Task Force on the Safe and Limited Re-opening of Long- term Care Facilities August 26, 2020 1
Task Force Focus Areas The Task Force has focused on the following: Safely allowing essential caregivers to visit long-term care facilities; Safely allowing compassionate care visits in long-term care facilities; and Visitation options including indoor and outdoor visitation. These slides outline the Task Force’s recommended guidelines in these areas. 2
Essential Caregivers Provide health care services and/or assistance with activities of daily living to help maintain or improve the quality of care or quality of life of a facility resident Care or service provided by the essential caregiver is included in the plan of care or service plan for the resident Activities of daily living include bathing, dressing and eating 3
Compassionate Care Visitors Intended to Examples: provide Allowed on a End of life emotional limited basis as an Major upset exception to support to Difficult transition or restricted help a loss visitation resident face a hard situation 4
Essential and Compassionate Care: Facility Requirements Identify those who Facility shall set a Allow resident to provided EC limit on the total Establish policies designate 2 ECs and Develop a before the number of visitors CCs , and allow no and procedures schedule – work more than one EC or pandemic or have allowed in the for how to with resident and CC per visit; ICF and asked to provide facility based on designate and EC/CC to define an APD licensed Group since, consult with the ability of staff agreeable Homes may allow utilize an EC and resident or to safely screen two ECs or CCs at schedule allow CC visits representative for and monitor one time. concurrence visitation 5
Essential and Compassionate Care: Facility Requirements No resident visits Provide infection The facility may Allow evening if the resident is prevention and restrict or revoke if control training, quarantined or if and weekend the EC/CC fails to including proper PPE the resident is visits to follow infection Maintain visitor use, hand hygiene positive for COVID- prevention and accommodate log for signing in and social control requirements 19 or distancing; work or and out or other COVID-19 symptomatic, Designate key staff childcare related rules of the unless the visit is to support infection facility after attempts barriers for compassionate control training of to mitigate concerns Caregivers care 6
Essential and Compassionate Caregiver Requirements Testing and PPE While in Facility Symptoms EC/CC: Wear a surgical mask and other EC/CC: Comply with facility- provided • EC/CC: Provide care or visit in the PPE as appropriate for the care provider, COVID-19 testing if offered resident’s room, or in facility - PPE for EC should be consistent with CDC Facility use of testing must be based guidance for health care workers designated areas within the building on current CDC and FDA guidance equivalent to staff EC/CC: Be trained on infection EC/CC: Inform the facility if they • Maintain social distance of at least prevention and control, use of PPE, develop a fever or symptoms 6 feet with staff and other residents use of masks, hand sanitization and consistent with COVID-19 within 14 - limit movement in the facility social distancing days of a visit EC/CC: Sign acknowledgement and adhere to training 7
General Visitation: Facility Requirements 14 days with no new Adequate Referral facility onset of resident or Sufficient staff Adequate cleaning/ staff COVID-19 cases, to support Hospitals excluding dedicated disinfecting management PPE units/wings accepting Have Capacity of visitors COVID-19 cases from the supplies community 8
General Visitation: Facility Requirements Schedule Designate key Facility may Continue with visitors by Notify staff to support perform testing Visit spaces must visitor screening, infection control appointment; residents, their (deleted may Maintain a be cleaned and i.e., temperature education of monitor for representatives require negative disinfected visitor log for checks and visitors including, tests ) Facility use adherence to and recurring between visitors symptom/ PPE, use of masks, signing in and of testing must be and contain proper use of visitors of any proper hand exposure based on current out handwashing or masks and changes in the hygiene, social screening CDC and FDA sanitation stations social visitation policy distancing and questions guidance visitation policies distancing 9
General Visitation: Facility Requirements For indoor visitors, Restrict Facility shall limit Facility shall set a facilities can create visitation for any indoor spaces for limit on the total the length of Facility shall limit resident in residents in a room number of visitors Visitors must visits, days, Allow residents to the number of isolation for that is not accessible allowed in the should be 18 hours, number designate up to five visitors per resident by other residents, or facility based on suspected or visitors to no more than years or older of visits per in the resident’s the ability of staff confirmed two visitors per visit private room if the week by one to safely screen and COVID within the resident is bedbound visitor monitor visitation and for health facility reasons cannot leave their room 10
General Visitation: Outdoor Visitation Facilities can create outdoor visitation spaces for Protection from heat and sun is Facilities are Strongly residents that are protected essential. Cooling devices may be from weather elements, Encouraged to Provide required to maintain safe such as porches, courtyards, temperatures Outdoor Visitation on patios, or other covered areas 11
General Visitation: Visitor Requirements Exception to Infection Policy Fever/ While in Control Social Consent Symptoms Facility Distancing PPE Inform the facility if Visit in the Properly wear a face A visitor may be closer than 6 Sign a consent form they develop a fever or feet to the resident who they mask and other resident’s room or noting understanding symptoms consistent are visiting if they comply with necessary PPE and in facility- CDC PPE requirements for of visitation policies with COVID-19 within perform hand hygiene healthcare workers. designated areas 14 days of a visit Maintain social distance of at least 6 feet with staff and residents - limit movement in the facility 12
Process Upon Identification of New COVID-19 Cases Indoor and Outdoor visitation is prohibited until the facility achieves a continuous 14-day period without the facility-onset of a resident or staff COVID-19 case (if staff person was in the facility in the 10 days prior to the positive test). Any facility that has a resident test positive for COVID-19, or a staff tests positive for COVID-19 if the staff person was in the facility in the 10 days prior to the positive test, must immediately cease all indoor and outdoor visitation. Essential Caregivers and Compassionate Caregivers are still permitted. 13
Beauty Salons and Barbers Beauty salons and barbers help improve resident morale and quality of life. Hair salons may resume providing services to residents with the following precautions in place Criteria for facilities to resume beauty salon and barber services: 14 days with no new onset of resident COVID-19 cases Barbers and hairdressers providing services must wear a surgical mask , gloves and perform hand hygiene and follow the same requirements as essential caregivers visitors Residents receiving services must wear face masks Waiting customers shall follow social distancing guidelines Only residents of the facility are allowed in hair salon for services; no services can be provided to outside guests Services may not be provided to any resident in isolation for suspected or confirmed COVID-19 Providers must properly clean and disinfect equipment between residents 14
Resident Absence for Medical Appointments Residents leaving the facility/group home temporarily for medical appointments must wear a face mask at all times if tolerated and be screened upon return to the facility. Eye protection should also be encouraged. Healthcare Provider Visits Healthcare providers serving residents in the facility/group home must comply with CDC requirements for PPE, must be screened prior to entry, must comply with all infection control requirements of the CDC. The resident receiving the healthcare services should wear a facemask during the service if tolerated. Medical appointments should be scheduled through the facility/group home to comply with the facility’s/group home’s ability to ensure appropriate screening and adherence to infection control requirements. 15
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