Alabama nursing homes and assisted living facilities went into lockdown Saturday in the wake of the president declaring a national state of emergency from the COVID-19 virus.

The facilities are implementing a no-visitors regulation from the federal Centers for Medicare and Medicaid Services.

Alabama Nursing Home Association President Brandon Farmer on Saturday urged its 231-member nursing homes statewide to restrict all visitors and non-essential personnel from going inside the facilities.

His action was mirrored by the Assisted Living Association of Alabama. The same regulation applies to nursing homes and assisted living facilities. Some veterans homes in Alabama also joined in closing off the sites to visitors.

There is one exception to the federal rule: If there is an end-of-life situation, affected visitors will be limited to a specific room inside the nursing home after they are screened for fever and respiratory symptoms.

The regulation directs both facility types to cancel communal dining and group activities and actively screen residents and staff for respiratory symptoms.

These actions are imperative because nursing homes serve people who are particularly vulnerable to COVID-19, Farmer said. Older people have a much higher death rate when they contract COVID-19.

The president of the American Health Care Association, Mark Parkinson, earlier this week called the mortality rate at Seattle-area nursing homes “shocking.”

Twenty-five people associated with one nursing home being called America’s epicenter of the pandemic have died, and many of those still in the home have tested positive for the virus. Parkinson predicted that the death rate from the infected may well exceed the 15% reported in China for people aged 80 and older.

Alabama nursing homes have been practicing protective protocols similar to the new CMS guidance for several days, Farmer said. The same is true for assisted living facilities, but their association left the visitors restrictions up to individual facilities.

“We know this is a difficult time for our residents and their family members,” Farmer said, and he asked them to be understanding and cooperate.

“Protecting the health and well-being of those in our care at all times and the protection of the general public during this health-related emergency are our priority,” Farmer said.

The nursing home association represents 231 nursing homes, or 94% of those in the state. For more information, visit anha.org

The assisted living association adopted the same federal regulation and added that all facility staff be screened prior to resident contact each day. Anyone entering the facility, such as home health or hospice staff, should also be screened for fever and respiratory symptoms before being allowed into the facility.

The regulation can be found at CMS.gov.