With guidance from Kansas and Missouri in hand, PMMA (Presbyterian Manors of Mid-America) is finalizing plans for reopening its 16 senior living communities to visitors in the coming weeks. In the meantime, the organization will continue to restrict visitors to the 16 PMMA communities per the guidance provided by the Centers for Medicare and Medicaid Services (CMS) on March 13, 2020.

“As Kansas and Missouri reopen their states, there is one thing that remains constant – COVID-19 is still a significant part of our lives—especially for our senior population’s health,” said Bruce Shogren, PMMA president and CEO.

On May 18, 2020, the Centers for Medicare and Medicaid Services (CMS) issued a memorandum entitled “Nursing Home Reopening Recommendations for State and Local Officials.” In the memorandum, CMS passed the formulation of reopening plans onto state and local officials, but they also provided “recommendations” on limiting the COVID-19 exposure in nursing homes to those state and local officials.

The Kansas Department of Aging and Disability Services (KDADS) issued Kansas’ guidance on reopening requirements for both nursing homes (June 12, 2020) and adult care homes (June 17, 2020). The guidance requires nursing homes and adult care homes, including assisted living, to develop a phased plan for reopening that includes a plan for testing residents and employees, grouping residents by COVID-19 status, reporting COVID testing results to required local state and federal entities, and consulting with the local health officer to determine reopening timelines. The guidance aligns with the CMS recommendations for reopening issued May 18, 2020.

Missouri’s Department of Health and Senior Services (DHSS) issued guidance June 15, 2020, on visitation, communal dining and group activities for nursing homes, residential care facilities and adult care homes. Testing requirements for Missouri have not yet been announced.

“We are acutely aware of the need of residents and family members to be able to re-unite,” Shogren said.

Each community reopening timeline will depend on the local health department, the number of COVID-19 cases both at the campus and in the greater community surrounding the PMMA campus. Nursing centers will be among the last to reopen within the greater community to ensure the safety of residents. As our communities move through the phases of reopening, visitation will be among the last restrictions lifted as part of phase 3 of the reopening plans.


Limited access means all visits to the community must be rescheduled except in case of end-of-life situations. Families should communicate with their loved one via telephone, email or other electronic methods. PMMA’s IT department and community staff are working to establish electronic communications options such as Skype or FaceTime. Contact your community for information.

In addition, CMS has recommended temporarily stopping group activities and communal meal service and limiting communities to essential staff only. All residents are encouraged to practice social distance – or remaining 6-feet apart at all times for infection prevention.

Employees are screened at the beginning of each shift at the point of entry to the community building and before employees have any direct contact with residents. These screening measures include taking staff temperatures and asking a set of questions about travel, health status, COVID-19 exposure risks and reviews a list of possible COVID-19 symptoms. Employees who have a fever or report feeling unwell are not allowed to work and are asked to get tested for COVID-19 if they have symptoms of the disease. These measures have been in place since March 13 and continue to be updated as guidance changes. In addition, staff members should continue to wear masks per Centers for Disease Control and Prevention (CDC) recommendations.


With PMMA President and CEO Bruce Shogren's memo dated June 19, 2020, PMMA is lifting the restrictions on direct delivery of resident care packages and flowers and the 3-day quarantine restriction on packages delivered through official carriers such as USPS, UPS, FedEx and DHL. Local PMMA communities will be contacting families with their own specific processes for delivering packages and the start date for accepting packages.


If your visit is not absolutely necessary due to end of life, reschedule your visit to the community.

If your visit meets this exception, you should:

  • Expect to answer a questionnaire about your recent travel, health status and exposure risk.
  • Have your temperature taken.
  • Wash hands with soap and warm water for 20 seconds, rubbing palms together, cleaning between fingers and the backs of hands.
  • Utilize hand sanitation stations prior to entering and upon leaving resident rooms.
  • Limit movement within the community to your resident’s room or your contact’s office
  • Limit physical contact with the resident – no hugging, kissing or hand-shaking – and remain 6 feet apart
  • Report to the community any signs or symptoms of COVID-19 or acute illness within 14 days after visiting the community

Personal protective equipment (PPE), which includes gloves, masks and gowns, are available as necessary.