of Tuesday: “Waiting until the virus starts to spread in the community has been shown in prior viral epidemics to be too late. (Note the case fatality rate in the Kirkland WA SNF was over 50% based on data available on King County Health Departments website as of 3-7-20).”

The Minnesota Department of Health on Tuesday had not itself made the recommendations, but its senior infectious disease official said the stringent guidelines “make sense.” Similarly, while the CDC didn’t itself put out the recommendations, they deferred to the nursing homes themselves, as well as the federal Centers for Medicare and Medicaid Services, which regulate some functions of the facilities. The centers issued guidance in line with what industry leaders wanted.

VISITING RULES

The new visitor guidelines, which don’t all apply to essential employees or medical workers, amount to this:

If you’re sick, don’t come.

If your community has positive cases, don’t come. The federal guidance explains that “facilities that are in counties, or counties adjacent to other counties where a COVID-19 case has occurred, should turn away visitors. With cases in Ramsey, Anoka and Carver counties in Minnesota, as well as Pierce County, Wis., that pretty much covers the entire metro.

If you’re healthy and planning a social visit, please don’t come. You’ll be “strongly discouraged,” if not outright barred from entry. Staff will relay a message or help you arrange a video chat with the resident.

Exceptions will be made for loved ones of those near death or in hospice care, or if your presence is essential for a resident’s physical or mental well-being. Those who do visit will be subject to screening, mandatory hand-washing, likely restrictions on where they can go, and possibly a requirement to wear surgical masks or other equipment.

These don’t have the force of law, and it’s up to each facility how to enforce it. But they should now be considered “best practices” for all such facilities, Beardsley said.

“This is a really uncomfortable thing for these places to do, and it can be difficult to enforce,” Beardsley said. “We certainly don’t want to create policies that might violate resident rights.”

The blessing of federal regulators was needed because the restrictions could be seen as infringing on the rights of patients’ and residents, who generally enjoy the right to receive visitors at any hour.

NOT A QUARANTINE

Important distinction: The new guidelines don’t mean residents can’t leave to visit family or friends, go shopping, or whatever.

That sort of a quarantine can generally only be mandate by an outside authority, such as a public health department, Beardsley said.

But many residents might see swift changes to their activities. Many centers are offering the option of bringing food to residents’ rooms to avoid requiring them to dine in communal spaces.

And a lot of fun activities might be on hold while the outbreak continues.

“It’s not a good time to bring in the Girl Scouts for a concert,” Beardsley said. “You might want to cancel the large gathering you were planning or that field trip to the park.”

VULNERABLE FACILITIES

COVID-19 attacks the lungs — a weak organ for many older adults, who already have an immune system that grows less limber with age.

But there are more reasons why nursing homes appear especially vulnerable.

Related Articles Study suggests sufficient vitamin D levels can lower coronavirus risk

Coronavirus Friday update: New infections top 1,000 and eight more Minnesota deaths

Group of ‘armed citizens’ confronts health workers conducting random COVID-19 testing

Minnesota’s obesity rate at 30 percent, bringing higher risk for serious COVID-19 infection

National bone-marrow registry to host virtual gala online Many nursing homes include patients traveling back and forth to hospitals, which could be prime locations to become infected. Inside the facilities, resident live in relatively close quarters.

And the facilities, while offering health care, aren’t often equipped for the type of isolation being recommend to COVID-19, such as rooms designed to suck air in and not let it out.

And COVID-19 is novel.

“No herd immunity, no vaccine and no treatment,” Dr. David Dosa, a geriatrician and expert in emergency preparedness medicine at Brown University, told the Times.

“What is going to happen in each of these cases is the virus will get in, and presuming it’s not easily stopped once it gets in, everybody in the building will get it,” he said. “Then you’ll see mortality and morbidity rates that are very significant.”