VISITATION POLICY

Oak Hammock at the University of Florida, Inc. is committed to upholding the rights, dignity, and well-being of all residents by ensuring safe, equitable, and consistent access to visitation. The organization recognizes that visitation is a critical component of resident-centered care and quality of life. We affirm that residents have the right to receive visitors of their choosing at any time, subject only to limited and clearly defined clinical and safety exceptions. Visitation shall not be restricted based on vaccination status, disability, race, color, national origin, religion, sex, gender identity, sexual orientation, or payment source. Oak Hammock at the University of Florida, Inc., is committed to following federal and state guidelines, including nationally recognized sources for infection prevention and control.

DEFINITIONS

Airborne precautions – refer to actions taken to prevent or minimize the transmission of infectious agents/organisms that remain infectious over long distances when suspended in the air. These infectious particles can remain suspended in the air for prolonged periods of time and can be carried on normal air currents in a room or beyond, to adjacent spaces or areas receiving exhaust air.

Alcohol-based hand rub (AHBR) – refers to 60-95% ethanol or isopropyl alcohol-containing preparation based designed for application to the hands to reduce the number of viable microorganisms.

Communicable Disease – an illness due to a specific infectious agent or its toxic products which arises through transmission of that agent or its products from a reservoir to a susceptible host, either directly from an infected person or animal, or indirectly, through an intermediate plant or animal host, vector, or the inanimate environment.

Contact precautions – refer to measures that are intended to prevent transmission of infectious agents that are spread by direct or indirect contact with the resident or the resident’s environment

Droplet precautions – refer to actions designed to reduce/prevent the transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions

Facial covering – a cloth or surgical face mask, a face shield, or any other facial covering that covers the mouth and nose.

Hand hygiene – refers to a general term that applies to hand washing, antiseptic handwash, and alcohol-based hand rub.

Outbreak – the occurrence in persons in a community, institution, region, or other defined area of a group of cases of an illness of similar nature clearly in excess of normal expectancy.

Personal protective equipment (PPE) – A variety of barriers used alone or in combination to protect mucous membranes, skin, and clothing from contact with infectious agents. PPE includes gloves, masks, respirators, goggles, face shields, and gowns.

Procedure mask – A covering for the nose and mouth that is intended for use in general patient care situations. These masks generally attach to the face with ear loops rather than ties or elastic. Unlike surgical masks, procedure masks are not regulated by the Food and Drug Administration.

Reasonable clinical and safety restrictions – includes practices that protect the health and security of all residents and staff. These may include, but are not limited to:

• Restrictions placed to prevent community-associated infection or communicable disease transmission to one or more residents. A resident’s risk factors for infection (e.g., immunocompromised condition) or current health state (e.g., end-of-life care) should be considered when restricting visitors.
• In general, visitors with signs and symptoms of a transmissible infection (e.g., a visitor is febrile and exhibiting signs and symptoms of an influenza-like illness) should defer visitation until he or she is no longer potentially infectious (e.g., 24 hours after resolution of fever without antipyretic medication), or according to Centers for Disease Control and Prevention (CDC) guidelines, and/or local health department recommendations.
• Keeping the facility locked or secured at night with a system in place for allowing visitors approved by the resident;
• Denying access or providing limited and supervised access to an individual if that individual is suspected of abusing, exploiting, or coercing a resident until an investigation into the allegation has been completed or is abusing, exploiting, or coercing a resident;
• Denying access to individuals who have been found to have been committing criminal acts such as theft;
• Denying access to individuals who are inebriated or disruptive; or
• Denying access or providing supervised visitation to individuals who have a history of bringing illegal substances into the facility, which places residents’ health and safety at risk.

Respiratory Hygiene/Cough Etiquette – A combination of measures designed to minimize the transmission of respiratory pathogens via droplet or airborne routes in health care settings. The components of respiratory hygiene/cough etiquette are:

• Covering the mouth and nose during coughing and sneezing,
• Using tissues to contain respiratory secretions with prompt disposal into a no-touch receptacle,
• Offering a surgical mask to persons who are coughing to decrease contamination of the surrounding environment, and
• Turning the head away from others and maintaining spatial separation, ideally >3 feet, when coughing.

Source control – The process of containing an infectious agent either at the portal of exit from the body or within a confined space. The term is applied most frequently to containment of infectious agents transmitted by the respiratory route.

Transmission-based precautions – a set of infection control measures used in addition to standard precautions for patients who are known or suspected to be infected or colonized with certain infectious agents.

