As concerns about the coronavirus continue to rise, the state is taking steps to try to stop outbreaks in the places where some of the most vulnerable people are — nursing homes and other residential care facilities for the elderly.

In an effort to prevent the spread of the virus, the state's secretary of health and human services, Marylou Sudders, announced new directives for nursing homes and rest homes at a press conference Tuesday.

"No visitor access for anyone who displays signs or symptoms of a respiratory infection, such as fever, cough, shortness of breath or sore throat," Sudders said.

Also, Sudders said people should be stopped at the door if they've been around anyone who's been diagnosed with a respiratory illness in the last two weeks.

"Visitor access will also be restricted to anyone who had international travel within the last 14 days and individuals who are residing in a community where community based spread of COVID-19 is occurring," she said.

With many people coming to see parents, grandparents and friends, screening every visitor to a nursing home or assisted living facility isn't an easy task. But many homes for the elderly are taking that directive seriously.

Sarah Tribuzio runs Decatur House Assisted Living in Sandwich, on the Cape, which has 23 residents.

"We've decided to up our game a bit and implement a system where visitors that are coming to Decatur House can only come through one doorway and will need to be screened before they're they can visit their loved one," Tribuzio told WGBH News.

Up until now, Tribuzio said they were just asking guests not to come if they knew they were at risk, and that they've also been taking steps to limit unnecessary visitors. And since some of their residents still drive, they're also trying to prevent them from bringing the virus back into the home.

"We've canceled outside performers," she said. “We'll be changing up our activity schedule to do more things in house. We're not going to go on outings. We're discouraging, you know, our residents to go out in public places because there's a risk for them to get sick."

Even as nursing homes, rest homes and assisted living facilities follow the advice of state health officials in an effort to reduce the risk of the virus coming in from outside, those in charge of the facilities still have a lot of questions about what would happen if the virus does get in. Some say they don't have enough supplies like face masks. And they say a conference call with state health officials yesterday didn't make it clear how the state could address those shortages.

Ronald Kowelsky, the president of the Massachusetts Association of Residential Care Homes — the trade association representing about 60 homes in the state — said state officials have promised to boost the supply of respirators.

"Given the fact that there are there is a backlog in the supply of respirators that the Commonwealth, it is my understanding that the Commonwealth is going to make available those particular supplies," Kowelsky said.

But Kowelsky said he's not sure how many respirators the state has or is getting, and how rest homes can get them, if needed. The State Executive Office of Health and Human Services did not respond to requests for comment.

If a virus does spread throughout some kind of residential care facility, it's unlikely to just hit the residents. The staff could get it, too.

Tim Foley is with the union 1199 SEIU, which represents more than 60,000 health care workers in the state, including many at nursing homes and similar facilities. "We're working diligently right now to figure out how can we ensure that nursing home workers and all health care workers have some resources made available to them so that if they're required to go in quarantine or if they feel the need to self-quarantine, that that doesn't mean they can't put food on the table or pay the rent for that month," Foley said.

But if a home really gets hit and most of the staff have to quarantine, some administrators at rest homes, including Micha Shalev, who owns both the Dodge Park and Oasis rest homes in Worcester, aren’t sure who will care for residents.

"I don't know,” Shalev said. “I mean, I don't have an answer for this. Nobody answered this."

It's just one of many questions still unanswered as residential care facilities — like everyone else — try to figure out what's coming next.