Dear Family Member or Designated Representative,

Topic: Visitation Plan and Policy during a Pandemic

Effective Date: 7/10/2020

Revised: 9/15/2020; 9/17/2020, 10/08/2020

Policy:

In conjunction with NYSDOH memo of July 10, 2020 and our Covid-19 Management plan, the following policy will be followed for the safe return of Visitors for our Residents.

The Facility will follow all NYSDOH and CMS guidelines to ensure appropriate Infection Control and to minimize any transmission risk. This includes the latest revised guidance from NYSDOH issued September 15, 2020 and effective September 17, 2020.

Procedure:

1. Facility Criteria in conjunction with DOH mandates have been met:
   1. The Facility has entered Phase 3 in the community
   2. Absence of any new nursing home onset of COVID-19 in the nursing home as reported to the Department on the daily HERDS survey and as reported weekly to the NHSN for a period of no less than fourteen (14) days.
   3. The Facility attests that the NH is in full compliance with all State and Federal requirements, State Executive Orders and guidance, State reporting requirements; including COVID-19 Focus IC Survey, HERDS and staff testing surveys, as well as federally required submission of COVID-19 data to the National Healthcare Safety Network (NHSN).
   4. The facility has access to adequate testing. The facility has a testing plan in place that, at a minimum, ensures that all consenting residents have received a single baseline COVID-19 test. In addition, the facility has the capability to test, or can arrange for testing of, all residents upon identification of any individual with symptoms consistent with COVID-19. If a staff member tests positive for the SARS-CoV-2 virus, the facility has the capacity to continue weekly re-testing of all nursing home residents until all residents’ test negative.
   5. All of our Staff have been tested and testing continues weekly with directives for immediate furlough for any staff members who may test positive.
   6. All Staff continue to be screened for signs and symptoms of COVID virus daily.
   7. All residents will be monitored daily for temperature, oxygen saturation levels, breath sounds and COVID signs/symptoms.
2. The Facility has protocols to separate residents into cohorts of positive COVID, negative COVID, unknown COVID and new admissions/re-admissions for observation. At this time, we are COVID free. (if applicable)
3. The Facility has submitted to NYSDOH our specific Plan for visitors and have received confirmation to begin visitation.
4. All staff have been educated on this Policy, and the contents of the DOH 9/15/2020 memo for compliance and implementation.
5. All visitation shall be suspended and the NYSDOH notified immediately if there are any changes in our plan, i.e. positive case of COVID – 19 identified, or changes in mitigation.
6. A copy of the facility’s formal visitation plan is posted to their public website and 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 an increase in the number of residents and/or staff with confirmed positive COVID-19 diagnosis.

7. Current COVID-19 positive residents, residents with COVID-19 signs or symptoms, and residents in a 14-day quarantine or observation period are not eligible for visits.
8. Visitors under the age of 18 must be accompanied by an adult 18 years of age or older.
9. An executed and operationalized arrangement with laboratories to process SARS-CoV-2 virus tests. The test used should be able to detect SARS-CoV-2 virus (e.g., polymerase chain reaction (PCR) with greater than 95% sensitivity, greater than 90% specificity, with results obtained and rapidly reported to the nursing home.
10. Visiting will be allowed on a developed schedule. The current schedule will be as follows: Monday through Friday, 10:00am – 5:00pm weather permitting for outdoor visits and when applicable indoor visits.

The Following General Guidelines and Criteria will be followed:

1. All families and residents have been made aware of the revised NYSDOH September 15, 2020 guidance by phone call, email and/or public website.
2. Social Services will be responsible to arrange and set up visitor appointments and communicate with families as needed. Unannounced/unscheduled visits are not allowed.
3. Visitation will be limited to outdoor areas, weather permitting and inside in designated well ventilated areas individuals who are appropriately socially distanced and wear a facemask or face covering while in the presence of others.
4. The Facility will have designated areas for visitation where social distancing can be monitored and enforced for safety. The designated location for outdoor visits is the Front patio. The designated locations for indoor visits are the small dining room area.
5. Visitors, including long-term care ombudsman, will be screened for signs and symptoms of COVID-19 prior to resident access. Additionally, all visitors must present a verified negative test result within the last week (7 days) and visitation will be refused if the individual(s) fails to present such negative test result, exhibits any COVID-19 symptoms, or does not pass screening questions. End of life and compassionate care visits are not subjected to a verified negative test result but are subject to all other COVID – 19 screening requirements.
6. The number of visitors to the nursing home must not exceed ten percent (10%) of the resident census at any time and only two visitors will be allowed per resident at any one time.
7. The facility maintains signage regarding facemask utilization and hand hygiene, and applicable floor markings to cue social distancing delineations in all visitation areas.

