VISITATION POLICY, COVID 19

RESTRICTED VISITATION POLICY

During the Pandemic, visitation is permitted for compassionate care, eg.  End of life care, until we reach certain parameters as described by governmental guidelines for broader visitation allowance.  In Friedwald, we will define it as allowing in-person visitation for patients for whom prognosis is terminal with a short life expectancy or other extenuating circumstances on a one to one basis. For those residents, visitations will be subject to the following guidelines:

 

  1. All visitation must be cleared with the medical or nursing team. Eg. DON, ADON, Medical Director, Infection Preventionist, or MD/PA of record who confirm that the resident is terminal or falls under the term compassionate care.
  2. All visitation will be made by appointment only and must be scheduled in advance with the social work team and/or director of recreation. They will screen visitor by phone prior to visit asking if they have any fever, symptoms, exposure to any person with COVID in the past 14 days, or has travelled from any of the states or countries under quarantine. (see attached screening from). It will be the responsibility of the social work staff to keep up to date on NYS travel restrictions designated under the Commissioner’s travel advisory. This will restrict visitors from even entering the facility if they fail initial screening question, resident access and visitation will then be refused. Visitor will be instructed at that time that each visitor is required to wear a surgical (not cloth) mask upon visiting. Any visitor without a mask, will be denied entry.
  3. Upon arrival, visitor will be screened for signs and symptoms of COVID, have temperature taken, and above questions will be repeated. Visitors who have or exhibit symptoms or whose temperature is over 99’ will not be permitted into the facility. However, as scanning thermometers are sensitive to ambient heat, and can have a false negative reading if the person has been in very hot weather, temperature may be repeated after a 3-5 minute period to confirm accuracy.  Documentation must include the following for each visitor to the nursing home:  first and last name of the visitor; physical (street) address of the visitor; daytime and evening telephone number; date and time of visit; and email address, if available. This information will be maintained onsite in an electronic format.
  4. Upon passing screening, visitors will be given a sticker with a date, which they must wear during the duration of their visit. This will communicate to all staff that the visitor has successfully passed all aspects of the appointment and screening process, and is allowed to visit.
  5. Visitors will be instructed that they must wear, at a minimum, a surgical mask for the entire time they are in the facility. The mask must cover both the mouth and nose at all times. Visitors will be instructed on proper hand hygiene; alcohol-based hand rub (of at least 60% alcohol) will be available for residents, visitors, and staff. Those individuals must be able demonstrate appropriate use. Friedwald will maintain adequate PPE and ensure residents wear a facemask which covers both the nose and mouth during visitation, if medically tolerated.
  6. Visitors must maintain social distancing at all times.
  7. Friedwald will maintain signage regarding facemask utilization and hand hygiene and applicable floor markings to cue social distancing delineations.
  8. Visitation is strictly prohibited in resident rooms or care areas unless patient is too fragile to move, eg: end of life or patient who is unable to transfer to a wheelchair, or those residents who are unable to move, eg: those residents who are on a ventilator. The social worker, or assigned designee, will accompany visitor to the residents room. Visitor will contact social worker/designee when the visitation is complete, and will be escorted out of the building. If the visit must take place in a residents room, we will limit it to one visitor in a cohorted room, but 2 visitors at a time may attend residents in a private room. Visitor may be outside residents room only when arriving and departing the room.
  9. All visitors will be instructed that they may not leave the residents room under any circumstances, including during rehabilitation services or patient care. If the visitor or the patient is not comfortable with their presence during care, the visitor can call social worker/designee and escort visitor to exit the building. They will not be permitted immediate re-entry after care is over, to decrease the burden on social work team. Visitor may be given the option to turn away from the patient during care, to help maintain dignity without having visitor in public areas.
  10. The minimum age of a visitor will be 16 years old for a standard visit and minimum age of 10 for an end of life/compassionate care visit. Any visitor under the age of 18, must be accompanied by an adult aged 18 or older. Visitors over the age of 65, or those who state they are medically compromised will be made aware of the inherent risks of visiting, but we will leave it up to their discretion.
  11. A record will be kept of all visitation as well as pre-visit screening.
  12. Residents will be limited to a total of 8 hours of visitation a day.
  13. Visiting hours for those who are end of life will be during 6 am – 7pm.
  14. If the medical team feels that resident has less than 72 hours to live, or under other extenuating circumstances, such as if the absence of a family member would cause the resident extreme anxiety, the time limit, or other restrictions may be lifted on a case-by-case basis as best determined by the social work and medical teams.
  15. For those who are not deemed end-of-life/compassionate care, Friedwald will do its utmost to accommodate connection between residents and loved ones to the best of our ability. To this end, we will continue to skype/facetime residents and loved ones and allow “window” visits.
  16. The window visits can be facilitated in many ways.1) bringing a resident down to the ground level, usually in the day care center, near a window. The family/loved ones stand outside the building. 2)Bringing a resident down to the day care center next to closed glass doors. Both the resident and visitor will use a phone so they can communicate, while being able to see each other clearly.3) Bringing a resident to the window of their room and coordinating a time when family can come and seeing each other that way, a cell phone may also be used during that time to facilitate communication.

