Policy Update March 3rd, 2022: Based on NYS Department of Health DAL #22-26
The Department of Health (“Department”) expects all adult care facilities to immediately implement and comply with the following provisions which echo those previously issued by the Centers for Medicare and Medicaid Services (CDC) on November 12, 2021. This guidance supersedes and replaces previous Department-issued guidance and recommendations related to ACF visitation
General Visitation Guidance (DAL# 22-26 3/3/22)
Harbor View Home will:
- Document visitation refusals made in accordance with 18 NYCRR §485.14(h)
- If or when there is a confirmed positive case of communicable disease, Harbor View Home will notify the local health department (LHD) if not already involved, and follow all recommendations made by the LHD.
- CDC Core principles of COVID-19 infection prevention will be always adhered to.
- If there is a current outbreak investigation, visitors will be permitted and made fully aware of potential risks associated with visitation during an outbreak investigation and always adhere to the core principles of infection prevention. Residents and their visitors will be required to wear face masks during visits regardless of their vaccination status, and such visits should occur in the resident’s room. Harbor View will contact its LHD to discuss how to structure visitation to reduce COVID-19 transmission during an outbreak investigation.
- Visitors must maintain physical distance from other residents and facility staff.
- Visitors who have a positive viral test for COVID-19, symptoms of COVID-19 irrespective of test result, or currently meet the criteria for quarantine, will not be permitted to enter the facility.
- All who enter, except for emergency personnel responding to an emergency, must be screened for these exclusions.
- Compassionate care visitors must be always allowed.
- If a resident’s roommate is unvaccinated or immunocompromised (irrespective of vaccination status) then visits will not be permitted in the resident’s room, if possible. Instead, if the immunocompromised resident or roommate is unable to leave the room, then Harbor View enable in-room visitation while adhering to the core principles of infection prevention.
- All residents and visitors should wear face coverings or masks and physically distance, particularly if either is at increased risk for severe disease or are unvaccinated.
- Visitors should wear face masks when around other residents or healthcare personnel, regardless of vaccination status.
- While not recommended, residents who are on transmission-based precautions or quarantine can receive visitors. Such visits should occur in the resident’s room and the resident must wear a well-fitting facemask (if tolerated). Before visiting such residents, visitors must be made aware of the potential risks of visiting and the precautions necessary to visit the resident. Visitors must adhere to the core principles of infection prevention. Facilities may offer well-fitting facemasks and other forms of personal protective equipment (PPE) if available, but facilities are not required to provide PPE to visitors.
- Unvaccinated residents may choose to have physical touch based on preferences and needs. In such instances, the facility must advise the resident and their visitor of the risks of such contact prior to the visit
- Harbor View may ask a visitor about their vaccination status however, visitors are not required to be tested or vaccinated or show proof of such as a condition of visitation.
- If the visitor declines to disclose vaccination status, the visitor should always wear a face mask.
- This applies to representatives of the Office of the State Long-Term Care Ombudsman, peer bridgers, housing contractors, care managers and other similar providers (collectively, “Settlement Providers”), and protection and advocacy representatives. o If a provider referenced in the preceding paragraph is planning to visit a resident who is either on transmission-based precautions or quarantine, or an unvaccinated resident, the surveyor or provider must be made aware of the potential risks and the visit should take place within the resident’s room.
- If the resident or provider requests alternative communication in lieu of an inperson visit, the facility must facilitate such communication. This may include a phone or technology-based platform.
- All healthcare workers must be permitted to come to the building unless they are subject to a work exclusion or are symptomatic for COVID-19.
- Accordingly, nothing herein absolves the facility of its responsibility to perform regulatorily-required supervision services and to ensure that resident and family communication is ongoing. Based on residents’ needs and consistent with Harbor View staffing and physical plant, visitation can be accommodated in a variety of means including in resident rooms, dedicated visitation spaces, and outdoors (weather permitting); and should always be person-centered with consideration of the individual residents’ physical, mental, and psychosocial well-being, and support their individual quality of life.
- Visitation by State Representatives and Settlement Providers
- Consistent with 18 NYCRR §§485.14 and 485.18, Harbor View shall not restrict visitation absent reasonable cause such would directly endanger the safety of residents. Accordingly, Harbor View will facilitate in-person visitation consistent with the applicable regulations and within the parameters of this guidance. Failure to facilitate visitation without adequate cause will result in an investigation and enforcement action.