1. The facility has posted at each active visitation area, an easy to read fact sheet outlining visitor expectations including appropriate hand hygiene and face coverings. The fact sheet will also be provided to all visitors upon initial screening.
2. Visitation is strictly prohibited in resident rooms or care areas with few exceptions such as situations referenced below and end of life visits. In those instances, all other requirements listed in this policy apply.

For residents who are bed bound we will continue to use alternative methods of visitation such as through videoconferencing through skype or facetime as much as possible. Limited visitation may be permitted but must adhere to the same requirements for other visitors as much as possible. Visitors must go to the patient room and not any other areas in the facility.

1. No food or drinks shall be allowed during visits.
2. Residents may be assisted to go to the designated visitation areas with staff supervision and the appropriate infection control, safety and social distancing requirements maintained.
3. If any visitor fails to adhere to the protocol, he/she/they will be prohibited from visiting for the duration of the COVID-19 state declared public health emergency.

Screening Procedures:

1. All visitors must sign in on a Visitors Log for validation, as well as sign out for validation and security.
2. Documentation of screening must be maintained onsite in electronic format:
   1. First and last name of the visitor;
   2. Physical (street) address of the visitor;

• Daytime and evening telephone number;

1. Date and time of visit; and
2. Email address, if available; and
3. A notation indicating the individual cleared the screening (both temperature and questions) that does not include any individual temperatures or other individual specific information, as well a recent COVID-19 negative result within 7 days.
4. All visitors will be educated on our safety plan and visitation policy.
5. All visitors will be required to use alcohol – based hand sanitizer after successfully completing the screening process.

Face Masks:

1. Only disposable paper masks are permitted for use. Cloth masks are not permitted.
2. An approved mask will be provided to all visitors free of charge at each visit.
3. Face masks must be worn in such a manner that the nose and mouth are fully covered.
4. Face masks must be worn and remain in place during the entire visit.

Hand Hygiene:

1. Alcohol – based hand sanitizer will be available in all designated visitation areas.
2. All visitors must perform hand hygiene with the alcohol – based hand sanitizer before and after each visit.

Physical space, distancing, and occupancy:

1. Outdoor patio area:
   1. There will be 1 visitation station set up on the patio.
   2. There are clear floor markings indicating the location the resident is to be seated at and the location the visitors are to be seated at, ensuring at least 6 feet social distancing is being maintained at all times.

• Face masks and alcohol – based hand sanitizer will be available at all times.

1. Indoor visitation area:
   1. There will be 1 visitation station set up, located in the small dining room.
   2. There are clear floor markings indicating the location the resident is to be seated at and the location the visitors are to be seated at, ensuring at least 6 feet social distancing is being maintained at all times.

• Residents and visitors will have a clear physical barrier between them.

1. Face masks and alcohol – based hand sanitizer will be available at all times.
2. Visitors will be escorted by a staff member to the designated visitation areas.
3. Visitors will not be permitted to go to any other area in the facility outside of the designated visitation area.
4. Visits will be monitored at all times by a facility staff member.
5. Physical contact (touching, hugging, kissing, etc.) is not permitted.
6. Visitors must maintain a six-foot distance from other visitors, staff and residents at all times.

Cleaning and disinfecting procedures:  

1. All visitation areas will be disinfected with an EPA approved disinfectant before and after each visit.
2. Disinfecting of visitation areas will be logged for reference.

Resumption of existing construction projects, and specifically, those projects directly impacting the lives of nursing home residents that were previously approved by the NYSDOH with submission of and approval by the Department of a revised mitigation/prevention plan outlining at a minimum, testing, screening, PPE use, distance from residents, etc.

Under no circumstance such resumption of a renovation or construction project(s) in or adjacent to a functioning and occupied dedicated COVID unit.