 

EXPANDED VISITATION POLICY

Friedwald expanded visitation policy will be in place when meeting the following criteria:

 

1.Rockland County, which is located within the Hudson Valley Area is in at least Phase 3.

 

  1. Friedwald will maintain full compliance, and is attesting to such compliance with this document to be 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).

 

  1. Friedwald will maintain protocols to separate residents into cohorts of positive, negative, and unknown as well as separate staffing teams to deal with COVID-positive residents and nonpositive residents.

 

  1. Friedwald will complete the NY Forward Safety Plan and submit a copy of the completed plan to covidnursinghomeinfo@health.ny.gov. Friedwald will retain a copy of the plan at the facility where it is easily accessible and immediately available upon request of the Department or local health department. Friedwald will immediately communicate to the Department of Health if any changes are made.

 

  1. Friedwald will allow limited visitation, including, but not limited to, family members, loved ones, representatives from the long-term care ombudsman program (LTCOP).

 

  1. Friedwald currently has no staffing shortages as evidenced by our individual staffing plan and will continue to report staffing plan through submissions to the National Health Safety Network (NHSN). However, if a staffing shortage should occur, we will notify appropriate regulatory departments.

 

  1. 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 twenty-eight (28) days, consistent with CMS established thresholds and DOH mandates.

 

  1. Friedwald is able to maintain adequate testing for COVID-19. Friedwalds testing plan including all consenting nursing home residents have received at least a single baseline COVID-19 test. In addition, Friedwald has the capability to test or can arrange for testing of all residents upon identification of any individual with symptoms consistent with COVID-19. If a staff member tests positive for the SARS-CoV-2 virus, Friedwald will maintain the capacity to continue re-testing all nursing home staff and residents, as applicable.
  2. Friedwald maintains relationships with accredited laboratories which can perform COVID testing with greater than 95 percent sensitivity, greater than 90 percent specificity, with results obtained and reported on a timely fashion to the Nursing home.

 

  1. 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. Resident monitoring must include daily symptom checks, vital signs, and pulse oximetry.

 

  1. A copy of Friedwalds formal visitation plan is posted to their public website and shared on our hotline to provide visitors with clear guidelines for visiting and to announce if and when visitation is paused due to an increase in the number of residents and/or staff with a confirmed positive COVID-19 diagnosis.

 

  1. Friedwald will develop a short, easy-to-read fact sheet outlining visitor expectation including appropriate hand hygiene and face coverings. The fact sheet will be provided upon initial screening to all visits.

