Based off of new guidance from the federal government, Colorado announced this week that it would completely open up indoor visitation in long-term care facilities, except when certain COVID thresholds are hit.

The newly revised order, released Monday, is the most significant shift to visitation within long-term care facilities since the pandemic began. Those facilities, populated by elderly, often chronically ill residents, have been battered by COVID, in Colorado and across the country. Visitation was long limited to outdoor visits, after it was completely barred in the early weeks of the pandemic.

Under the state’s new public health order, “facilities must allow for indoor and outdoor visitation at all times for all residents, regardless of vaccination status,” if certain parameters are met. The facilities must meet testing surveillance and outbreak requirements; ensure all staff are trained and updated on infection control; and the facility follows state protocols for visitation.

The change comes in the wake of widespread vaccination uptake within the state’s nursing homes and assisted-living facilities. That uptake — plus the state’s stabilized COVID numbers — has led to a dramatic reduction in the number of outbreaks within those facilities, as well as a drop in mortality and hospitalizations, according to state data.

If the residents are fully vaccinated, they “can choose to have close contact (including touching) with their visitor while wearing a well-fitting face mask and cleaning their hands before or after,” the state Department of Public Health and Environment said in a statement announcing the change. Visitation will also not be halted if a resident within the facility tests positive. 

The new order also doesn’t require quarantine for residents newly admitted to the facilities.

Indoor visitation can be limited if the facility’s county’s positivity rate tops 10% and if fewer than 70% of residents are fully vaccinated. Residents who are COVID positive will also have limitation visited, as will residents in quarantine, regardless of vaccination status.

“The new visitation guidelines are a milestone for our residential care facilities as we continue to move towards a new normal,” said Randy Kuykendall, the director of the health department’s Health Facilities and EMS Division, said in the state’s announcement. “The last year has been extremely difficult and this step forward has been a long time in the making. I am optimistic about this guidance, as well as the continued vaccination in our residential care facilities to ensure that residents have both physical safety and good mental health.”

Colorado’s elderly population — both those in and outside of long-term care facilities — have accounted for the vast majority of COVID deaths and a plurality of hospitalizations. They were given significant vaccine priority: The federal government spent weeks vaccinating residents and staff at those facilities, and the state focused on those Coloradans who are 70 years of age and older throughout February.

Doug Farmer, the head of the nursing home group the Colorado Health Care Association, hailed the decision.

“After a year of relative isolation, we’re beyond happy that our residents and their friends and family can have private visits with one another, and vaccinated residents can hold the hand of a loved one, or share a hug,” he said in an email. “We know that friends and family are excited to visit, and we want to make sure that they understand the need to make a reservation for a visit. That requirement is in place to insure that the number of people in the care community remains safe.”

In the Centers for Disease Control and Prevention’s updated guidance, which allowed for Colorado’s shift, federal officials wrote that facilities should consider the size of their buildings when considering how many visitors to allow at a time. They should also consider, the officials wrote, whether to schedule visitations.