Visitation Policy

It is the policy of Brookhaven Rehabilitation and Health Care Center to begin visitation for residents, families and resident representatives while ensuring safety and adherence to infection prevention strategies to minimize any potential spread of infection. This will be done in accordance with all state and federal guidance for the prevention of COVID-19.

Brookhaven Rehabilitation and Health Care Center will implement actions to assess visitors and staff upon entrance to the building, and reinstate limited visitations to the facility when allowed per CMS and New York State Department of Health guidelines. These actions will be implemented and changed as needed in conjunction with updated guidance/directives from the CDC, NYSDOH and governmental authorities. Our purpose is to promote and enhance resident quality of life by implementing visitation to combat psychosocial impacts of isolation from family and representatives.

Criteria

Nursing Homes may expand visitation and/or activities beginning February 26, 2021 under the following revised guidance if able to

  1. The facility is in full compliance with both state and federal requirements including Covid-19 focus surveys, daily HERDS, weekly staff testing surveys and the federally required weekly submission of Covid-19 data to the National Healthcare Safety Network (NHSN).
  2. The facility has completed the NY Forward Safety Plan and submitted a copy of the complete plan to covidnursinghomeinfo@health.ny.gov. The facility must retain a copy of the plan at the facility where it is accessible and immediately available upon request of the Department or local health department. Any changes to the plan must be immediately communicated to the Department.
    1. The plan must clearly articulate the space(s) to be used for visitation (outdoors and indoors) including the number of visitors and residents which could be safely socially distanced within the space.
  3. There has been no new onset of Covid-19 cases in the last 14 days and the facility is not currently conducting outbreak testing as reported on daily HERDS submissions.
  4. Visitors must be able to adhere to the core principles, including infection prevention and control policies, and staff are expected to provide monitoring for those who may have difficulty adhering to core principles.
  5. Facilities must have policies widely communicated to residents, staff and visitors that limit the number of visitors per resident at one time and limit the total number of visitors in the facility at one time (based on the size of the building and physical space). Facilities should consider scheduling visits for a specified length of time to help ensure all residents are able to receive visitors.
  6. Facilities should limit movement in the facility, including limiting visitors from walking around different halls of the facility. Instead, visitors should go directly to the resident’s room or designated visitation area. Visits for residents who share a room should not be conducted in the resident’s room unless the roommates are spouses.
  7. Adherence to written screening protocols for all staff during each shift, each resident daily and all persons entering the facility or grounds of such nursing home including visitors, vendors, students and volunteers.
  8. The number of visitors to the nursing home must not exceed twenty percent of the resident census at any time and the number of visitors and time allocated to visitation should take into consideration that many residents and their loved ones will want to avail of such visits. Policies and procedures should be revised to afford every opportunity for visits in a safe and thoughtful manner. Policies should also contemplate the need for adequate supervision and strict adherence to the core principles of infection prevention and control.
  9. Visitors under the age of 16 must be accompanied by an adult 18 years of age or older.
  10. Current Covid-19 positive residents, residents with Covid-19 signs or symptoms, and residents in a 14-day quarantine or observation period remain ineligible for in person visitation. In these instances, every effort should be made to accommodate visits using electronic devices and alternative visitation techniques.
  11. Facilities should use the Covid-19 county positivity rates, found on the CMS Covid-19 Nursing Home Data site (link can be found at https://data.cms.gov/stories/s/Covid-19-Nursing-Home-Data/bkwz-xpvg) to determine when visitation should be paused. When the county positivity rate us high (>10%), visitation must occur only for compassionate care situations according to the core principles of Covid-19 infection prevention and facility policies.
  12. Facilities should accommodate and support indoor visitation, including visits for reasons beyond compassionate care situations based on the following guidelines:
    1. There has been no new onset of Covid-19 cases in the last 14 days and the facility is not currently conducting outbreak testing;
    2. Visitors should be able to adhere to core principles and staff must provide monitoring for those who may have difficulty adhering to core principles, such as children;
    3. Facilities should limit the number of visitors per resident at one time and limit the total number of visitors in the facility at one time (based on the size of the building and physical space). Facilities should consider scheduling visits for a specified length of time to help ensure all residents are able to receive visitors and;
    4. Facilities should limit movement in the facility. For example, visitors should not walk around different halls of the facility. Rather, they should go directly to the resident’s room or designated visitation area. Visits for residents who share a room should not be conducted in the resident’s room. For situations where there is a roommate and the health status of the resident prevents leaving the room, facilities should attempt to enable in room visitation while adhering to the core principles of Covid-19 infection prevention.
  13. Facilities must use the CMS COVID-19 county positivity rate, found on the COVID-19 Nursing Home Data site (link available at: https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg) as additional information to determine how to facilitate indoor visitation, and must abide by the following:

Low (<5%) = Visitation should occur according to the core principles of Covid-19 infection prevention and facility policies (beyond compassionate care visits). For county Covid-19 positivity rates below 5%, visitor testing is strongly encouraged; facilities may utilize rapid testing

Medium (5%-10%) = Visitation should occur according to the core principles of Covid-19 infection prevention and facility policies (beyond compassionate care visits). Visitor testing is required. Visitors must either: present a negative Covid-19 test result from within the past seventy-two hours (72), or facilities may utilize rapid testing to meet the testing requirements. Additionally, all visitors must adhere to all infection control practices.

High (>10%) = Visitation must only occur for compassionate care situations according to the core principles of Covid-19 infection prevention and facility policies. Facilities should offer rapid testing whenever possible.