EXPANDED VISITATION POLICY, AS PER DOH

 

  1. .All visitation will be made by appointment only and must be scheduled in advance with the social work team and/or director of recreation. They will screen visitor by phone prior to visit asking if they have any fever, symptoms, exposure to any person with COVID in the past 14 days, or has travelled from any of the states or countries under quarantine. (see attached screening from). It will be the responsibility of the social work staff to keep up to date on NYS travel restrictions designated under the Commissioner’s travel advisory. This will restrict visitors from even entering the facility if they fail initial screening question, resident access and visitation will then be refused. Visitor will be instructed at that time that each visitor is required to wear a surgical (not cloth) mask upon visiting. Any visitor without a mask, will be denied entry.
  2. Upon arrival, visitor will be screened for signs and symptoms of COVID, have temperature taken, and above questions will be repeated. Visitors who have or exhibit symptoms or whose temperature is over 99’ will not be permitted into the facility. However, as scanning thermometers are sensitive to ambient heat, and can have a false negative reading if the person has been in very hot weather, temperature may be repeated after a 3-5 minute period to confirm accuracy.  Documentation must include the following for each visitor to the nursing home:  first and last name of the visitor; physical (street) address of the visitor; daytime and evening telephone number; date and time of visit; and email address, if available. This information will be maintained onsite in an electronic format.
  3. Upon passing screening, visitors will be given a sticker with a date, which they must wear during the duration of their visit. This will communicate to all staff that the visitor has successfully passed all aspects of the appointment and screening process, and is allowed to visit.
  4. Visitors will be instructed that they must wear, at a minimum, a surgical mask for the entire time they are in the facility. The mask must cover both the mouth and nose at all times. Visitors will be instructed on proper hand hygiene; alcohol-based hand rub ( of at least 60% alcohol) will be available for residents, visitors, and staff. Those individuals must be able demonstrate appropriate use. Friedwald will maintain adequate PPE and ensure residents wear a facemask which covers both the nose and mouth during visitation, if medically tolerated.
  5. Visitors must maintain social distancing, except when assisting with wheelchair mobility.
  6. Friedwald will maintain signage regarding facemask utilization and hand hygiene and applicable floor markings to cue social distancing delineations.
  7. Visitation should be limited to outdoor areas, weather permitting. Under certain limited circumstances, as defined by the facility, visitation can be inside, in a well-ventilated space with no more than 10 individuals who are appropriately socially distanced and wearing a facemask or face covering while in the presence of others.
  8. Friedwald will optimally use its back patio area to accommodate outdoor visit, which will comfortably accommodate 10 people, while maintaining a minimum of 6 feet of social distancing.
  9. If weather conditions (or if a patient is sensitive to the weather) make visits outside not feasible, Friedwald will utilize its adult day care center for such visitations, which will accommodate 10 people while maintaining social distancing.
  10. Visitation is strictly prohibited in resident rooms or care areas unless patient is too fragile to move, eg: end of life or patient who is unable to transfer to a wheelchair, or those residents who are unable to move, eg: those residents who are on a ventilator. The social worker, or assigned designee, will accompany visitor to the residents room. Visitor will contact social worker/designee when the visitation is complete, and will be escorted out of the building. If the visit must take place in a residents room, we will limit it to one visitor in a cohorted room, but 2 visitors at a time may attend residents in a private room. Visitor may be outside residents room only when arriving and departing the room.
  11. All visitors will be instructed that they may not leave the residents room under any circumstances, including during rehabilitation services or patient care. If the visitor or the patient is not comfortable with their presence during care, the visitor can call social worker/designee and escort visitor to exit the building. They will not be permitted immediate re-entry after care is over, to decrease the burden on social work team. Visitor may be given the option to turn away from the patient during care, to help maintain dignity without having visitor in public areas
  12. The minimum age of a visitor will be 16 years old for a standard visit and minimum age of 10 for an end of life/compassionate care visit. Any visitor under the age of 18, must be accompanied by an adult aged 18 or older. Visitors over the age of 65, or those who state they are medically compromised will be made aware of the inherent risks of visiting, but we will leave it up to their discretion.
  13. Residents will be limited to a total of 4 hours of visitation a day.
  14. Visiting hours for those who are end of life will be from 8 am – 6pm.
  15. No more than 10 percent (10%) of the residents shall have visitors at any one time and only two visitors will be allowed per resident at any one time.
  16. A record will be kept of all visitation as well as pre-visit screening.
  17. 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
  18. The staff is required to monitor the visitation process. 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

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Our primary mission is to attain and maintain the highest level of trust and confidence in both our staff and services, by residents, family members, regulatory agencies and the community. More…

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friedwald-contact475 New Hempstead Road
New City, NY 10956
(845) 678-2000

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