Key takeaways
- Falls are the leading cause of injury death for adults 65 and older, and about 1 in 4 report a fall each year (CDC).
- Clear the ambulance route and main entrance first, then staff lots before every shift change.
- Dialysis rides run on fixed slots three times a week. Know the pickup times and clear those curbs.
- Michigan’s adult foster care rules require sidewalks, fire escape routes and entrances to be kept reasonably free of ice and snow.
On this page
How is senior living different from a medical office or a home?
A medical office sees patients during business hours. A senior living community has people on site around the clock: independent living residents driving to appointments and walking to the mailbox, assisted living residents with walkers, memory care residents in a secured courtyard, and staff arriving at every shift change. Ambulances come at any hour, and families visit on weekends and holidays. It also differs from an older adult living at home, where the problem is getting anyone to show up. See snow removal for seniors.
The numbers explain the stakes. The CDC reports that over 14 million adults 65 and older, about 1 in 4, report falling every year, and that falls are the leading cause of injury death in that age group.
What should be cleared first?
| Priority | Area | Timing |
|---|---|---|
| 1 | Main entrance drive, fire lanes and the route ambulance crews use | Throughout the storm |
| 2 | Entrance canopy, drop-off and its access aisle | Every visit, treated |
| 3 | Staff lot, staff entrance and the walk between them | Before each shift change |
| 4 | Accessible and visitor parking, and routes to the doors | Before visiting hours |
| 5 | Transport pickup points | Before scheduled rides |
| 6 | Walking paths, courtyards and memory care gates | Before residents go out |
| 7 | Delivery doors and the generator fuel route | Before scheduled deliveries |
The 2010 ADA Standards (209.3) call for at least one accessible passenger loading zone at an accessible entrance to state-regulated long-term care facilities where stays exceed 24 hours. Its access aisle needs the same no-stack treatment as any accessible space.
Ambulances, dialysis rides and deliveries
Ambulance crews push stretchers on small wheels that stall in slush. They need a plowed and treated path from the drive to the door they actually use, which is not always the front door.
Dialysis is the ride that cannot slip. NIDDK says in-center hemodialysis usually runs three times a week in a fixed slot, Monday, Wednesday and Friday or Tuesday, Thursday and Saturday, for about four hours each time. Give the contractor the pickup times and pickup points, never resident names, and clear those curbs first on those mornings.
Pharmacy, food and medical supply deliveries need a clear door and a path for hand trucks, timed to the delivery schedule.
Generator fuel and the back of the building
A standby generator is only as good as the fuel truck that can reach it. Keep the truck route, the fill point and the generator enclosure clear, and never pile snow against the enclosure's louvers or exhaust. Nursing homes that take Medicare or Medicaid and keep generator fuel on site must have a plan to keep emergency power running during an emergency, unless they evacuate (42 CFR 483.73). If your campus includes a skilled nursing wing, the snow plan is part of that plan.
Memory care courtyards, gates and walking paths
A secured courtyard lets memory care residents go outside safely, which only works if the paths are clear and the gates work. Clear and treat courtyard paths, keep snow from drifting against gates so they open as designed, and keep piles away from fences and walls, where a pile becomes a step. Clear the path from every fire exit to the street or parking area.
Stake curb ramps, entrance bollards, light-pole bases, benches and the edges of walking paths. Never stack snow in the drop-off aisle or accessible spaces, against the generator, against courtyard fences and gates, or across fire exit paths.
Michigan's adult foster care rules require sidewalks, fire escape routes and entrances to be kept reasonably free of hazards such as ice, snow and debris (R 400.647). Homes for the aged have a separate rule set, so ask your administrator which rules apply. This is general information, not legal advice.
Staff walk outside in every kind of weather. Ice cleats help maintenance and care staff between visits.
Zero tolerance or bare pavement?
Zero-tolerance service aims for no accumulation at all during a storm, with crews working through it. A bare-pavement standard is less demanding: lots and walks cleared and treated down to bare pavement once the snow stops. Few communities need zero tolerance on the whole site. A workable split is zero tolerance, or close to it, on the main entrance, the drop-off and the ambulance route, and a low trigger with a bare-pavement finish everywhere else, plus pre-treatment before forecast ice. Walks residents use should be treated on every visit and rechecked on mornings after a thaw.
Records and contract questions
Keep timestamped records of each visit and treatment, plus staff inspections and incident reports. See snow logs. Ask before signing:
- Are the entrance and ambulance route covered throughout storms?
- Are clear-by times set for each shift change?
- Are transport pickup points and times on the schedule?
- Are courtyards, gates and fire exits in the scope?
- Is the generator fuel route cleared before deliveries?
- Are walks treated on every visit, with refreeze checks?
Sources
- CDC: older adult falls data — about 1 in 4 adults 65 and older report a fall each year
- NIDDK: hemodialysis — in-center treatment schedule
- 42 CFR 483.73, emergency preparedness for long-term care facilities (eCFR) — emergency generator fuel
- Michigan LARA: Adult Foster Care Technical Assistance Manual — R 400.647(15): sidewalks, fire escape routes and entrances
- U.S. Department of Justice: 2010 ADA Standards for Accessible Design — 209.3, 209.4 and 503: passenger loading zones
Written by the Macomb Lawn & Snow Solutions team in Macomb Township, Michigan. We plow and salt homes and businesses across all 26 Macomb County communities, November 15 to April 15. Published October 5, 2026. About us · How we research these guides · How our dispatch works