The Gardens at DePugh Visitation
Policy Statement
Our facility permits residents to receive visitors subject to the resident’s wishes and the protection of the rights of other residents in the facility.
Policy Interpretation and Implementation
• The Gardens has established processes and procedures to safely allow visitation based on the most recent guidelines from regulatory /advisory bodies including AHCA, CMS, and/or from the State of Florida- DEM.
• This facility allows in-person visitation from anyone at any time regardless of vaccination status, unless the resident objects to the visit, and provided the visitor complies with the infection control measures imposed by the facility.
• The Gardens reserves the right to change policies and procedures at any time depending on updated guidance from these regulatory/implementing bodies.
• The Gardens will follow the core principles consistent with the Centers for Disease Control and Prevention (CDC) guidance for nursing homes. The Gardens’ visitation process will be person-centered, and will consider the residents’ physical, mental, and psychosocial well-being, and will support their quality of life.
• Infection Control Process will be strictly implemented. 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. By adhering to these core principles, visitation can occur safely and risk of Covid19 entry to facility will be reduced.
Core Principles
• The Gardens will provide guidance (e.g., posted signs at entrances) about recommended actions for visitors who have a positive viral test for COVID-19, symptoms of COVID-19, or have had close contact with someone with COVID-19.
• The Gardens provides Infection Control Education policies for visitors upon entry and admission.
• Visitors with confirmed COVID19 infection or compatible symptoms should defer non-urgent in-person visitation until they meet CDC criteria for healthcare settings to end isolation. For visitors who have had close contact with someone with COVID-19 infection, it is safest to defer non-urgent in-person visitation until 10 days after their close contact if they meet criteria described in CDC healthcare guidance (e.g., cannot wear source control).
• Hand hygiene (use of alcohol-based hand rub is preferred)
• Face covering or mask (covering mouth and nose) in accordance with CDC guidance
• Post visual alerts (e.g., signs, posters) at the entrance and in strategic places. These alerts should include instructions about current IPC recommendations (e.g., when to use source control).
• Cleaning and disinfecting of frequently touched surfaces in the facility often, and designated visitation areas after each visit
• Appropriate staff use of Personal Protective Equipment (PPE)
General Guidelines
• Resident and staff testing conducted following nationally accepted standards, such as CDC recommendation
• The Gardens allows in-person visitation from anyone at any time regardless of vaccination status, unless the resident objects to the visit, and provided the visitor complies with the infection control measures imposed by the facility.
• The Gardens is open for visitation anytime. We, however, strongly encourage visitation from 10 am to 8pm daily, unless during end of life or crisis situations which can take place anytime.
• The Gardens does not limit number of visitors and length of visit that a resident can have at a time, but requests space and location permitting so as not to infringe on the resident’s roommate or life safety regulations.
• The Gardens allows in-person visitation in all of 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 decisions.
4. A resident, client, or patient is experiencing emotional distress or grieving the loss of a friend or family member who recently died.
5. A resident, client, or patient needs cueing or encouragement to eat or drink which was previously provided by a family member or caregiver.
6. A resident, client, or patient who used to talk and interact with others is seldom speaking.
7. While there is no limit on the number of visitors and on the visit length that a resident can have at one time; visits should be conducted in a manner that adheres to the core principles of COVID19 infection prevention and does not increase risk to other residents.
8. Advanced visitation scheduling is not required.
9. All visitors will be screened prior to entry. Screening will be in the main lobby.
Visitors who have a positive viral test for COVID-19, symptoms of COVID-19, or currently meet the criteria for quarantine will be denied entry until they meet the criteria used for residents to discontinue transmission-based precautions.
• All visitors must limit movement in the facility. (example, visitors should not walk around different halls of the facility; visitors must go directly to the resident’s room or designated visitation area).
Visitor / Covid-19 / Testing / Vaccination/ Face Covering
• Visitors may be required to sign a form to acknowledge agreement to visitation policies and procedures including basic education on PPE and infection control measures in the facility.
• All visitors must sign in and out in the facility’s visitor log which is completed through Accushield.
• All visitors must immediately inform the facility if they develop a fever or symptoms consistent with COVID-19 or test positive for COVID-19 within 48 hours of facility visit.
