The Arlington of Naples Policy: Covid-19 Visitation‑R
Revised 4.6.2022 to Reflect the State of Florida “No Patient Left Alone Act” April 6, 2022
Indoor In-Person Visitation
With Residents of the Arlington of Naples
The administration and staff of The Arlington of Naples understand the importance of the residents being able to spend time with their loved ones, family, and friends. During COVID-19 Public Health Emergency (PHE) per Centers for Medicare and Medicaid Services (CMS), indoor general visitation for all residents has been very restrictive to protect the health and safety of those most vulnerable, our residents, as well as the protection of the facility staff needed to care for our residents. The Arlington of Naples has updated the relevant policies to the September 17, 2020, QSO-20 – 39-NH revised March 10, 2022, by CMS in conjunction with the Centers for Disease Control and Prevention (CDC) regarding resident visitation and the April 6, 2022, State of Florida SB 988, “No Patient Left Alone Act.” Consequently, this facility will not restrict visitation without a reasonable clinical or safety cause consistent the 42 CFR §483.10(f) (4) (Resident Rights). Policies will continue to be updated as regulatory guidance is updated.
The Arlington of Naples acknowledges the concerns for infections transmission to resident/patients, visitors and staff associated with open visitation and will continue to require staff and visitors to adhere to the core principles of COVID-19 infection prevention to mitigate these concerns. The requirement for resident/patients wearing of masks is mentioned throughout our visitation policies. It is understood that many of facilities residents/patients are unable to tolerate masks due to medical conditions and that those with memory issues cannot remember to leave a mask in place and may therefore not be able to consistently follow the source control portion of these policies. The Arlington of Naples staff will continue to encourage resident/patient compliance with all infection control practices. The administrator or designee is responsible for ensuring that staff and other persons in the facility adhere to the policies and procedures of the facility.
Core Principles of COVID-19 Infection Prevention
Visitation at The Arlington of Naples will be conducted following the core principles of COVID-19 infection prevention and the best practices consistent with the Centers for Disease Control and Prevention (CDC) guidance for nursing homes, assisted livings, and other healthcare settings in order to reduce the risk of COVID-19 transmission.
- Staff, visitors to The Arlington of Naples and other persons entering the facility will be screened for signs and symptoms of COVID-19 in conjunction with a manual temperature check. The Arlington of Naples administration and nursing staff have the responsibility to deny entry to the facility of any persons failing to meet the screening guidelines including those with a positive viral test, with signs and symptoms of COVID-19 or who meet the criteria for quarantine.
- Visitors will follow the proper method for completing hand hygiene during their visit with proper use of alcohol-based hand rub being the preferred method.
- Instructional signage with source control information for visitors and staff will be placed throughout the facility.
- Visitor education will be provided on COVID-19 signs and symptoms, Arlington of Naples infection control precautions, required use of face coverings, hand hygiene, proper entrance and exits to use when arriving and departing the facility and the routes designated areas.
- The facility will clean and disinfect high frequency touched surfaces frequently and as needed.
- Staff will appropriately use and wear PPE.
- Effective cohorts of residents will be followed at the Arlington of Naples, (e.g., having separate areas for COVID-19 care and a separate transition area for new admission). The Arlington of Naples has 44-private rooms in the skilled area.
- Residents and staff testing will be conducted as required at 42CFR 483.80(h). (See QSO-20 – 38-NH)
Indoor In-Person Visitation
The Arlington of Naples will facilitate in-person indoor visitation for all residents/patients as permitted under the applicable CMS regulations and the April 6, 2022, State of Florida, SB 988, “No Patient Left Alone Act.” Residents/patients may receive visitors of their choosing at the time of their choosing that does not place other residents at risk or impose on the rights of another resident.
- Visitors to the Arlington of Naples’ residents/patients are not required to schedule a visit appointment in order to spend time with a resident/patient for a routine visit.
- The Arlington of Naples has placed no limit on the length of visits or the frequency of visits. The number of visitors an individual resident/patient may have at one time will be limited to the size of the space to allow for physical distancing in adherence to the COVID-19 principles of infection prevention.
- Outdoor visits are a preferred venue for residents/patients and visitors who are not up to date with vaccines for the protection of the other facility residents/patients but are not mandatory.
- Visits may take place for residents/patients in their room.
- Visitors must go directly to their designed visitation area or resident’s room after completing the COVID-19 screening and must leave the facility promptly at the end of the visit via the appropriate exit route.
- The staff of the Arlington of Naples values and honors the rights of the resident/patient to deny consent for a visit at any time and will assist the resident/patient as needed in such circumstances.
