Visitation Guidelines for Families/Healthcare Representatives

Last Updated: 01/13/2022

POLICY STATEMENT

It is the policy of this facility to promote and support visitation for residents, families and resident representatives while ensuring safety and adherence to infection prevention strategies to minimize any potential spread of infection. This will be done in accordance with all State and Federal guidance for the prevention of COVID-19.

PURPOSE

To enhance resident quality of life by implementing visitation to combat psychological impacts of isolation from family and representatives.

NYSDOH CRITERIA (Revised 01/12/2021)

Haym Salomon may conduct limited visitation and activities under the following revised NYSDOH guidelines, which align with CMS and CDC guidelines.

  1. The facility has protocols to separate residents into cohorts of positive, negative, and unknown as well as separate staff teams to manage COVID-19 positive residents and non-positive residents.
  2. The facility has completed the NY Forward Safety Plan and submitted a copy of the complete plan to [email protected].
    1. The facility must retain a copy of the plan at the facility where it is accessible and immediately available upon request of the Department or local health department.
  3. Adherence to written screening protocols for all staff during each shift, each resident daily, and all persons entering the facility or grounds of the facility, including visitors.
  4. The facility must verify that visitors have received a negative SARS-CoV-2 test result one day prior to visitation for antigen tests and two days prior to visitation for NAAT (e.g. PCR) tests. For visitors who visit for multiple days, including a visitor who comes every day, proof of negative testing is required as often as feasible, at a minimum every third day (meaning at a minimum testing is required on day one, day 4, day 7, and so on).
  5. The facility will conduct screening of all who enter the facility for signs and symptoms of COVID-19, including temperature checks, questions about and observation for signs or symptoms.
  6. Documentation of screening will be maintained in an electronic format and available upon request of the NYSDOH.
  7. Resident monitoring will include daily symptom checks, vital signs, and pulse oximetry.
  8. A copy of the facility’s visitation plan is posted to the facility’s public website and in the lobby.

PROCEDURE:

  • The facility will expand visitation and/or activities while following Federal and NYSDOH guidance.
  • Facility visitation can be conducted through a variety of means:
    • In resident rooms
    • Dedicated visitation spaces
    • Outdoors, weather permitting, (preferred when the resident and/or visitor(s) are not fully vaccinated).
  • Visitation may occur at all times, even during outbreak investigations.
    • However, visitors are cautioned to refrain from visiting until outbreak has been contained
    • Facility will continue to notify residents, families, and/or healthcare representatives of any COVID-19 positive cases
  • In order to limit movement in the facility during visitation, the following guidelines will be followed:
  • Visitor(s) will go directly to the resident’s room or designated area.
  • If a resident shares a room, the facility will attempt to facilitate in-room visitation while adhering to the core principles of infection prevention as related to COVID-19.
  • The facility will post signage regarding face mask utilization and hand hygiene and will utilize floor markings to indicate physical distancing as applicable.
  • The facility will allow the number of visitors based on the ability to adhere to IC principles, including the ability to maintain 6 feet physical distancing between residents and visitors, as applicable.
  • All visitors must wear a well-fitting non-surgical paper mask or a mask of higher quality (i.e., surgical mask, KN95 or N95) at all times during any visitation at the facility.
    1. If the visitor wishes, a cloth mask may be placed over the paper mask. The masks must cover both the nose and the mouth.
    2. Staff must be masked at all times, regardless of vaccination or booster status, and should consider wearing N95 respirators, especially in facilities where residents are unable to consistently wear face masks.
  • In instances where there is an unvaccinated or moderately to severely immunocompromised roommate who does not wish to leave the room during the visit, all parties (residents and visitors) will be required to wear a face covering (residents = as tolerated)
  • A log will be kept for all visitors that includes:
    • First and last name of the visitor;
    • Physical (street) address of the visitor;
    • Daytime and evening telephone number;
    • Date and time of visit;
    • Email address, if available;
  • All visitors must be at least 18 years of age
  • If a resident is fully vaccinated, they may choose to have close contact (including touch) with an unvaccinated visitor while both are wearing a well-fitting face mask and performing hand hygiene before and after.
  • If both the resident and their visitor(s) are fully, vaccinated and the resident and visitor(s) are alone in the resident’s room or designated visitation area, the resident and visitor(s) may choose to have close contact (including touch) without a mask or face covering when the county’s transmission rate is low to moderate.
  • Current COVID-19 positive residents and residents on a quarantine stay will be permitted to receive visitors
    • Visitors will be provided with the following education:
      • Visiting is not recommended as it may increase the risk of visitor getting COVID
      • Visits will be limited to the resident’s room
      • A face covering to cover the nose and mouth must be worn at all times
      • Facility may require visitor to wear additional personal protective equipment to include gown, eye protection, and gloves
      • Visitor must perform hand hygiene before leaving resident’s room
    • The facility will provide and post a fact sheet outlining visitor expectations including appropriate hand hygiene and face coverings. The fact sheet will be provided upon initial screening to all visitors.
    • If any visitor fails to adhere to the visitation protocols, he/she/they will be asked to leave and may not be permitted to visit in the future (CMS QSO-20-39-NH, rev 11/12/2021)

REFERENCES:

NYSDOH (9/15/2020). Health Advisory: Skilled Nursing Facility Visitation. https://health.ny.gov/facilities/nursing/docs/2020-09-15_nursing_facility_visitation.pdf

CMS (9/17/2020). Ref: QSO-20-39-NH. Nursing Home Visitation: Covid-19. Nursing Home Visitation-COVID-19 (mo.gov)

NYSDOH (Rev 2/22/2021). Health Advisory: Skilled Nursing Facility Visitation. https://www.governor.ny.gov/sites/default/files/atoms/files/NH_Visitation_update_2-22-2021.pdf

CMS (3/10/2021). Ref: QSO-20-39-NH. Nursing Home Visitation: Covid-19 (Revised). QSO-20-39-NH Revised (cms.gov)

NYSDOH (3/25/2021). Health Advisory: Skilled Nursing Facility Visitation. https://coronavirus.health.ny.gov/system/files/documents/2021/03/updated_nursing_home_visitation_guidance.pdf

CDC (Updated 4/27/2021). Updated Healthcare Infection Prevention and Control Recommendations in Response to Covid-19 Vaccination. https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-after-vaccination.html

CMS (Rev 4/27/2021). QSO-20-39-NH: Nursing Home Visitation- Covid-19. https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf

NYSDOH (6/1/2021). Personal Caregiving and Compassionate Caregiving Visitors in Nursing Homes and Adult Care Facilities. https://regs.health.ny.gov/sites/default/files/pdf/emergency_regulations/Personal%20Caregiving%20and%20Compassionate%20Caregiving%20Visitors%20in%20Nursing%20Homes%20and%20Adult%20Care%20Facilities.pdf

NYSDOH (7/8/2021). Health Advisory: Revised Skilled Nursing Facility Visitation. https://coronavirus.health.ny.gov/system/files/documents/2021/07/nh_visitation_guidance_-7-8-2021.pdf

CMS (Rev 11/12/2021). QSO-20-39-NH: Nursing Home Visitation- Covid-19. https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf

NYSDOH (11/16/2021). DAL: Revised Nursing Home Visitation Guidelines.  https://www.health.ny.gov/professionals/nursing_home_administrator/dal/docs/dal_nh_21-27.pdf

NYSDOH (1/12/2022). Health Advisory: Nursing Home Staff and Visitation Requirements.

health-advisory-nursing-home-visitation_1-12-22.pdf (ny.gov)