PROCEDURE

MONITORING

• The Infection Preventionist (IP) will collaborate with the Florida Department of Health on the status of any community transmission rates for communicable diseases.
• During heightened times of transmission of communicable disease, the facility will post signage at the entrances educating visitors on signs and symptoms of respiratory viral or influenza-like illnesses, including core infection prevention and control (IPC) practices to adhere to during their visit. Visitors are asked to postpone and reschedule their visit if they are feeling ill or have recently tested positive for a communicable disease.
• Core Infection Prevention and Control Practices include but are not limited to:
  1. Frequent hand hygiene utilizing alcohol based hand rub (ABHR) as the preferred method
  2. Respiratory Hygiene and Cough Etiquette
  3. Universal Source Control with a disposable procedure mask. The facility will provide facemasks to residents, visitors, and staff free of charge.
     1. Per 59AER23-2 F.A.C., Health care practitioners and health care providers may choose to require a patient to wear a facial covering only when the patient is in a common area of the health care setting and is exhibiting signs or symptoms of or has a diagnosed infectious disease that can be spread through droplet or airborne transmission.
     2. Health care practitioners and health care providers may choose to require a visitor to wear a facial covering only when the visitor is:
        1. Exhibiting signs and symptoms of or has a diagnosed infectious disease that can be spread through droplet or airborne transmission
        2. In sterile areas of the health care setting or an area where sterile procedures are being performed
        3. In an inpatient or clinical room with a patient who is exhibiting signs or symptoms of or has a diagnosed infectious disease that can be spread through droplet or airborne transmission, or
        4. Visiting a patient who treating health care practitioner has diagnosed the patient with or confirmed a condition affecting the immune system in a manner which is known to increase risk of transmission of an infection from employees without signs or symptoms of infection to a patient and whose treating practitioner has determined that the use of facial coverings is necessary for the patient’s safety.

• In accordance with the Florida Patient Bill of Rights and Responsibilities, section 381.026, F.S., and Emergency Rule 59AER23-2(1), health care practitioners and health care providers who choose to require a facial covering for any visitor must include in the policy a provision for opting-out of wearing a facial covering if an alternative method of infection control or infectious disease prevention is available.

1. Suppose an outbreak investigation is initiated, which occurs when a single new case of COVID-19 respiratory viral illness, influenza-like illness or communicable disease is identified among residents or staff. In that case, the facility may recommend for staff to use source control, including the use of respirators or well-fitting masks to cover the mouth and nose to prevent the spread of respiratory secretions when they are breathing, talking, coughing and sneezing. Pursuant to Emergency Rule 59AER23-2(2), health care practitioners must allow an employee to opt out of facial covering requirements unless the employee is:
   1. Conducting sterile procedures
   2. Working in a sterile area
   3. Working with a patient whose treating health care practitioner has diagnosed the resident with or confirmed a condition affecting the immune system in a manner which is known to increase the risk of transmission of an infection from employees without signs or symptoms of infection to a resident and who treating practitioner has determined that the use of facial coverings is necessary for the resident’s safety
   4. With a resident on droplet or airborne isolation; or,
   5. Engaging in non-clinical potentially hazardous activities that require facial coverings to prevent injury or harm in accordance with industry standards.

• If a visitor tests positive for a communicable disease or experiences signs and symptoms of an influenza-like illness within seven (7) days of their visit. They are asked to notify the facility’s Infection Preventionist (IP) at 352-548-1137.
• For visitors who have had close contact with someone diagnosed with a respiratory viral or influenza-like illness, it is safest to defer their non-urgent in-person visit for seven (7) days.

VISITATION

• All visitors who are not members of Oak Hammock will check in at the Security Guard Gate and receive a visitor’s badge. Visitors are required to always have the badge visible while on campus. Members of Oak Hammock may visit residents at any time.
• Visitors must adhere to the CDC’s Core Principles of Preventing Respiratory Pathogens in Nursing Homes.
• Oak Hammock will not restrict visiting hours and will make reasonable accommodations for residents’ visitation requests. The facility will provide immediate access to a resident by others who are visiting with the consent of the resident, subject to reasonable clinical and safety restrictions and the resident’s right to deny or withdraw consent at any time.
• Oak Hammock at the University of Florida, Inc., will not request or mandate viral testing or proof of vaccination to visit residents.
• Oak Hammock at the University of Florida, Inc, will provide immediate access to any resident by:
  1. Any representative of the Secretary;
  2. Any representative of the State;
  3. Any representative of the Office of the State Long Term Care Ombudsman;
  4. The resident’s physician;
  5. Any representative of the agency responsible for the protection and advocacy system for the developmentally disabled individuals;
  6. Any representative of the agency responsible for the protection and advocacy system for individuals with mental disorders;
  7. The resident representative.
• The facility will provide immediate access to a resident by immediate family and other relatives of the resident, subject to the resident’s right to deny or withdraw consent at the time. Resident’s family members are not subject to visiting hour limitations or other restrictions not imposed by the resident, except for reasonable clinical and safety restrictions, placed by the facility according to CDC guidelines, and/or local health department recommendations
• The facility will inform each resident and/or resident representative of his or her visitation rights and related facility policies and procedures, including any clinical or safety restriction or limitation of such rights, in a manner he or she understands.
• The facility will inform each resident of the right, subject to his or her consent, to receive the visitors whom he or she designates as well as deny visitation, including but not limited to:
  1. A spouse, including a same-sex spouse
  2. A domestic partner, including a same-sex domestic partner
  3. Another family member
  4. Adoptive/foster family members
  5. A friend
• Residents have the right to define their family. During the admissions process, facility staff will discuss this issue with the resident.  If the resident is unable to express or communicate who they identify as family, facility staff will discuss this with the resident’s representative.
• Oak Hammock at the University of Florida, Inc. reserves the right to limit or restrict visitation if the visitation is necessary to maintain the residents’ reasonable clinical and safety.
• Oak Hammock at the University of Florida, Inc. is a No Tobacco Use Campus. Any tobacco use, including the use of e-cigarettes, is strictly prohibited.

