No Patient Left Alone
Overview of In-Person Visitation Guidelines in the Health Pavilion
The administration and staff at Oak Hammock at the University of Florida understand the importance of our residents being able to spend time with loved ones, family, and friends. During the COVID-19 Public Health Emergency (PHE), per the Centers for Medicare and Medicaid Services (CMS), indoor general visitation for all residents was very restrictive in an effort to protect the health and safety of the residents and the facility staff needed to care for our most vulnerable population. Oak Hammock at the University of Florida 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.” CMS indicates that indoor visitation between residents and their desired guests be resumed “at all times and for all residents, regardless of vaccination status.” Oak Hammock at the University of Florida will not restrict visitation without a reasonable clinical or safety cause consistent with 42 CFR §483.10(f) (4) (Resident Rights). The facility will accommodate and support indoor visitation, including visits for reasons beyond compassionate care, based on the guidelines issued by CMS and the CDC. Policies related to visitation will continue to be revised as regulatory guidance is updated.
Oak Hammock at the University of Florida acknowledges the concerns for infection transmission to residents, 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.
Core Principles of COVID-19 Infection Prevention
Visitation at the Oak Hammock at the University of Florida will be conducted following Core Principles of COVID-19 Infection Prevention and best practices consistent with the Centers for Disease Control and Prevention (CDC) guidance for nursing homes in order to reduce the risk of COVID-19 transmission. While visiting our facility, a resident should be aware that they are at risk for potential exposure to COVID-19.
- Visitors will enter and exit building preferably using the front entrance. Members of the Independent Living community at Oak Hammock at the University of Florida alternatively may enter through the hallway connecting Independent Living to Assisted Living or through the hallway connecting Independent Living to Skilled Nursing.
- Upon entering the facility, all visitors will be screened for signs and symptoms of COVID-19 using the screening kiosk, which includes an automated temperature check. Visitors who have had a recent positive viral test for COVID-19, symptoms of COVID-19, or currently meet the criteria for quarantine should not enter the facility until they meet the criteria for discontinuation of quarantining. Oak Hammock at the University of Florida administration and/or 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 or symptoms of COVID-19, or who meet the criteria for quarantine.
- All visitors will follow the proper method for completing hand hygiene during their visit with the proper use of alcohol-based hand rub being the preferred method. Alcohol-based hand rub dispensers have been placed at the entry to the facility, throughout common areas of the facility, and at the entry/exit to resident rooms.
- All visitors must wear a well-fitted mask covering their mouth and nose at all times when entering the facility, while inside the facility’s common areas and when around any other residents. KN-95 masks are made available to all visitors, free of charge, adjacent to the check-in area. Residents, regardless of vaccination status, can choose not to wear face coverings or masks when other residents are not present.
- Visitors are discouraged from walking around in the facility. It is highly recommended that a visitor goes directly to the resident’s room or designated visiting area.
- All visitors, regardless of vaccination status, will adhere to the CDC guidance for physical distancing of at least 6 feet from staff and other residents during their visit.
- For the protection of residents and staff, visitors who violate the Core Principles of COVID-19 Infection Prevention and the Oak Hammock at the University of Florida policies and procedures after being educated, will be asked to leave the facility and in-person visitation will be suspended for the specific visitor.
- Visitor education will be available, including the following: COVID-19 signs and symptoms; Infection control precautions and best practices; Required use of face coverings; Proper hand hygiene; and proper entrance and exits to use when arriving and departing the facility and the routes to designated areas.
- Instructional signage with source control information (e.g., masking) for visitors and staff will be readily visible within the facility.
- Oak Hammock at the University of Florida will clean and disinfect high-frequency touched surfaces often and will clean and disinfect the designated visitation areas after visits.
- All visitors are encouraged to inform administrative staff if they develop a fever or symptoms consistent with COVID-19, or test positive for COVID-19 within 10 days after visiting.
Indoor In-Person Visitation
Oak Hammock at the University of Florida will facilitate in-person indoor visitation for all residents, regardless of vaccination status, as permitted under the applicable CMS regulations and the April 6, 2022, State of Florida, SB 988, “No Patient Left Alone Act.” Residents may receive visitors of their choosing at the time of their choosing in a manner that does not place other residents at risk or impose on the rights of another resident.
- Visitors to Oak Hammock at the University of Florida residents are not required to schedule a visit appointment in order to spend time with a resident for a routine visit.
- Oak Hammock at the University of Florida has placed no limit on the length of visits, the frequency of visits or the number of visitors an individual resident may have at one time as long as visitors are adhering to the Core Principles of COVID-19 Infection Prevention. In an effort to ensure that physical distancing is maintained in adherence to the Core Principles of COVID-19 Infection Prevention, large gatherings with a large number of visitors in the same place at the same time should be avoided unless a venue suitable to maintain the required physical distancing is available.