Harbor View Home remains committed to the following:
CDC Core Principles of COVID-19 Infection Prevention (Ref: QSO-20-39-NH)
- Visitors who have a positive viral test for COVID-19, symptoms of COVID-19, or currently meet the criteria for, are not permitted to enter the facility.
- Harbor View screens 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) • Resident and staff testing conducted as required at 42 CFR § 483.80(h) (see QSO20- 38-NH)
Visitors who are unable to adhere to the core principles of COVID-19 infection prevention will not be permitted to visit or will be asked to leave. Harbor View Home will document this occurrence in accordance with Title 18 of New York Codes, Rules and Regulations, §485.14(h). Refer to # 14 in this policy for additional details.
It is the policy of Harbor View Home to conduct visitation in accordance with the most recent Department of Health/ CDC guidance regarding adult care facility visitation outlined herein (3/3/22 DAL 22-26). Strategies will be updated as additional specific information becomes available and guidance changes.
Conditions for Visitation
- All visitors must be screened prior to entry into the facility (regardless of age).
- There have been no orders by local health department or NYS Department of Health to quarantine the community.
- Compassionate care and end of life visitation will be permitted when visitation is not otherwise permitted in accordance with the Department of Health’s current visitation guidance.
- Visitation Spaces:
Harbor View Home is designating the following spaces for visitation that can maintain socially distancing:
- Main dining areas
- Common sitting areas
- Outdoor areas, garden and patio as weather permits
- Private Spaces:
Harbor View clearly identifies private space(s) to be used for visitation when privacy is requested as:
- Visitation in a private room (if the resident has a private room).
- Conference rooms
- Screening/ Infection Control
- Signage is present at all entrances, hallways, by the elevators and at all exit doors providing information on infection control requirements, wearing of masks and handwashing.
- All visitors are screened for signs and symptoms of COVID-19 at the reception area.
- Screening consists of both temperature checks and asking screening question(s) to assess potential exposure to COVID-19
- Harbor View may ask a visitor about their vaccination status however, visitors are not required to be tested or vaccinated or show proof of such as a condition of visitation. If the visitor declines to disclose vaccination status, the visitor should always wear a face mask and socially distance from others.
- Harbor View Home now permits visitation in all areas of the community that are deemed safe for residents and visitors. This includes all common areas and resident rooms.
- Visits with residents who share a room are permitted with roommate permission.
- Harbor View will make every effort to enable in-room visitation while adhering to the core principles of COVID-19 infection prevention, CDC and DOH Guidance.
- Adherence to written screening protocols remain in effect for all staff during each shift, each resident daily, and all persons entering or on the grounds of Harbor View Home, including visitors, vendors, contractors, and volunteers.
- Harbor View Home policies and procedures have been updated to afford every opportunity for visits in a safe and thoughtful manner per the March 3rd, 2022, NYS DOH guidance. Harbor View Home policies also contemplate the need for adequate supervision and strict adherence to the core principles of infection prevention and control.
- Maximum Visitors. Harbor View does not limit # of visitors or length of visitation but will monitor for safety and infection control concerns.
- Children/ Minors. Harbor View Home will permit children to visit their loved ones at the community. All minors must be accompanied by an adult and must adhere to safety conditions.
- Noncompliant visitors: If Harbor View Home determines that a noncompliant visitor must end their visit or not be allowed a future visit because Harbor View reasonably believes the visitor is directly endangering the safety of any resident, Harbor View will record and maintain on-site a written statement of the incident including why visitor access was denied or cut short, the date and time and identification of the individual, and make the documentation available upon request to the resident involved and to the person denied visitor access. Additionally, this may be reported to the Department of Health.
- Adequate PPE is available at Harbor View Home to ensure residents wear a face mask, or if able.. Visitors must wear a face mask or face covering at all times when on the premises of the facility and maintain social distancing. The Harbor View Home maintains an adequate supply of masks on hand for visitors and make available to visitors who lack an acceptable face covering.
- Harbor View Home provides access to alcohol-based hand sanitizing to visitors or representatives of the long-term care ombudsman visiting residents
Updated based on the March 3rd, 2022, DAL # 22-26.