FSLA Answers Your Questions Related to the
New Visitation Order
On Wednesday during our COVID video call, we received many questions about the new visitation rules. Click below to print a copy of the Q&As.
These questions and answers are based on DEM Emergency Order 20-009 and AHCA’s’ verbal clarification from FSLA’s 9/2/20 video meeting and the 9/3/20 Industry Partner Call. As always, local governments may have more stringent requirements.
Implementation
Q: What is the expectation of the date communities need to implement?
A: Originally, DEM EO 20-006 suspended statutes regarding a community’s obligation to support visitation. The new Emergency Order (DEM 20-009, effective as of 9/1/20) partially lifts those suspensions. AHCA’s expectation requires communities to have policies and procedures in place, since communities should have known this day was coming. AHCA’s request is that implementation is done safely and thoughtfully, but with a sense of urgency. Family members are ready to begin visiting, and AHCA wants to make sure communities can meet the demands and expectations as quickly as possible.
Q: Can the general visitor policy acknowledgment be signed once for each registered visitor, and kept on file, or does this need to be done each time they visit?
A: The acknowledgement is sufficient if signed once. Communities may want verbally reinforce expectations of signed acknowledgement during screening.
Q: Does the Emergency Order allow or prohibit visitors from touching/helping residents?
A: General visitors must follow social distancing and may not touch. Essential and compassionate caregivers may touch as allowed under their respective criteria.
Essential Caregivers / Compassionate Caregivers
Q: Is allowing essential/compassionate caregivers a requirement or at the facility’s discretion?
A: The Emergency Order requires communities, in part, to “establish policies and procedures for designation and utilizations of essential caregivers and compassionate care visitors” and to “develop an agreeable schedule in concert with the resident and visitor.”
Q: Are service plans only required if a resident receives essential caregiving services?
A: The Emergency Order states that “care or services provided by essential caregivers must be identified in the plan of care or service plan and may include, bathing, dressing, eating, and/or emotional support."
Q: Where should we document the ADL performed by the essential caregivers?
A: The Emergency Order states that care services provided by Essential Caregivers must be identified in the plan of care or service plan, and may include bathing, dressing, eating, and/or emotional support."
Q: Can you provide clarification re “emotional support.”
A: As with any service in a service plan, there needs to be a formal conversation that is recognized in the service plan that includes a discussion with family member, any other clinician to support the decision.
General Visitation
Q: Can general visitors be within six feet of the resident they are visiting?
A: No.
Q: For indoor visitation is any barrier required such as plexiglass, etc.?
A: No.
Q: Can two designated visitors assist with moving in or out a resident's belongings?
A: AHCA should be able to look into this.
Q: If a new resident is isolated upon move-in and tests positive prior to release, would that be considered a "new facility onset resident case"?
A: This question has been forwarded to AHCA for response.
Q: What are the considerations for communities that have different types of licensed facilities under one roof in terms of new COVID cases shutting down visitation? Do they have to be in separate buildings? No staff crossover? Are they looked at as one facility for visitation or can the COVID-free entity allow visitation? Does this change at all for independent living?
A: AHCA will take these questions into further consideration.
Q: Are quarantine requirements still in effect for people who are traveling to Florida to visit their loved ones?
A: The CDC has revised their guidance around travel and are no longer requiring a 14-day quarantine for travel. AHCA encourages all communities to review CDC travel guidance, as there are exceptions based on which states/countries people have traveled to.
Q: When does the 14-day timeline start for new COVID cases?
A: For symptomatic cases, the 14 days starts as soon as symptoms are identified. For asymptomatic cases, the 14 days starts as soon as they are tested.
Q: With cold and flu season coming upon us, if anyone shows symptoms of cold and flu that are similar to COVID, does visitation have to cease immediately while we identify if they are COVID positive?
A: AHCA is evaluating how this will be considered/differentiated.
Q: General visitation guidelines require adequate staff. If our facility does not have enough staff, how do we get around that?
A: This question has been forwarded to AHCA for response.
Testing
Q: Are testing protocols continuing for staff and vendors (e.g., Curative testing)?
A: The Emergency Order has no implication on the statewide biweekly staff testing requirements. There a lot of conversations about the Curative contract and mandatory testing rule while, at the same time, trying to balance with the nursing home testing requirements that came out of CMS. There will be more to come from AHCA in the next week or two.
PPE
Q: Is a surgical mask a requirement for facility staff or can staff wear their own mask?
A: AHCA’s expectation is that staff are wearing PPE that serves the purpose consistent with CDC requirements.
Q: If an essential caregiver comes to our facility and no other community, do they need to wear a PPE while providing services?
A: Yes.
Q: What are the specific PPE requirements for visitors?
A: For essential caregivers and compassionate care visits, it is dictated by the interaction. For essential and compassionate caregivers, PPE must be consistent with the care being provided and for the resident in terms of risk. This would likely be a surgical mask and gloves, with gowns and/or eye protection if needed. General visitors are required to wear a face mask.
Salons
Q: Salon workers must meet the "same requirements as Essential Caregivers." Does this mean they must wear the same PPE as health care workers? Must they complete Infection control and prevention training?
A: The Emergency Order states, in part, that “barbers and salon staff must wear surgical masks, gloves, practice hand hygiene, and follow the same requirements as essential caregivers.”
Q: The Order states that salon services cannot be provided to residents who test positive? What if the resident has recovered and is no longer subject to CDC quarantine?
A: This question has been forwarded to AHCA for response.
Q: Do the beauty salons have to close if a positive resident or associate occurs following the reopening?
A: The Emergency Order states that barbers and beauty salon services are permissible only if: the facility has had no new facility onset of resident COVID-19 cases in the previous 14 days; and 14 days have passed with no new staff COVID-19 cases where a positive staff was in the facility in the 10 days prior to the positive test.
Q: Do allowable Salon services include nail services and waxing?
A: This question has been forwarded to AHCA for response.
Tours
Q: Are we allowed to have prospects tour/visit inside our communities?
A: AHCA is working on this and will provide further information.
Residents Leaving the Facility
Q: Are residents allowed to leave communities for reasons other than essential medical visits, ie: entertainment, dinner with family members, off-site visits?
A: The Executive Order states in part that residents leaving the community temporarily for medical appointments or other activities must wear a face mask if tolerated by the resident’s condition. All residents must be screened upon return to the community.
Q: Do we still need to quarantine residents who leave the facility and then return, or is encouraging them to wear masks, screening them upon return, monitoring for symptoms, etc. sufficient?
A: This question has been forwarded to AHCA for response.
Miscellaneous
Q: How do we know if a community’s referral hospital has adequate capacity?
A: This question has been forwarded to AHCA for response.
Q: Are we allowed to have outside entertainment?
A: This question has been forwarded to AHCA for response.
Q: Where can I find the new screening question criteria?
A: DEM Emergency Order 20-009, section 2.