- Outdoor visits are recommended for residents and visitors who are unvaccinated for the protection of the other facility residents.
- Visitation will only be allowed in designated common spaces or in the resident’s room. Alternatively, outside areas will be available for visitation and pre-approval to use these spaces is not required. Visitors will be encouraged to eat or drink during their visit only while in the resident’s room.
- The staff at Oak Hammock at the University of Florida values and honors the rights of the resident to deny consent for a visit at any time and will assist the resident as needed in such circumstances.
- Consensual physical contact between a resident and a visitor will be allowed.
- While not recommended, residents who are on transmission-based precautions (TBP) or quarantine can still receive visitors. In these cases, visits should occur in the resident’s room and the resident and visitor should wear Personal Protective Equipment (PPE) during the visit. Visitors will be made aware of the potential risk of visiting and precautions necessary in order to visit the resident.
Important Considerations for Visitation
Visitation for an Oak Hammock at the University of Florida resident will be person-centered, considering the resident’s physical, mental and psychosocial well-being, and will support their quality of life.
In accordance with the April 6, 2022, State of Florida, SB 988, “No Resident Left Alone Act,” each resident of Oak Hammock at the University of Florida will be asked to designate a family member, friend, guardian or other person as an “essential caregiver.” Under the Act, this essential caregiver is allowed to visit the resident for at least 2 hours daily in addition to any other visitation authorized by Oak Hammock at the University of Florida. The essential caregiver is not required by Oak Hammock at the University of Florida to provide any form of care to the resident during their visits. Residents have the right to decline designation of an essential caregiver. The designated essential caregiver will be documented in the resident’s clinical record.
The Centers for Medicare and Medicaid Services (CMS) guidelines do not indicate any age restriction for visitors; however, all visitors to Oak Hammock at the University of Florida must be able to adhere to the Core Principles of COVID-19 Infection Prevention, or must have a responsible party who is able to facilitate these principles.
In accordance with the April 6, 2022, State of Florida, SB 988, “No Resident Left Alone Act,” unless a resident objects, Oak Hammock at the University of Florida must allow in-person visitation for end-of-life situations or for a resident who:
a. was living with family before being admitted and is struggling with the change in environment and lack of in-person family support;
b. who is in the process of making one or more major medical decisions;
c. is experiencing emotional distress or grieving the loss of a friend or family member who has recently died;
d. needs cueing or encouragement to eat or drink which was previously proved by a family member or caregiver;
e. used to talk and interact with others is seldom speaking.
Oak Hammock at the University of Florida, in accordance with the April 6, 2022, State of Florida, SB 988, “No Resident Left Alone Act,” will allow consensual physical contact between a resident and their visitor, regardless of vaccination status.
During an outbreak status, visitation will still be allowed per Centers for Medicare and Medicaid Services (CMS) and Centers for Disease Control and Prevention (CDC) guidelines. An outbreak exists when a new nursing home onset of COVID-19 occurs among a resident or a staff member. Visitors will be required to adhere to the Core Principles of COVID-19 Infection Prevention and will be required to wear a well-fitted mask throughout the length of their visit with the resident.
COVID-19 Testing and Vaccination of Visitors
Oak Hammock at the University of Florida may encourage testing of visitors during times when Oak Hammock at the University of Florida’s county community transmission rate is at the substantial or high level. The facility will encourage all visitors to be tested on their own prior to coming to the facility (e.g. within 2-3 days) of their visit. However, under Centers for Medicare and Medicaid Services (CMS) guidance, visitors are not required to test or to show proof of having tested as a condition of visitation.
Oak Hammock at the University of Florida will educate and encourage visitors to become vaccinated against COVID-19 to help prevent the spread of COVID-19 illness. Visitors are not required to be vaccinated or to show proof of vaccination as a condition of visitation. Visitors who decline to disclose their vaccination status will be assumed to be unvaccinated and will be required to wear a face mask at all times while in the facility. This assumption applies to representatives of the Office of the State Long-Term Care Ombudsman and protection and advocacy systems.
Responsibilities of Administrative Staff
The Administrator of Oak Hammock at the University of Florida, and other designated staff, including the Director of Nursing, Assistant Director Nursing, and Infection Control Nurse, will make every effort to facilitate safe indoor in-person visitation consistent with the 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.”
Designation of Responsible Party
The Administrator of Oak Hammock at the University of Florida is responsible for ensuring that all staff adhere to the policies and procedures set forth by this organization.
Any comments or complaints regarding Oak Hammock's visitation policies should be submitted to the Agency for Health Care Administration, or AHCA, at https://ahca.myflorida.com/visitation/.
References: CMS QSO-20-39-Nh/revised 3/22/2022, F.S.408.823 In-person visitation “No Patient Left Alone Act”