Long-Term Care, Retirement Homes, and Congregate Living Centers: Visits and Absences

The Ontario government has announced requirements for visits and absences to long-term care homes, retirement homes, and other residential care settings, indoors and outdoors, based on the COVID-19 Response Framework level of the local public health unit region in which the home is located and the facility’s outbreak status.

People planning a visit to a long-term care home are advised to contact the home in advance to make sure the home is free of outbreaks, and to get information on the home's visitor policy and any other restrictions.

For current visitation requirements, please refer directly to the Ministry of Long-Term Care, the Ministry for Seniors and Accessibility, and the Ministry of Children, Community and Social Services.

This is a summary of general requirements for visitors of long-term care homes, retirement homes, and other residential care settings. These requirements are in addition to the ones in the COVID-19 Response Framework and the Additional Public Health Measures for All Sectors.

NOTE: For a home to be able to accept visitors, they must have an established process for communicating visitor protocols and associated safety procedures; and maintain the highest infection prevention and control standards.

Types of Visitors

Restrictions for visits vary by setting and according to the type of visitors requesting to enter the facility. Please consult the COVID-19 Response Framework for current visitor restrictions.

Essential visitors

Essential visitors are defined a person performing essential support services or a person visiting a very ill or palliative resident. Essential visitors also include support workers and caregivers:

  • A support worker is a type of essential visitor who is brought into the home when there are gaps in service to perform essential support services for the home or for a resident at the home. Support workers do not include home staff. Examples of support workers include:
    • Regulated health care professionals,
    • Contract workers hired by the home, external care providers hired by the resident, or LHIN care services, including home care providers (e.g., nursing care, physiotherapy, occupational therapy, social workers, unregulated care providers)
    • Authorized third parties who accommodate the needs of a resident with a disability
    • Maintenance workers or a person delivering food
    • Private housekeepers
  • A caregiver is designated by the resident and/or their substitute decision-maker and is visiting to provide direct care to the resident (ex. supporting feeding, mobility, personal hygiene, cognitive stimulation, communication, meaningful connection, relational continuity, and assistance in decision-making).
    • A maximum of 2 caregivers may be designated per resident at a time. The designation should be made in writing to the home. Homes should have a procedure for documenting caregiver designations. The decision to designate an individual as a caregiver is entirely the remit of the resident and/or their substitute decision-maker and not the home.
    • A resident and/or their substitute decision-maker may change a designation in response to a change in the resident's care needs that is reflected in the plan of care, or the availability of a designated caregiver, either temporary (for example, illness) or permanent.
    • Examples of caregivers include family members who provide care, a privately hired caregiver, paid companions, and translators.

Non-Essential Visitors

A general/non-essential visitor is a person who is not an essential visitor and is visiting:

  • to provide non-essential services, who may or may not be hired by the home or the resident and/or their substitute decision maker
  • for social reasons (for example, family members or friends) that the resident or their substitute decision-maker assess as different from direct care, including care related to cognitive stimulation, meaningful connection, and relational continuity.

A Personal Care Service Provider is a person who is not an essential visitor and visits to provide non-essential personal services to residents such as hair dressing or nail care.

Requirements for Visits and Absences

In addition to the rules for visitors in the COVID-19 Response Framework, below are the requirements for the different types of settings and more information on safely visiting your loved ones:

Long-Term Care Homes
Retirement Homes
Congregate Living Centers

Interested visitors should also contact the home to learn about any specific requirements and/or to schedule their visit. 

Requirements for Visits to Long-Term Care Homes

Note: Retirement homes co-located with a long-term care home must adopt the policies of that long-term care home (whichever is more restrictive).

Please see the COVID-19 Response Framework for additional information on visitor restrictions according to the level in which the local public health unit is placed.

  • At any level, if a resident is self-isolating or symptomatic, or the home is in an outbreak:
    • Essential visitors are the only type of visitors allowed.
    • A maximum of 1 caregiver per resident may visit at a time
    • General visitors are not permitted
  • A caregiver may not visit any other resident or home for 14 days after visiting another resident who is self-isolating or symptomatic or another home in an outbreak.
  • The local public health unit may provide direction and/or restrictions on visitors to the home, depending on the specific situation.
  • Homes must ensure a safe environment, including managing visitations. The home’s visitor policy should include visitors regularly reading the home’s visitor policy and undergoing PPE training.

