The government on Friday instructed nursing homes to open their doors to tourists, relaxing many remaining pandemic restrictions, while urging residents, families and facility staff to stay vigilant in case of an outbreak.

New guidelines from the Centers for Medicare and Medicaid Services instruct nursing homes to allow all residents to see a doctor at any time. Facilities will no longer be able to limit the frequency and length of visits, or need to be arranged in advance. Although large numbers of visitors are discouraged, nursing homes are not allowed to limit the number of relatives and friends that can visit residents.

Many states and communities are still struggling to cope with the surge in COVID-19 driven by radical delta variants, but the latest government data shows that cases among residents and staff continue to decline after rising early in the summer and autumn season.

Nationwide, the average vaccination rate for nursing home residents is 86% and staff is 74%, although this may vary by state and facility. Many nursing homes are scrambling to provide booster injections for their residents. The government recently required staff to be vaccinated.

Jodi Eyigor, director of quality and policy for nursing homes at LeadingAge, an industry group that represents non-profit organizations, said this “brings us the closest we ever have to pre-pandemic visits.”

Eyigor added: “But this does not mean that the pandemic is over and the COVID is not spreading.” “The nursing home, residents and their loved ones must all work together to ensure visits and safe conduct.”

Federal guidelines draw a line on the visits of people who have tested positive for COVID or meet quarantine standards. Nursing homes should not allow visitors who are COVID-positive to enter.

However, residents can still be interviewed if their facilities are undergoing an epidemic investigation, or if they themselves are under special precautions to prevent the spread of COVID. In this case, residents and visitors must wear masks and protective equipment.

It was unclear on Friday how the new federal guidelines will be used in conjunction with potentially more restrictive local and state requirements.

People in long-term care facilities have paid a heavy price for the pandemic. They make up about 1% of the U.S. population, but about 3 out of every 10 people. The mandatory quarantine has exacerbated the devastation of COVID. The nursing home was blocked in March last year, and residents could not see their relatives until early this spring.