Nursing homes were directed to prohibit all visitors to its facilities and cease all communal dining under federal guidance issued March 13. The directive aimed to stem the spread of the novel coronavirus, which is 10 times more deadly than the common flu.

The guidance expanded on a less stringent yet unprecedented recommendation to limit visits earlier that week. The tougher measure received instant support from providers, even though it meant further stressing already stretched staffs.

The Centers for Medicare & Medicaid Services declared that providers should restrict visits to only essential healthcare personnel, with the only exceptions being for compassionate care situations such as end-of-life. Healthcare workers and surveyors were exceptions to the restrictions, provided they pass a health screening each time they entered a facility.