Prior to visiting any resident for the first time:

  • Caregivers must verbally attest to the home that they have read/re-read the home's visitor policy (and at least once every month thereafter).
  • The home should provide training to caregivers that addresses how to safely provide direct care, including putting on and taking off required PPE, and hand hygiene.

For every visit, visitors must:

  • Pass an active screening every time they are on the premises and attest that they are not experiencing any of the typical and atypical symptoms of COVID-19. Visitors will not be allowed to visit if they do not pass the screening.
  • For caregivers: verbally attest that, in the last 14 days, they have not visited another resident who is self-isolating or symptomatic or a home in an outbreak.
  • Follow the facility’s infection prevention and control (IPAC) protocols, including proper use of face coverings or surgical/procedural masks.
    • For outdoor visits, visitors must wear a mask (face covering). Visitors are responsible for supplying their own mask for outdoor visits.
    • For indoor visits, a surgical/procedure mask must be worn at all times.  
    • A surgical/procedure mask will be provided by the home to essential visitors and indoor visitors.
  • Maintain physical distancing at all times and practise good hand hygiene.
  • When permitted to visit, general visitors must stay in the designated visitor area (indoor/outdoor area or suite) according to the home’s visitation policy.

Refusal to follow these rules will be the basis for ending a visit or discontinuing visits for the non-compliant visitor.

Requirements for Absences From Long-Term Care Homes

In addition to the rules for absences in the COVID-19 Response Framework, long-term care home residents who wish to go outside of the home (e.g. absences for personal reasons, medical appointments, etc.) are permitted to do so if the following requirements are met:

  • The long-term care home must NOT be currently in a COVID-19 outbreak, nor located in a public health unit region under Orange (Restrict), Red (Control) or Grey (Lockdown) in the COVID-19 Response Framework.
  • The resident must pass active screening every time they re-enter the home. If a resident does not pass screening, the home will follow existing isolation policies.
  • The resident wears a medical mask while outside the home and respects physical distancing. The home supplies medical masks for absences.
  • If permitted, upon return to the LTCH from a short term (if permitted) or a medical absence (i.e., outpatient visits, single night emergency room visit), residents must be actively screened but are not required to be tested or self-isolate.
  • If permitted, a resident returning from a temporary (overnight) absence must, upon return to the home, follow 14 days of self-isolation.

Requirements for Visits to Retirement Homes

Note: Retirement homes co-located with a long-term care home must adopt the policies of that long-term care home (whichever is more restrictive).

In addition to the rules for visitors in the COVID-19 Response Framework, the following restrictions for visitors apply:

  • If the home is NOT in an outbreak and the resident is NOT self-isolating or symptomatic:
    •  Any number of Support Workers brought into the home to support IPAC or Health and Safety reasons are permitted (e.g., deep cleaning or emergency maintenance).
    • Any number of Support Workers who are care providers (e.g., regulated health care professionals or unregulated care providers) may visit a resident in a home at a time.
    • A maximum of two caregivers per resident may visit at a time.
    • Access to the home for general visitors and personal care service providers corresponds to the visitor restrictions listed in the COVID-19 Response Framework.
  • At any level, if a resident is self-isolating or symptomatic, or the home is in an outbreak:
    • General visitors and personal care service providers are not permitted to visit.
    • Only essential visitors are permitted to visit the resident/home:
      • Any number of Support Workers brought into the home to support IPAC or Health and Safety reasons are permitted.
      • Any number of Support Workers who are care providers may visit a resident in a home at a time.
      • A maximum of 1 Support Worker who is not a care provider (e.g. regulated health care professional or unregulated care provider) per resident may visit at a time
      • A maximum of 1 caregiver per resident may visit at a time. Exceptionally, if 2 caregivers live together, they may visit a resident at the same time.
  • A caregiver may not visit any other resident or home for 14 days after visiting another resident who is self-isolating or symptomatic or another home in an outbreak.
  • The local public health unit may provide direction and/or restrictions on visitors to the home, depending on the specific situation.

Homes must ensure a safe environment, including managing visitations. The home’s visitor policy should include visitors regularly reading the home’s visitor policy and undergoing PPE training.

