Long-Term Care Facility COVID-19 Procedures


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27.3COVID-19 Practices and Procedures

27.4COVID-19 Vaccination Monitoring and Reporting

27.5Proof of Vaccination or Testing for Visitors

Title 216 Department of Health
Chapter 40 Professional Licensing and Facility Regulation
Subchapter 10 Facilities Regulation
Part 27 Long-Term Care Facility COVID-19 Procedures
Type of Filing Adoption
Regulation Status Inactive
Effective 01/10/2022 to 05/10/2022

Regulation Authority:

R.I. Gen. Laws § 23-1-1
R.I. Gen. Laws § 23-17-10
R.I. Gen. Laws § 23-17.4-10

Purpose and Reason:

To provide COVID-19 procedures for long-term care facilities regarding testing of residents and personnel; collecting vaccination status of personnel; and provide requirements for visitors and essential caregivers to enter the facility. 

Brief statement of Reason for Finding Imminent Peril:

The Rhode Island Department of Health (RIDOH) is filing a new emergency regulation, effective upon filing with the Rhode Island Secretary of State, entitled “Long-Term Care Facility COVID-19 Procedures” (216-RICR-40-10-27), that requires long-term care facilities, specifically nursing facilities and assisted living residences, to deny entrance to any visitors, including essential caregivers, who do not provide proof of vaccination against COVID-19.  For those who are not vaccinated against COVID-19, proof of a negative polymerase chain reaction (PCR) COVID-19 test completed within the previous 72 hours or proof of a negative test result from a point-of-care rapid antigen test (e.g., Binax NOW) completed within the previous 48 hours must be provided to long-term care facility staff prior to entry.


Additionally, a visitor must keep a mask on throughout the duration of a visit with a resident.   


RIDOH anticipates that these mandatory requirements will be time-limited.  Rhode Island is experiencing a sharp increase in COVID-19 cases.  The uptick in cases may be driven by the speed at which the new Omicron variant is spreading.  Omicron arrived in the United States around Thanksgiving and during the week of December 12 – December 18, 2021,  Omicron accounted for 73 percent of all new infections, according to the Centers for Disease Control and Prevention.[1]

Rhode Island is in a period of high COVID-19 transmission. As of December 23, 2021, there were 728.5 new cases per 100,000 persons in the last seven days in Rhode Island, with a test positivity rate of 6.1 percent.  Of approximately 1.1 million residents, 794,940 (72%) are fully vaccinated against COVID-19. [2]


According to a report from the United Kingdom (UK), which may be predictive for the United States, Omicron cases were multiplying at a pace of 35 percent per day.[3]  “There are legitimate concerns about the trajectory of the newest variant, Omicron, and public health experts are paying close attention to the exponentially mounting cases, particularly in the United Kingdom, which in the past has functioned a canary in the Covid-19 coal mine for the U.S.”[4]   


The relationship between case fatality rates and the Omicron variant is still emerging:   “With Omicron, however, we not only don’t see the rise in death rates that were associated with the first waves, but we actually see a continuing decline in death rates, despite a radical increase in cases. Whether or not this breakdown of the relationship between Omicron cases and deaths will play out in other countries, like the U.S., is hard to say,” according to STAT NEWS reporter Duane Schulthess. [5] 


It is important to point out that earlier in the pandemic (2020), Kaiser Family Foundation reported that  Rhode Island was one of two states that had the highest percentage (78%) of long-term care deaths as a share of total state deaths.[6]   COVID-19’s impact on the vulnerable long-term care population has been dramatic and disproportionate to the general population.  RIDOH’s goal is to mitigate COVID’s effects on this population by requiring long-term care facilities to screen visitors for proof of COVID-19 vaccination and to have visitors mask up while in the facility.


The COVID-19 pandemic continues to have a profoundly disruptive effect on the lives of Rhode Island’s nursing home and assisted living residents and their families, particularly as the second year of the pandemic draws to a close.  

These emergency regulations are intended to protect nursing home and assisted living residents’ lives; maintain safety in Rhode Island long-term care facilities; and avoid imminent peril during this challenging time by requiring proof of vaccination against COVID-19 and mask-wearing throughout the duration of a visit with a long-term care resident.


[1] See:  Centers for Disease Control & Prevention, COVID Data Tracker, “United States at a Glance - NOWCAST”,  Available online at: CDC COVID Data Tracker Accessed December 23, 2021.

[2] See:  Rhode Island Department of Health, COVID-19 Data Tracker, Available here: RI Department of Health COVID-19 Response Data Hub (arcgis.com)  Accessed December 23, 2021.

[3] See: UK Health Security Agency,  SARS-CoV-2 variants of concern and variants under investigation (publishing.service.gov.uk), Technical Briefing #31, December 10, 2021.

[4] See: Schulthess, Duane, “An Omicron oddity:  The number of cases doesn’t predict the number of deaths.”  STAT NEWS, December 22, 2021 and available here: An Omicron oddity: unlinking case rates and death rates - STAT (statnews.com) Accessed December 23, 2021.

[5] Ibid at page 3.

[6] See:  Kaiser Family Foundation, State Data and Policy Actions to Address Coronavirus, November 2020.  Available online at:  https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/