WASHINGTON — The government on Friday directed nursing homes to open their doors wide to visitors, easing many remaining pandemic restrictions while urging residents, families and facility staff to keep their guard up against outbreaks.

The new guidance from the Centers for Medicare and Medicaid Services instructs nursing homes to allow visits at all times for all residents. Facilities will no longer be able to limit the frequency and length of visits, or require advance scheduling. Although large groups of visitors are discouraged, nursing homes won't be allowed to limit the number of loved ones and friends who can pay a call on residents.

Many states and communities are still grappling with COVID-19 surges driven by the aggressive delta variant, but the most recent government data show that cases among residents and staff have continued to decline after rising earlier in the summer and fall.

Nationally, vaccination rates average 86% for nursing home residents and 74% for staff, although that can vary dramatically from state to state and facility to facility. Many nursing homes are rushing to provide booster shots for their residents. Staffers were recently required by the government to get vaccinated.

This "gets us the closest to pre-pandemic visitation that we've ever been since the beginning of the pandemic," said Jodi Eyigor, director of nursing home quality and policy for LeadingAge, an industry group that represents nonprofit facilities.

"But it doesn't mean that the pandemic is over and that COVID is not circulating," Eyigor added. "The nursing homes, the residents and their loved ones are all going to have to work together to make sure that visits are occurring and they are occurring safely."

The federal guidance draws a line on visits by people who have tested positive for COVID or meet the criteria for quarantine. Nursing homes should not allow COVID-positive visitors to enter.

But residents can still receive visits if their facility is in the midst of an outbreak investigation or if they themselves are under special precautions to prevent COVID transmission. In such cases, residents and visitors must wear masks and protective gear.

It was unclear Friday how the new federal guidance would work with local and state requirements that may be more restrictive.

People in long-term care facilities have borne a cruel toll from the pandemic. They represent about 1% of the U.S. population, but accounted for roughly in 3 in 10 deaths. The ravages of COVID were compounded by enforced isolation. Nursing homes went on lockdown in March of last year and residents were unable to see their loved ones in person until early this spring.

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