Visitor Policy St. Catherine of Siena Nursing & Rehabilitation Care Center
In accordance with the most recent “Health Advisory: Skilled Nursing Facility Visitation” dated July 10, 2020, the New York State Department of Health will now permit outside visitation and limited indoor visitation and activities, if the nursing facilities meet specific benchmarks and develop a reopening plan.
The directive outlines criteria the nursing facilities must follow for reducing such restrictions, while mitigating the risk of resurgence of COVID-19.
Nursing facilities in Phase 3 regions may resume limited visitation and activities beginning July 15, 2020, if the facility meets the following conditions:
- The region in which the nursing facility is located is in Phase III or greater.
- The nursing facility is in full compliance with all state and federal requirements, state Executive Orders and guidance, state reporting requirements, including COVID-19 focus surveys, HERDS and staff testing surveys, and federally-required submission of COVID-19 data to the National Healthcare Safety Network (NHSN).
- The nursing facility has written protocols to separate residents into cohorts of positive, negative, and unknown as well as separate staffing teams to work with positive COVID-19 residents and non-positive residents. If any facility is unable to meet these requirements, the nursing facility shall transfer the residents to an alternate facility that is able to meet this criteria.
- The nursing facility has completed the “NY Forward Safety Plan” and submitted a copy of the completed plan to firstname.lastname@example.org. The facility must maintain a copy of the plan that is easily accessible. Any changes to the plan must be immediately communicated to the NYS Department of Health. The plan must clearly articulate the spaces used for visitation (outdoors and indoors) including the number of visitors and residents which could be safely socially distanced within the spaces. The facility must also provide an attestation that they are in compliance with state and federal guidelines described under number 2 above.
- The nursing facility has no staff shortages as evidenced by the nursing facility individual staffing plan and as reported to NHSN.
- The absence of any new onset of COVID-19 among staff or residents as reported to the Department on the HERDS and staff testing surveys and as reported to the NHSN for a period of no less than 28 days (consistent with CMS thresholds).
- Access to adequate testing. The nursing facility should have a testing plan in place, and at a minimum, ensures all consenting residents have received a single baseline COVID-19 test. The nursing facility must have the capability to test or can arrange for testing all residents upon identification of any individual with symptoms consistent with COVID-19. If a staff member tests positive, the nursing facility must have the capacity to continue re-testing all nursing home staff and residents, as applicable.
- An executed and operational arrangement with laboratories to process COVID-19 tests as per CMS recommendations and guidelines.
- Adherence to written screening protocols for all staff during each shift, each resident daily, and all persons entering the facility or grounds of the nursing facility, including visitors. Resident monitoring must include daily symptom checks, vital signs, and pulse oximetry.
- A copy of the nursing 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 visitation is paused due to an increase in the number of residents and/or staff with a confirmed positive COVID-19 diagnosis.
When a nursing facility meets all of the above criteria, the nursing facility may resume visitation following the guidelines outlined below, which must also be included in the nursing facility’s NY Forward Safety Plan.
1. Visitation should be limited to outdoor areas, weather permitting.
a. Lower Level Patio, Upper Level Patio
b. 9:30AM – 11:30AM, 3:00PM – 5:00PM Monday - Friday (by appointment). Visits will be 45-minute increments
2. At this time, visitation in resident rooms or care areas is prohibited. Under certain circumstances, such as end-of-life or facility-deemed-need for a compassionate visit based on the assessment of the resident by the interdisciplinary team, a resident room visit may be permitted. Face mask and social distancing requirements would still be required.
3. Specialty practitioners, podiatry, and dental services may continue with strict infection control guidelines
4. Visitation is limited to family members, loved ones, representatives from the Long-Term Care Ombudsman Program (LTCOP), and resident advocacy organizations under the following conditions:
a. Adequate staff are present to allow for personnel to help with the transition of residents, monitoring of visitation, and cleaning and disinfecting areas used for visitation after each visit using an EPA-approved disinfectant.
b. The facility maintains signage regarding face mask utilization, employs hand hygiene and uses applicable floor markings to cue social distancing.
c. Visitors are screened for signs and symptoms of COVID-19 prior to resident access. Visitation will be refused if the visitor exhibits any COVID-19 symptoms or does not pass the screening questions. The facility must maintain screening questions asked onsite and make available upon request.
d. Documentation of screening must be maintained onsite in an electronic format and available upon request by the NYS Department of Health for purposes of inspection and potential contact tracing. Documentation must contain the following:
i. First and Last Name of the Visitor
ii. Physical (street) address of the visitor
iii. Day and evening phone number
iv. Date and time of visit
v. Email address, if available
vi. Notation of screening results
e. There is adequate PPE made available by the nursing facility to ensure residents and visitors wear a facemask or facial covering which cover both the nose and the mouth.
f. Visitors must wear a face mask or facial covering which covers both the nose and the mouth when on the premises of the nursing facility and must maintain social distancing, except when assisting with wheelchair mobility. The nursing home must provide face masks or facial covering to visitors who lack adequate covering.
g. The facility will provide an alcohol-based hand rub, consisting of at least 60% alcohol to residents, visitors, and representatives. Individuals must demonstrate appropriate use.
h. No more than 10% of the residents shall have visitors at any one time in the facility and only two visitors will be allowed per resident at any one time.
i. Visitors under the age of 18 must be accompanied by an adult 18 years old or older
j. 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.
k. The nursing facility shall develop a short, easy-to-read fact sheet outlining visitor expectations, including appropriate hand hygiene and face coverings. The fact sheet must be provided upon initial screening to all visitors.
5. Residents may be assisted to go outdoors with staff supervision. Infection control, safety, and social distancing requirements must be maintained.
6. An interdisciplinary team must be created by the facility to review the visitation program compliance.
7. If any visitor fails to adhere to the protocol, he/she will be prohibited from visiting for the duration of the COVID-19 State-declared public health emergency.
In addition, the following restrictions will continue:
- Nursing facilities must refrain from sending residents to non-medically necessary trips outside the nursing facility until further notice.
- Communal dining and hairdresser services remain suspended at this time.
If the facility falls out of compliance with requirements/guidelines specified within this policy and/or the Health Advisory, the nursing facility shall immediately halt visitation and inform the NYS Department of Health. The NYS Department of Health can halt visitation at the nursing facility at any time due to community or facility spread of infection, or when the Department identifies that the facility has failed to comply with the guidelines of the Health Advisory.