See also our COVID-19 FAQ
Safe Re-Opening and Visitation for Residents During and Post COVID-19
Policy/Procedure #: 30-1000
Effective Date: 09/03/2020
Reviewed/Revised Date: 08/25/2022
SUBJECT: Safe Re-Opening and Visitation for Residents
AREAS AFFECTED
All Departments
AREAS AFFECTED
All Departments
POLICY
- To open and allow visitation under guidelines set forth by CDC/AHCA/DOH that:
- Safely allows Essential Caregivers to visit at The Cove at Tavares Village, and
- Safely allows Compassionate Care visits at The Cove at Tavares Village, and
- Safely allows general visitation with family/friends, options of indoor and outdoor visits
POLICY INTERPRETATION AND IMPLEMENTATION
Essential Caregivers (EC)
- Provide healthcare services and/or assistance with activities of daily living to help maintain or improve the quality of care or quality of life of a facility resident
- Care or service provided by the essential caregiver is included in the plan of care or service plan for the resident
- Activities of daily living include bathing, dressing and eating
Compassionate Care Visitors (CC)
- Allowed as an exception to restricted visitation intended to provide emotional support to help a resident face a hard situation
- Examples: End of life, major upset, difficult transition or loss
The Cove does not require an essential caregiver to provide necessary care to a resident.
Essential and Compassionate Care: Facility Requirements
- Establish policies and procedures for how to designate and use an EC and allow CC visits
- Identify those who provided EC before the pandemic or have asked to provide since, consult with resident or representative for concurrence
- Allow resident to designate ECs and CCs and allow unlimited visitation
- Facility shall set a limit on the total number of visitors allowed in the facility based on the ability of staff to safely screen and monitor visitation
- Work with resident and family to designate an EC/CC if they choose
- Provide infection prevention and control training, including proper PPE use, hand hygiene and social distancing; Designate key staff to support infection control training of Caregivers
- Allow evening and weekend visits to accommodate work or childcare barriers
- Maintain visitor log for signing in and out
- Resident visits are allowed even if the resident is positive for COVID-19 or symptomatic/quarantined
- The facility may restrict or revoke if the EC/CC fails to follow infection prevention and control requirements or other COVID-19 related rules of the facility after attempts to mitigate concerns
Essential and Compassionate Caregiver Requirements
PPE
- EC/CC: Wear PPE as appropriate for the care provider; PPE for EC should be consistent with CDC guidance for health care workers
- EC/CC: Be trained on infection prevention and control, use of PPE, use of masks, hand sanitization and social distancing.
- EC/CC: Sign acknowledgment and adhere to the training
Testing and Symptoms
- EC/CC: Comply with facility-provided COVID-19 testing if offered; Facility use of testing must be based on current CDC and FDA guidance .
- EC/CC: Inform the facility if they develop a fever or symptoms consistent with COVID-19 within 10 days of a visit
While in Facility
- EC/CC: Provide care or visit in the resident’s room, or in facility-designated areas within the building (providing care is not required)
- Maintain social distance of at least 6 feet with staff and other residents – limit movement in the facility
The administrator will be designated as the person responsible for ensuring that staff adheres to the policy and procedures
General Visitation: Facility Requirements
- Indoor visitation allowed at all times and for all residents
- Sufficient staff to support management of visitors
- Adequate PPE. Facility will provide surgical face mask and face shield if necessary A cloth mask is not permitted. Gloves will be provided by the facility if needed.
- Adequate cleaning/disinfecting supplies
- Visitors may visit without an appointment; staff will monitor for adherence to proper use of PPE and social distancing if necessary.
- Notify residents, their representatives and recurring visitors of any changes in the visitation policy
- Continue with visitor screening, i.e., temperature checks and symptom/exposure screening questions
- Designated key staff to support infection control education of visitors including, PPE, use of masks, proper hand hygiene, social distancing and visitation policies
- Maintain a visitor log for signing in and out
- Visit spaces must be cleaned and disinfected between visitors and contain handwashing or sanitation stations
- Facility shall not set a limit to the number of visitors
- Facility shall not limit the length of visits, days, hours, number of visits per week
- Facility will not restrict visitation for any resident in isolation for suspected or confirmed COVID within the facility unless resident does not wish to have visitors or visitor wishes not to enter facility
- Regardless of vaccination status of resident or visitor, residents may have visitors. It is still encouraged for all parties to be fully vaccinated and to wear proper PPE if either party has not been fully vaccinated for COVID-19
- For indoor visitors, facilities can create indoor spaces for residents in a room that is not accessible by other residents, or in the resident’s private room if the resident is bedbound and for health reasons cannot leave their room
(The designated space will be the café in front lobby)
General Visitation: Outdoor Visitation
- The Cove at Tavares Village will utilize the front parking area as the designated outdoor space. Shaded areas under the trees or under large patio umbrellas may be used.
- Protection from heat and sun is essential. Cooling devices may be required to maintain safe temperatures
General Visitation: Visitor Requirements
- Infection Control: Wear necessary PPE and perform hand hygiene
- Policy Consent: Sign a consent form noting understanding of visitation policies
- Fever/ Symptom: Inform the facility if they develop a fever or symptoms consistent with COVID-19 within 10 days of a visit
- While in Facility: Visit in the resident’s room or in facility-designated areas and maintain social distance of at least 6 feet with staff and residents – limit movement in the facility
- Exception to Social Distancing: A visitor may be closer than 6 feet to the resident who they are visiting if the resident wishes to have close contact or physical contact.
- Resident may choose to have close contact with any visitor if they so desire whether either party is vaccinated or not. It is encouraged for all parties to be fully vaccinated.