- As per the CDC Core Principles of COVID-19 Infection Prevention, source control (masking) and physical distancing will be observed by visitors, regardless of vaccination status, based on the Collier County facilities community transmission rate as indicated in the CDC’s COVID online Data Tracker-County View.
- The CDC Core Principles recommend:
- When the Arlington of Naples County’s level of community transmission rate is substantial or high, residents/patients and visitors should wear face masks and practice physical distancing regardless of vaccination status.
- When the Arlington of Naples County’s level of community transmission is low to moderate residents/patients and visitor are recommended to wear face masks and practice physical distancing especially if either the resident or the visitor is not up to date with all recommended COVID-19 vaccines doses. If both resident/patient and visitor are up to date with all recommended COVID-19 vaccine doses and neither one is at risk for severe disease, both may choose to remove face masks and forego physical distancing during the visit.
- Residents, regardless of vaccination status, can choose not to wear face coverings or masks when other residents are not present and have close contact (including touch) with their visitor. 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 not physical distancing during the visit.
- The April 6, 2022, Florida State, “No Patient Left Alone Act” SB 988 mandates that consensual physical contact between a resident/patient and their visitor must be allowed.
- The CDC Core Principles recommend:
- For the protection of resident/patients and staff, visitors who violate the Core Principles of COVID-19 Infection Prevention and the Arlington of Naples policies and procedures after being educated, will be asked to leave the facility and in-person visitation will be suspended for the specific visitor.
Designation of and In-person Visitation by an Essential Caregiver
In accordance with the April 6, 2022, State of Florida, SB 988, “No Resident Left Alone Act,” each resident/patient will be asked to designate a family member, friend, guardian, or other person as an “essential caregiver.” Under the Act, the essential caregiver is allowed to visit the resident/patient for at least 2 hours daily in addition to any other visitation authorized by the Arlington of Naples. The essential caregiver is not required by the Arlington of Naples to provide any form of care to the resident/patient during their visits. Residents/patients have the right to decline designation of an essential caregiver. This designated essential caregiver will be documented in the resident/patient clinical record.
In-person Visitation during COVID-19 Outbreak in the Facility
Under the November 12, 2021, CMS guidance, indoor visitation for the Arlington of Naples residents/patients may occur for all residents at all times including during the times when the facility is investigating or experiencing an outbreak of COVID-19. An outbreak is defined by the CDC as a new COVID-19 infection in any healthcare personnel or the facility onset of COVID-19 infection in a resident.
- The Arlington of Naples will make a resident/patient or their representative and the visitor(s) aware of the facilities status when under investigation or outbreak for COVID-19, the risks associated with visiting during this time and the infection control practices to be followed during their visit.
- During such times visitation should take place in the resident’s/patient’s room.
- Both resident/patient and visitor must wear face masks regardless of vaccination status.
- Residents/patients on transmission-based precautions are not recommended to have visitors; however, CMS states that visitation may be allowed in the resident’s room with the resident wearing a face mask and the visitor wearing required Personal Protection Equipment (PPE) during the visit. The Arlington of Naples may offer to provide PPE to the visitors to wear during the visit but under this guidance is not required to do so.
- When other Personal Protective Equipment (PPE) in addition to face coverings is necessary for the visit, visitors must follow the instructions from staff and wear the PPE properly during the entire visit.
Important Considerations for Visitation
Visitation for the Arlington of Naples resident/patient will be person-centered, considering the resident’s/patient’s physical, mental, and psychological well-being and will support their quality of life.
The CMS guidelines do not indicate any age restriction for visitors; however, all visitors to the facility must be able to adhere to the core principles of COVID-19 infection prevention. If a specific visitor violates the core principles of COVID-19 infection prevention and the facility policies and procedures, in-person visits will be suspended, and the visitor will be asked to leave. Facility staff will monitor for any visitors having difficulty adhering to the core principles of COVID-19 infection prevention and take appropriate action to educate and/or to ensure that the visitor leaves the facility.
Covid-19 Testing and Vaccination of Visitors
Under CMS guidance, visitors are not required to test or to show proof of having tested as a condition of visitation.
Visitors are not required to be vaccinated or to show proof of vaccination as a condition of visitation. Visitors who decline to disclose with vaccination status will be assumed to be unvaccinated and will be required to wear a face mask at times while in the facility. This assumption applies to representative of the Office of the State Long-Term Care Ombudsman and protection and advocacy systems.
The Administrator of the Arlington of Naples will make every effort to facilitate safe indoor, in-person visitation consistent with regulations set forth by the Centers for Medicare and Medicaid Services, the Centers for Disease Control, the Florida Department of Emergency Management, the Agency for Health Care Administration and the State of Florida SB 988, April 6, 2022, “No Patient Left Alone Act.” This policy will be updated as regulatory guidance from CMS is announced.