Visitation Policy & Procedures

Exhibit

  1. FloridaLaw Chapter 2022-34 Committee Substitute for Senate Bill 988
  2. Resident Essential Caregiver Designation _form
  3. Essential Caregiver Acceptance Form

Purpose

In-Person Visitation bill has been signed into law, creating Chapter 408.823, which

is subject “In-person visitation.” This policy and these and procedures are intended promote resident visitation, while maintaining prudent infection control practices in an attempt to reduce the probability of transmission of COVID within the Community, in compliance with the regulations set forth in Chapter 408.823, Florida Statutes. A resident may designate a visitor who is a family member, friend, guardian, or other individual as an Essential Caregiver.

Policy

The following are the procedures to be followed relating to visitation and to identify Essential Caregivers for residents as well as the expectations of both General Visitors and Essential Caregivers. These procedures will be administered equally to all residents that request to have an Essential Caregiver, without regard to race, color, religion, sex (including gender identity and transgender status), age, national origin, disability, or veteran status.

Essential Caregiver visitors provide emotional support to help a resident deal with a difficult transition or loss, upsetting event, making major medical decisions, needs cueing to eat and drink, stops speaking, or end-of-life (“Essential Caregiver”). Essential Caregiver visitors may be allowed entry into facilities on a limited basis for these specific purposes. At a minimum, the Community must allow an Essential Caregiver in-person visitation for at least 2-hours daily under the above referenced circumstances. At Concordis communities, the 2-hour visitation will be between 9:00a.m. – 9:00p.m.

The Executive Director of the Community may make exceptions to the 2-hour visitation on a case-by-case basis for end-of-life situations. These exceptions will be discussed and agreed upon in writing by the Community’s Executive Director and the Resident and/or Resident’s responsible party in advance.

All visitors who do not meet the requirements of an Essential Caregiver shall be considered General Visitors (“General Visitors”).

Procedures:

I. For compliance with Florida Statute Chapter 408.823, designation and utilization of essential caregiver visitors and rules of visitation.

  1. The community will provide the Agency for Health Care Administration (AHCA) with a copy of the Community’s visitor policy and procedure, with the initial licensure application, renewal application and/or change of ownership
  2. The visitation policy and procedure for the Community, including Essential Caregiver designation and visitation, shall be available on the home page of Community website.
  3. Unless otherwise designated by the Executive Director, the Director of Nursing of the Community shall be responsible for infection prevention and control training.
  4. The Executive Director will set a limit on the total number of visitors allowed in the Community at any given time based on the ability of staff to safely screen and monitor and the space to accommodate General Visitors and/or the Essential Caregiver When there are no known cases of COVID among residents currently residing in the Community, visitation will be generally unrestricted. However, in the event Residents currently residing in the Community are known to be infected with COVID, restrictions will be placed upon General Visitors to reduce the possible spread of COVID. Visitation by Essential Caregivers will always be allowed to occur as detailed herein. Efforts to continue General Visitation even when a COVID positive resident is residing in the community shall be made, and protocols shall be implemented at the discretion of the Executive Director along the lines of the following (when practical):

    1. Identify locations for visitation/care to occur planning for residents in shared spaces and facilities with minimal common space to identify maximum time availability.
    2. Provide outdoor visitation spaces that are protected from weather elements, such as porches, courtyards, patios, or other covered areas that are protected from heat and sun, with cooling devices, if needed
    3. Create indoor visitation spaces for residents in a room that is not accessible by other residents or in a resident’s private room if the resident 1s bedbound and for health reasons cannot leave his or her room

  5. All residents and/or POA/Guardian, if appropriate, will be asked if they want to identify an Essential

  6. All new residents will be asked if they would like to identify an Essential Caregiver upon move-in.
  7. All residents will be allowed to update as requested the named Essential Caregiver of record within 2 business days of
  8. Residents are allowed in-person visitation by the Essential Caregiver in all the following circumstances, unless the resident, client, or patient objects:

    1. End-of-life situations.
    2. A resident, client, or patient who was living with family before being admitted to the provider’s care is struggling with the change in environment and lack of in- person family support.
    3. The resident, client,or patient is making one or more major medical
    4. A resident, client, or patient is experiencing emotional distress or grieving the loss of a friend or family member who recently
    5. A resident, client, or patient needs cueing or encouragement to eat or drink which was previously provided by a family member or
    6. A resident, client, or patient who used to talk and interact with others is seldom speaking.