  1. While taking a person centered approach and adhering to the core principles of Covid-19 infection prevention, outdoor visitation can be conducted in a manner that reduces the risk of transmission. Outdoor visitation poses a lower risk of transmission due to increased space and airflow. Therefore, all visits should be held outdoors whenever practicable. Aside from weather considerations (e.g., inclement weather, excessively hot or cold temperatures, poor air quality), an individual resident’s health status (e.g., medical condition(s), Covid-19 status), or a facility’s outbreak status, outdoor visitation should be facilitated routinely. Facilities should create safe and accessible outdoor spaces

Procedure

  • Facility visitation will be conducted in the outdoor patio area, weather permitting, with no more than 17 individuals at one time. Social distancing and face mask/face covering use is required at all times.
  • In inclement weather such as high heat and as facility space allows, visitation will be inside, in the well-ventilated first floor main dining room with no more than 12 individuals who are socially distanced and wearing a facemask / face covering at all times. This may include residents visiting each other.
  • In certain circumstances in-room visitation may be permitted. Residents who have roommates will not be permitted to have in room visitors unless the roommates are spouses and/or unless deemed medically necessary. If deemed medically necessary, the facility will ensure that the core principles of Covid-19 infection prevention are adhered to at all times.
  • Visits will be by appointment only, limited to 2 people per resident at a time, be time limited and scheduled by Activities staff.
    • The facility will assign staff to assist with the transition of residents, monitoring of visitation to ensure the core principles of Covid-19 infection prevention are being followed and cleaning and disinfecting areas used for visitation after each visit using an EPA-approved disinfectant.
    • The facility will post signage regarding facemask utilization and hand hygiene and will have applicable floor markings/postings visible for social distancing adherence.
    • Covid-19 testing:
      • The Administrator/designee will be responsible for checking the CMS COVID-19 county positivity rate daily. This rate can be found on the COVID-19 Nursing Home Data site (link available at: https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg).
      • Low (<5%) = Visitation should occur according to the core principles of Covid-19 infection prevention and facility policies (beyond compassionate care visits). For county Covid-19 positivity rates below 5%, visitor testing is strongly encouraged.
      • Medium (5%-10%) = Visitation should occur according to the core principles of Covid-19 infection prevention and facility policies (beyond compassionate care visits). Visitor testing is required. Visitors must either: present a negative Covid-19 test result from within the past seventy-two hours (72), or facilities may utilize rapid testing to meet the testing requirements. Additionally, all visitors must adhere to all infection control practices.
      • High (>10%) = Visitation must only occur for compassionate care situations according to the core principles of Covid-19 infection prevention and facility policies. Facilities should offer rapid testing whenever possible.

The facility strongly prefers that all visitors be tested regardless of county positivity rate and/or vaccination status. The facility will provide rapid testing to all visitors as needed.

    • The facility will screen all visitors for signs and symptoms of COVID-19 prior to resident access and visitation will be refused if the individual(s) exhibits any COVID-19 symptoms. This will include temperature checks and screening questions to assess potential exposure to COVID-19, international travel and domestic travel. The facility must maintain screening questions asked onsite in an electronic format and make it available upon the Department’s request.
    •  A log will be kept for all visitors that includes:
      • First and last name of the visitor;
      • Physical (street) address of the visitor;
      • Daytime and evening telephone number;
      • Date and time of visit;
      • Email address, if available; and
      • As per NYSDOH a notation indicating the individual cleared: the screening questions, temperature check and provided proof of a negative test result (if required). This does not include any individual temperatures or other individual specific information.
    • Visitors and residents must wear a facemask or face covering (must always cover both the nose and mouth when on the premises of the facility). Masks will be provided by the facility for residents and visitors as needed.
    • Visiting areas will have easily accessible alcohol-based hand rub, for residents, visitors, and staff.
    • The number of visitors will not exceed ten percent (20%) of the resident census at any time. Only two (2) visitors will be allowed per resident at any one time.
    • Visits will be scheduled through the Activities department and will be time limited to no more than 45 minutes unless otherwise approved by the Administrator or Director of Nursing.
    • Visitors under the age of 16 must be accompanied by an adult 18 years or older.
    • Current COVID-19 positive residents, residents with COVID-19 signs or symptoms, residents with an “unknown” status due non-testing and residents in a 14-day quarantine or observation period are not eligible for visits.
    • The facility will provide and post a fact sheet outlining visitor expectations including appropriate hand hygiene and face coverings. The fact sheet will be provided upon initial screening to all visitors.
  • Residents will also be assisted to go outdoors with staff supervision weather permitting. The appropriate infection control and safety and social distancing requirements must be maintained.
  • There will be no eating/drinking during visitation. Social distancing should be maintained at all times. If emotional/supportive physical contact must occur; it should be brief with proper face coverings in place at all times. Proper hand hygiene should occur pre and post the physical contact.
  • The IDT Team will review the Visiting program and monitor for any needed adjustments and report to QA Committee as needed.
  • If any visitor fails to adhere to the protocol, he/she/they will be prohibited from visiting for the duration of the COVID-19 state declared public health emergency.
  • Front Desk and Security staff will be advised of all visitation changes and required visitor assessments through Memo and/or in-service as applicable.
  • Staff will be kept informed of changes/restrictions to visitation through direct communication, memo’s, emails or postings.
  • Any assessment of visitors required for entrance to the facility is mandatory except when the person entering the facility as a responder to an emergency situation (such as a 911 response or FDNY) and the completion of the assessment would delay their response.
  • All end of life visits and compassionate care situation visits must be approved by Administration and/or DNS prior to visit. Once visit is approved, visitor(s) will be allowed to conduct a visit at bedside due to resident’s current medical condition. A list of all approved visits will be maintained at the front desk.
  • The facility will continue to offer and assist with resident communication to families through facetime, zoom, skype, etc.