• The facility Infection Preventionist or designee is responsible in ensuring that staff adhere to the policies and procedures.
• Visitors are not required to be tested or vaccinated as a condition of visitation.
• The Gardens does not require visitors to submit proof of any vaccination or immunization.
• Visitor Covid19 testing will not be required.
• The Gardens strongly encourages all visitors to become vaccinated.
• The Gardens will follow current recommendations from CDC, state and local health departments, and individual facility or visited resident’s circumstances regarding face coverings and masks.
• The Gardens will implement required PPE for resident on Transmission based precautions.
• Consensual physical contact is allowed between a resident and a visitor.
• Physical distancing during large gatherings is strongly encouraged.
• Residents (or their representative) and their visitors, who are not up-to-date with all recommended COVID-19 vaccine doses, will be advised of the risks of physical contact prior to the visit.
• The Gardens will offer well-fitting facemasks or other appropriate PPE.
Indoor / Outdoor / Visitation
• The Gardens offers both indoor and outdoor visitation.
• The Gardens will accommodate outdoor visitation upon availability of designated outdoor visitation area.
• Outdoor visitation is preferred when the resident and/or visitor are not up-to date with all recommended Covid
19 vaccine doses.
• Indoor visitation is allowed at all times and for all residents as permitted under the current regulations. The facility does not require advance scheduling of visits.
• Although there is no limit on the number of visitors that a resident can have at one time, visits should be conducted in a manner that adheres to the core principles of COVID19 infection prevention and does not increase risk to other residents.
Visitation during an Outbreak
• While it is safer for visitors not to enter the facility during an outbreak investigation, visitors are still allowed in the facility. Visitors will be made aware of the potential risk of visiting during an outbreak investigation and adhere to the core principles of infection prevention.
• While not recommended, residents who are on transmission-based precautions (TBP) or quarantine can still receive visitors. In these cases, visits should occur in the resident’s room and the resident should wear a well-fitting facemask (if tolerated).
• If residents or their representative would like to have a visit during an outbreak investigation, they should wear face coverings or masks during visits, regardless of vaccination status, and visits should ideally occur in the resident’s room.
Federal Disability Rights Laws and Protection and Advocacy (P&A) Programs
• Representatives of P&A programs are permitted access to all residents, which includes “the opportunity to meet and communicate privately with such individuals regularly, both formally and informally, by telephone, mail and in person.”
• If communicating with individuals who are deaf or hard of hearing, the facility may use a clear mask or mask with a clear panel- pending availability.
• Face coverings will not be placed on anyone who has trouble breathing or is unable to wear a mask due to a disability, or anyone who is unconscious, incapacitated, or otherwise, unable to remove the mask without assistance
• If a resident requires assistance to ensure effective communication (e.g., a qualified interpreter or someone to facilitate communication) and the assistance is not available by onsite staff or effective communication cannot be provided without such entry (e.g., video remote interpreting), the facility must allow the individual entry into the nursing home to interpret or facilitate, with some exceptions. This would not preclude this facility from imposing legitimate safety measures that are necessary for safe operations, such as requiring such individuals to adhere to the core principles of COVID-19 infection prevention.
Entry of Healthcare
• All healthcare workers will be permitted to come into the facility as long as they are not subject to a work exclusion or showing signs or symptoms of COVID-19. In addition to health care workers, personnel educating and assisting in resident transitions to the community should be permitted entry consistent with this guidance.
Workers and Other Providers of Services
• EMS personnel do not need to be screened, so they can attend an emergency without delay.
• All staff, including individuals providing services under arrangement as well as volunteers, should adhere to the core principles of COVID-19 infection prevention and must comply with COVID-19 testing requirements.
References
OBRA Regulatory Reference Numbers §483.10(f)(4) The resident has a right to receive visitors of his or her choosing at the time of his or her choosing, subject to the resident’s right to deny visitation when applicable, and in a manner that does not impose on the rights of another resident.
Survey Tag Numbers F562; F563; F564
Other References 1. CMS QSO-20-39-NH: Nursing Home Visitation - COVID-19 Rev 05/8/2023
2. Chapter 2022-34 Committee Substitute for Senate Bill no 988