Process Upon Identification of New COVID-19 Cases
While it is safer for visitors not to enter the facility during an outbreak investigation, visitors are still allowed inside the facility
- Visitors will be made aware of the potential risk of visiting during an outbreak investigation and will adhere to the core principles of infection prevention
- If residents or their representatives would like to have a visit during an outbreak investigation, they should be encouraged to wear face covering masks during visits, regardless of vaccination status, and visits should ideally occur in the resident’s room or they may choose to visit outside. If the resident is COVID +, visits must occur in resident room
Physical Distancing and Masking
Facilities should ensure that physical distancing can still be maintained during peak times of visitation (e.g., lunch time, after business hours).
- Facilities should avoid large gatherings where there may be many people in the same space at the same time.
- If the facilities county COVID-19 community level of transmission is substantial to high, all residents and visitors, regardless of vaccination status, should be encouraged to wear face coverings or masks and physically distance themselves at all times.
- If a resident’s roommate is unvaccinated or immunocompromised (regardless of vaccination status), visits should not be conducted in the resident’s room, if possible.
- If the facilities county COVID-19 community level of transmission is substantial to high, all residents and visitors, regardless of vaccination status, should be encouraged to wear face coverings or masks and physically distance themselves at all times.
- If the resident and all their visitor(s) are fully vaccinated, and the resident is not moderately or severely immunocompromised, they may choose not to wear face coverings or masks and to have physical contact. Unvaccinated residents may also choose to have physical touch based on their preferences and needs. In these situations, unvaccinated residents (or their representative) and their visitors should be advised of the risks of physical contact prior to the visit.
Transmission-Based Precautions
While not recommended, residents who are on transmission-based precautions (TBP) or quarantine can still receive visitors. In these cases, visits should occur in the resident’s room, and the resident and visitor should be encouraged to wear a well-fitting face mask (if tolerated). Before visiting residents who are on TBP or quarantine, visitors should be made aware of the potential risk of visiting and precautions necessary in order to visit the resident.
Testing of Visitors and Vaccination
Facilities are encouraged to offer COVID-19 testing to visitors in counties with substantial or high levels of community transmission. If they do not offer testing, facilities should encourage visitors to be tested on their own within two to three days prior to visiting. Facilities may ask about vaccination status, but may not require vaccination or testing or require proof of either.
Compassionate Care Visits
While always allowed, there are very few scenarios where residents should have only compassionate care visits. One example of a situation in which compassionate care visitation might be needed is when a resident is severely immunocompromised, and the number of visitors that he or she receives must be kept to a minimum.
Outings
Residents must be permitted to leave the facility. They and the person accompanying them should be reminded to follow recommended infection prevention practices. Upon their return, they should be screened for symptoms. If they report an exposure, they should be tested for COVID-19; if not fully vaccinated, they should be quarantined. They should also be monitored for signs and symptoms daily upon their return. Residents who leave for 24 hours or more should be managed as new admissions or readmissions, as recommended by the Centers for Disease Control and Prevention (CDC).
Beauty Salons and Barbers
- Beauty salons and barbers help improve resident morale and quality of life. Hair salons may resume providing services to residents with precautions in place
- Criteria for facilities to resume beauty salon and barber services:
- Barbers and hairdressers providing services must perform hand hygiene and follow the same requirements as essential caregiver visitors
- More than one resident may be in the salon at a time
- Only residents of the facility are allowed in the hair salon for services; no services can be provided to outside guests
- Services may not be provided to any resident in isolation for suspected or confirmed COVID-19
- Providers must properly clean and disinfect equipment between residenta
Resident Absence for Medical Appointments
Residents leaving the facility temporarily for medical appointments must be screened upon return to the facility.
Healthcare Provider Visits
- Healthcare providers serving residents in the facility must comply with CDC requirements for PPE, must be screened prior to entry, must comply with all infection control requirements of the CDC.
- Medical appointments should be scheduled through the facility to comply with the facility’s ability to ensure appropriate screening and adherence to infection control requirements.
Complaint Process
- For concerns regarding a health care facility in Florida, consumers, patient advocates and practitioners may file a complaint with the Agency for Health Care Administration. • Complaints can be filed anonymously
- However, please be sure to include sufficient information, such as the patient/resident name, date(s) of events, and any other specifics pertinent to the complaint, to allow proper assessment of concerns
- You may file a complaint with the Agency by calling their toll-free Complaint & Information Call Center at 1-888-419-3456, or by completing their online complaint form at: http://apps.ahca.myflorida.com/hcfc.
- Please refer to the Agency’s Consumer Complaint website for additional information at: http://ahca.myflorida.com/Contact/call_center.shtml
- The Long-Term Care Ombudsman Program is a volunteer-based advocacy organization seeking to improve long-term care facility residents’ quality of life and care. Investigates complaints made by or on behalf of residents. All investigations are confidential and provided at no charge.
- You may also file a complaint with the Long Term Care Ombudsman at 888-831-0404, http://ombudsman.myflorida.com/Complaint.php
Resources
- Video from the CDC: How to Safely Put On Personal Protective Equipment: https://youtu.be/H4jQUBAlBrI
- Video from the CDC: How to Safely Take Off Personal Protective Equipment: https://youtu.be/PQxOc13DxvQ
IF THEY PREFER, ANY RESIDENT, EMPLOYEE OR VISITOR MAY CHOOSE TO WEAR A SURGICAL MASK AT ALL TIMES WHILE INSIDE THE BUILDING.
Notice: The policies, procedures and forms here presented are intended as guidelines. It is recognized that situations can be unique. Personnel are expected to use established practice and sound judgement in making decisions in practicing safely in their daily activities.
DOWNLOAD THIS POLICY AS A PDF: Policy Template Re-opening Visitation post COVID 9-03-2022