Visitation Guidelines for Families/Healthcare Representatives
Last Updated: 04/05/2022
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.
To enhance resident quality of life by implementing visitation to combat psychological impacts of isolation from family and representatives.
Nursing Homes may conduct visitation and activities under the following revised NYSDOH guidelines, which aligns with CMS and CDC guidance.
- The facility has protocols to separate residents into cohorts of positive, negative, and unknown as well as separate staff teams to deal with COVID-positive residents and non-positive residents.
- The facility has completed the NY Forward Safety Plan and submitted a copy of the complete plan to [email protected].
- 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.
- 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. Visitors are encouraged to be vaccinated.
- 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, and questions to inquire about Covid-19 test result.
- The facility will deny entry for those with signs/symptoms or close contact with someone with COVID-19 infection in the past 14 days, regardless of vaccination status.
- Documentation of screening will be maintained in an electronic format and available upon request of the NYSDOH.
- Resident monitoring will include daily symptom checks, vital signs, and pulse oximetry.
- A copy of the facility’s formal visitation plan is posted to the facility’s public website and may be broadcasted via email or social media to provide visitors with clear guidelines for visiting and to announce if and when visitation is paused due to regulatory reasons associated with COVID-19 infection.
- 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-positive cases
- Visitors will be strongly encouraged to have a valid 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 encouraged as often as feasible, at a minimum of every third day (meaning at a minimum testing is required on day 1, 4, 7, and so on).
- Exemptions to the testing requirement includes:
- Personnel from the Office of the State LTC Ombudsman
- Compassionate caregiving visitors (e.g. visitors visiting in anticipation of the end of a resident’s life or in the instance of a significant mental, physical, or social decline or crisis of a resident)
- Emergency Medical Services (EMS) personnel
- If the visitor is unable to provide valid proof of a negative test conducted within the required timeframe, the visitor may be provided with an OTC Covid-19 Antigen test kit to test self at facility. Visitors will always be allowed to visit their loved one if they refuse testing and will be educated on infection control
- If the test results positive, the visitor will not be permitted to visit and will need to isolate in accordance with CDC/NYSDOH guidelines.
- The facility will set up testing area, as needed, to allow visitors to perform Covid-19 tests.
- Testing area will have test kits, instructions, alcohol-based hand sanitizers, and masks available
- The facility may provide at home test kits and accept a visitor photo of negative test and the visitors’ attestation of this negative test photo on Covid 19 entry screening.
- 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 facemask 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.
- The facility will make accommodations for large groups upon request
- Visitors and residents (as tolerated) are required to wear a face mask to cover the mouth and nose at all times, regardless of vaccination status, when the county’s transmission rate is substantial to high.
- Visitors must wear a well-fitting non-surgical paper mask or a mask of higher quality (e.g. surgical mask, KN95, or N95)
- If the visitor wishes, a cloth mask may be placed over the paper mask
- 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;
- Visitors who are younger than 16 years old should be accompanied by an adult 18 years of age or older.
- 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 mask 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 masks. 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)
- Visitors will be provided with the following education:
Instructions for Using OTC Covid-19 Antigen Test
- Remove the swab from the package (do not touch the tip of the swab)
- Swab right nostril x5; swab left nostril x5
- Open the large orange cap on the tube containing the solution
- Insert the swab into tube and stir at least 15 times
- Squeeze the sides of the tube to express as much liquid from the swab, then remove swab
- Close the tube using the large orange cap; place swab in garbage
- Twist open the small white cap on the tube, add 3 drops of the liquid to the Sample Port of the Test Card
- Wait 15 minutes and read results (results should not be read after 30 minutes)
- A negative result (1 line) will show a line under C. A positive result (2 lines) will show a line under C and T.
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. https://apps.health.ny.gov/pub/ctrldocs/alrtview/postings/Health_Advisory_Nursing_Home_Visitation_1-12-22_(003)_1642023748986_0.pdf.
NYSDOH Provider Association Webex Meeting ( 1/14/22)