 VISITATION DURING A COMMUNICABLE DISEASE OUTBREAK

• Oak Hammock at the University of Florida, Inc. will collaborate with the Florida Department of Health and the Agency for Health Care Administration for guidance or direction on how to structure visitation to reduce the risk of communicable disease transmission during an outbreak.
• There will be adequate signage with instructions for infection prevention, i.e., hand hygiene, cough etiquette, etc., posted at all entrances.
• The facility will ensure all visitors have access to hand hygiene supplies.
• Restrictions may be placed to prevent community-associated infection or communicable disease transmission to one or more residents. A resident’s risk factors for infection (e.g., immunocompromised condition) or current health state (e.g., end-of-life care) should be considered when restricting visitors.
• Resident’s family members are not subject to visiting hour limitations or other restrictions not imposed by the resident, with the exception of reasonable clinical and safety restrictions placed by the facility based on recommendations of CMS, CDC, or the local health department.
• Oak Hammock at the University of Florida, Inc. will offer alternatives to traditional visitation, such as outdoor visits, indoor designated visitation areas, and/or virtual communications (phone, video-communication). Staff will be alert to psychosocial needs, and take actions that would allow visitation to occur safely in spite of the presence of contagious infection.
• During a communicable disease outbreak, while not recommended, residents who are on transmission-based precautions (TBP) can still receive visitors. In these cases, before visiting residents who are on TBP, visitors will be made aware of the potential risk of visiting and the precautions necessary in order to visit the resident. Visitors will adhere to principles of infection prevention.
• Oak Hammock at the University of Florida, Inc. will keep families informed of visitation policies through listserv communication, designated primary contact for inbound calls, or regular outbound calls. Implement emergency communication procedures as needed.

REFERENCES

59AER23-2 Standards of the Appropriate Use of Facial Coverings. (2023, August 1). Retrieved from Florida Agency for Health Care Administration: https://ahca.myflorida.com/content/download/22817/file/59AER23-2_Final_Text.pdf

Epidemiology (Communicable Diseases). (2025, May 12). Retrieved from The Florida Department of Health: https://alachua.floridahealth.gov/

Florida Administrative Register. (2006, November 20). Florida Administrative Code. Retrieved from Florida Department of State: https://flrules.org/gateway/RuleNo.asp?title=CONTROL%20OF%20COMMUNICABLE%20DISEASES%20AND%20CONDITIONS%20WHICH%20MAY%20SIGNIFICANTLY%20AFFECT%20PUBLIC%20HEALTH&ID=64D-3.001

QSO-20-39-NH. (2023, May 8). Retrieved from The Centers for Medicare and Medicaid Services: https://www.cms.gov/files/document/qso-20-39-nh-revised.pdf

SBB 988 No Patient Left Alone Act. (2022, April 8). Retrieved from The Florida Senate: https://www.flsenate.gov/Session/Bill/2022/988

State Operations Manual Appendix PP – Guidance to Surveyors for Long Term Care Facilities. (2025, July 23). Retrieved from The Centers for Medicare and Medicaid Services: https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/downloads/som107ap_pp_guidelines_ltcf.pdf

The Centers for Disease Control and Prevention. (2024, September). 2007 Guideline for Isolation Precautions: Preventing Transmission of Infection Agents in Healthcare Settings. Retrieved from The Centers for Disease Control and Prevention: https://www.cdc.gov/infection-control/media/pdfs/Guideline-Isolation-H.pdf

Viral Respiratory Pathogens Toolkit for Nursing Homes. (2025, January 8). Retrieved from The Centers for Disease Control and Prevention: https://www.cdc.gov/long-term-care-facilities/hcp/respiratory-virus-toolkit/index.html#:~:text=Ensure%20access%20to%20respiratory%20viral,respiratory%20virus%20treatments%20or%20prophylaxis.