For every visit, visitors must:

  • Pass an active screening every time they are on the premises and attest that they are not experiencing any of the typical and atypical symptoms of COVID-19. Visitors will not be allowed to visit if they do not pass the screening.
  • Visit with only the resident who was intended.
  • Follow the facility’s infection prevention and control (IPAC) protocols, including proper use of face coverings or surgical/procedural masks at all times.
    • For outdoor visits, visitors must wear a mask (face covering).  
    • For indoor visits and when providing direct care to residents, a surgical/procedure mask must be worn at all times.  
    • All visitors are responsible for bringing their own face coverings/masks/PPE, or they may be refused entry.
  • When permitted to visit, general visitors stay in the designated visitor area (indoor/outdoor area or suite) with the resident that they are visiting.
  • Maintain physical distancing at all times and practise good hand hygiene.

Refusal to follow these rules will be the basis for no longer allowing visits.

Requirements for Absences From Retirement Homes

In addition to the rules for absences in the COVID-19 Response Framework, retirement home residents who wish to go outside of the home (e.g. absences with friends or family, shopping, medical appointments, etc.) are permitted to do so if the following requirements are met:

  • The retirement home must NOT
    • be in a COVID-19 outbreak;
    • located in a public health unit region under Orange (Restrict), Red (Control) or Grey (Lockdown) in the COVID-19 Response Framework; OR 
    • been directed by the local PHU to cease all short absences.
  • The resident must pass active screening every time they re-enter the home. If a resident does not pass screening, the home will follow existing isolation policies.
  • The resident wears a mask (face covering) while outside the home and respects physical distancing. The resident is responsible for supplying a mask while they are on absences. The home may, at its discretion, opt to supply masks for absences.
  • Education on all required protocols for short absences will be provided by the home.

Requirements for Visits to Congregate Living Centers

Effective September 9, 2020, essential visitors, designated visitors, and family and friends can visit residents of congregate (group) living centres outdoors and/or indoors, dependent upon physical space and capacity to maintain appropriate physical distancing. A maximum of 2 visitors at a time per resident is permitted. In the event of an outbreak, all non-essential visits must end.

For every visit, visitors must:

  • Pass an active screening every time they are on the premises. Visitors will not be allowed to visit if they do not pass the screening.
  • Follow the facility’s infection prevention and control protocols, including respiratory etiquette, proper use of face coverings or surgical/procedural masks at all times. 
    • Visitors must wear a mask (face covering) at all times.  
    • Non-essential visitors are responsible for supplying their own mask.
  • Non-essential visitors must stay in the designated visitor area (indoor/outdoor area or suite) with the resident that they are visiting.
  • Non-essential visitors must maintain physical distancing at all times. In situations where physical distancing is not possible, both the resident and the visitor must mask and practise good hand hygiene.

Requirements for Absences From Congregate Living Centers

Effective August 28, 2020, congregate living residents who wish to go outside of the home (e.g. absences with friends or family, shopping, medical appointments, etc.) are permitted to do so if the following requirements are met. Overnight absences should be permitted if essential to residents’ health, wellness and safety, and legal rights. During an outbreak, or suspected case of COVID-19, public health will provide direction on absences.

  • The resident must pass active screening every time they re-enter the home. If a resident does not pass screening, the home will follow existing isolation policies.
  • The resident wears a mask (face covering) while outside the home, respects physical distancing, and maintains hand hygiene. The resident is responsible for supplying a mask while they are on absences. The home may, at its discretion, opt to supply masks for absences.
  • Education on all required protocols for short absences will be provided by the home.
  • A resident returning from an absence that includes an overnight stay must, upon return to the home, follow 14 days of enhanced precautions, including: 
    • Upon return, pass active screening.
    • Do not receive indoor visitors during the 14 days.
    • Monitor for symptoms.
    • Avoid using common areas; however, if a common area cannot be avoided, the resident must use a mask.
    • Limit contact with other residents.
    • Only participate in group activities if physical distancing is maintained and using a mask (face covering)
    • Wash their hands often (soap and water, or use alcohol-based hand sanitizer).
    • Adhere to respiratory etiquette.
    • Follow appropriate physical distancing guidelines.
  • Residents who are following the 14-day period of enhanced precautions may leave the home for non-overnight absences (e.g. to buy groceries or other essentials). Doing so will NOT reset the 14-day time period. However, an overnight stay during the 14-day period will reset the 14-day time period.

Additional Information

Eastern Ontatio Health Unit / Bureau de santé de l'Ontario