Per revised QSO-20-39-H on 9/23/2022, in-person visitation is allowed for all residents at all times, without limit of number of visitors unless a physical space concern or limit of length of time, however centers must continue to maintain infection control practices. Risks of visitation are reduced by adhering to the core principles of COVID-19 Infection Prevention.
Core Principles of COVID-19 Infection Prevention
- Visitors who have a positive viral test for COVID-19, symptoms of COVID-19, or currently meet the criteria for quarantine should not enter the facility until they meet the criteria used for residents to discontinue transmission-based precautions (quarantine). Facilities should screen all who enter for these visitation exclusions.
- Hand hygiene (use of alcohol-based hand rub is preferred)
- Face covering or mask (covering mouth and nose) and physical distancing at least six feet between people, in accordance with CDC guidance
- Instructional signage throughout the facility and proper visitor education on COVID19 signs and symptoms, infection control precautions, other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene)
- Cleaning and disinfecting high-frequency touched surfaces in the facility often, and designated visitation areas after each visit
- Appropriate staff use of Personal Protective Equipment (PPE)
- Effective cohorting of residents (e.g., separate areas dedicated to COVID-19 care) (Unless local health department requests patients to ‘shelter in place’ due to moving COVID around the center.)
- Resident and staff testing conducted as required at 42 CFR § 483.80(h) (see QSO20-38-NH)
Other details to consider for Visitation:
- Notify the visitor of the risks associated with visitation.
- Visits should be encouraged to be in the resident’s room. If the roommate is immunocompromised, the visit should not be in the room, if possible. If not possible, close the curtain and ask that the visitor only stay on the side with the person being visited and encourage the visitor to wear a mask.
- Residents on transmission-based precautions (TBP) or on quarantine can receive visits as long as the resident wears a well-fitting facemask (if tolerated). Visitors should be aware of the risk of visiting someone who is on TBP or quarantine and wear appropriate personal protective equipment to include a well-fitting facemask.
- COVID-19 Levels of Community Transmission:
- High (Red): – residents and visitors (regardless of vaccination status) should wear a face covering or facemask and physical distance at all times. Encourage COVID-19 testing of visitors (can use rapid tests) or encourage them to be tested prior to entering the center.
- Low (Blue) to Moderate (Yellow)to Orange (Substantial): – residents and visitors do not have to wear a face covering or facemask (if they so choose) The visitors should wear a face covering or facemask if immunocompromised.
- Encourage COVID-19 vaccinations for visitors. Encourage and educate – may offer COVID- 19 vaccinations on-site for visitors.
- Center may enquire if the visitor is vaccinated with all COVID-19 vaccinations, but the visitor is not required to disclose vaccination status.
- Indoor visitation can still occur during an outbreak investigation. Visitors will be notified of the current outbreak status and potential risk. Visitors should wear a face covering or facemask during an outbreak.
- Ensure that physical distancing can be achieved during peak times of visitation.
- Ensure that close contact between resident and visitors is allowed if consensual between the two parties
- Infection Preventionist is responsible for compliance monitoring in the facility, resident/family education of infection control policies.
The following actions must be followed to allow for visitation:
- All visitors will need to pass the Center’s screening process and sign the risk waiver
- All visitors must wear a cloth face covering or face mask and perform hand hygiene with alcohol- based hand sanitizer immediately prior to the start of the visitation when county transmission level is high.
- The Center retains the right to immediately end the visit if any of the visitation guidelines are violated.
- Government officials and representatives from the State Survey Agency are exempt from signing the visitor waiver for entrance to the centers. They, however, must pass the visitor screening tool.
- Government officials and Ombudsman are to be admitted as long as they pass the screening process. There is no requirement for testing or vaccinations for these individuals.
ESSENTIAL CARE GIVERS:
- Essential Care Givers will be allowed entrance into the center to provide care and companionship to their loved one.
- Essential caregivers are typically family members or friends who were a steady presence at a loved one’s center before the pandemic, providing companionship and help with daily activities such as eating, bathing and grooming, or who commit to fulfilling that role now with the following requirements:
- COVID-19 Testing per frequency of the center, (encouraged during high COVID-19 transmission level of the county/outbreak status)
- Screening upon entrance to the center
- Waiver signed upon each entrance to the center
- Limit movement around the center to the resident’s room, restroom, and breakroom only
- Wear PPE to include face mask and eye protection based on high level of community transmission as indicated and other that may be required according to the type of isolation.