  9. The Community shall maintain a visitor log for signing in and

  10. No more than three Essential Caregiver visitors may be designated per resident.
  11. Essential Caregiver visitor visits may still continue even if the specific resident to be visited is quarantined, tested positive for COVID, or is showing symptoms of a communicable disease so long as the visits can be conducted safely, and all infection control protocols are followed by the Essential Caregiver and Visits in these circumstances will likely require a higher level of PPE than standard surgical masks. The general visitation requirement that the facility has no new facility-onset cases of a communicable disease (for example COVID-19) is not applicable to visitation by Essential Caregiver visitors.
  12. The Community is not required to provide for “facility-provided” COVID-19 However, the Community may choose to conduct COVID testing of residents, visitors, and staff, and said testing shall be in accordance with the most recent CDC and FDA guidance. The cost of this testing cannot be passed on to the visitor.
  13. Essential Caregiver visitors must wear Personal Protective Equipment (PPE) per Community’s Infection Control Policies. The PPE required must be consistent with the most recent CDC guidance for healthcare workers. At Concordis communities the Essential Caregiver visitors shall wear the same PPE that staff wear to provide care or services to the
  14. General Visitors must wear Personal Protective Equipment (PPE) per the Community’s Infection Control Policies at the time of their
  15. Any changes to Concordis Essential Caregiver visitor policies must be promptly communicated to affected residents and Essential Caregiver visitors.

II. To facilitate visits by General Visitors and Essential Caregiver visitors upon a request from a resident or friend/family member:

  1. The resident (or their representative) will read and sign the visitation policy and The acknowledgement of the signature represents that the resident (or their representative) understands that both General Visitors and Essential Caregiver visitor must abide by the policies set forth in this document.
  2. The Essential Caregiver visitor will sign an acknowledgement of their receipt and understanding of the visitation policies and procedures. The Essential Caregiver’s signature represents that they have received the policies and procedures, they understand the policies and procedures, and they agree to abide by said policies and procedures.
  3. The Essential Caregiver visitor will complete training on infection prevention and control including the use of PPE, use of masks, hand sanitation, and social
  4. The Essential Caregiver visitor must immediately inform the facility if they develop symptoms consistent with a communicable disease within 24-hours of their last visit at the facility.
  5. Essential Caregiver visits may take place in the resident’s room or a designated area determined by the Executive Director at the time the visitation scheduled is developed and agreed
  6. General Visitor visits may take place in accordance with the infection control protocols at the time of the Visits by General Visitors may be significantly limited when a resident residing in the Community is infected with COVID-19.

III. When an Essential Caregiver visitor is scheduled to visit, the Community will:

  1. The Community designee will thoroughly screen the visitor per the Community’s infection control policy and procedure and document the name of the individual, the date and time of entry, and the screening mechanism used, along with the screening employee’s name and signature. Just as with staff entering the building, if the visitor fails the screening, the visitor CANNOT be allowed
  2. The Executive Director will ensure that the required consents, and training and policy acknowledgements are in
  3. The Community designee will ensure that the Essential Caregiver visitor has appropriate PPE if
  4. The Community designee will require the Essential Caregiver visitor to sign in and out on the visitor log.
  5. The Community staff will monitor the Essential Caregiver visitor’s adherence to policies and procedures.
  6. If the Essential Caregiver visitor fails to follow the Community’s infection prevention and control requirements, after attempts to mitigate concerns, the Executive Director shall restrict or revoke visitation.
  7. In the event the Essential Caregiver visitor’s status is revoked due to the individual not following the Community’s policy and procedures, the resident may select a different Essential Caregiver visitor who will be granted visitation rights upon proper vetting and agreeing to policies and

IV.  When a General Visitor is scheduled to visit, the Community will:

  1. The Community designee will thoroughly screen the visitor per the Community’s infection control policy and procedure and document the name of the individual, the date and time of entry, and the screening mechanism used, along with the screening employee’s name and signature. Just as with staff entering the building, if the visitor fails the screening, the visitor CANNOT be allowed
  2. The Community designee will ensure that the General Visitor has appropriate PPE (if applicable).
  3. The Community designee will require the General Visitor to sign in and out on the visitor log.
  4. The Community designee will notify the General Visitor of any restrictions in place relating to visitation, or requirements relating to infection control, at that time of the visit.
  5. The Community staff will monitor the General Visitor’s adherence to policies and procedures.
  6. If the General Visitor fails to follow the Community’s infection prevention and control requirements, after attempts to mitigate concerns, the Executive Director shall restrict or revoke

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