Purpose

In-Person Visitation bill has been signed into law, creating Chapter 408.823, which is subject “In-person visitation.” A resident may designate a visitor who is a family member, friend, guardian, or other individual as an essential caregiver.

Policy

The following are the procedures to be followed to identify Essential Caregivers for residents and the expectations. These procedures will be administered equally to all residents that request to have an essential caregiver, without regard to race, color, religion, sex (including gender identity and transgender status), age, national origin, disability, or veteran status.

Essential caregiver visitors provide emotional support to help a resident deal with a difficult transition or loss, upsetting event, making major medical decisions, needs cueing to eat and drink, stops speaking, or end-of-life. Essential caregiver visitors may be allowed entry into facilities on a limited basis for these specific purposes. The provider must allow at a minimum in-person visitation for at least 2-hours daily under these circumstances. At, the 2-hour visitation will be between 9:00 a.m. – 9:00 p.m. may make exceptions to the 2-hour visitation on a case-by-case basis for end-of-life residents. These exceptions will be discussed and agreed upon in writing by the facility’s designee and the resident’s responsible party.

Procedures:

I. For designation and utilization of essential caregiver visitors.

1. Jennifer Gardens will provide the Agency for Health Care Administration (AHCA) with a copy of the facility’s essential caregiver visitor’s policy and procedure, with the initial licensure application, renewal application and/or change of ownership application.
2. Jennifer Gardens essential caregiver visitor’s policy and procedure is available on the homepage.
3. Jennifer Gardens will designate a key staff to support infection prevention and control training.
4. Jennifer Gardens will set a limit on the total number of visitors allowed in the facility at any given time based on the ability of staff to safely screen and monitor and the space to accommodate the essential caregiver visitors.
   1. Identify locations for visitation/care to occur planning for residents in shared spaces and facilities with minimal common space to identify maximum time availability
   2. Provide outdoor visitation spaces that are protected from weather elements, such as porches, courtyards, patios, or other covered areas that are protected from heat and sun, with cooling devices, if needed
   3. Create indoor visitation spaces for residents in a room that is not accessible by other residents or in a resident’s private room if the resident is bedbound and for health reasons cannot leave his or her room.
5. All residents and/or POA/Guardian if appropriate will be asked if they want to identify an Essential Caregiver.
6. All new residents will be asked if they would like to identify an Essential Caregiver upon move-in.
7. All residents will be allowed to update as requested the named Essential Caregiver of record within 2 business days of request.
8. Residents are allowed in-person visitation in all the following circumstances, unless the resident, client, or patient objects:
   1. End-of-life situations.
   2. A resident, client, or patient who was living with family before being admitted to the provider’s care is struggling with the change in environment and lack of inperson family support.
   3. The resident, client, or patient is making one or more major medical decisions.
   4. A resident, client, or patient is experiencing emotional distress or grieving the loss of a friend or family member who recently died.
   5. A resident, client, or patient needs cueing or encouragement to eat or drink which was previously provided by a family member or caregiver.
   6. A resident, client, or patient who used to talk and interact with others is seldom speaking.
9. Maintain a visitor log for signing in and out.
10. No more than one essential caregiver visitor may be designated per resident.
11. The policy need NOT prohibit essential caregiver visitor visits, if the specific resident to be visited is quarantined, tested positive, or showing symptoms of a communicable disease. Visits in these circumstances will likely require a higher level of PPE than standard surgical masks. The general visitation requirement that the facility has no new facility-onset cases of a communicable disease (for example COVID-19) is not applicable to visitation by essential caregiver visitors.
12. Jennifer Gardens is not required to provide for “facility-provided” COVID-19 testing if, and only if, it is based on the most recent CDC and FDA guidance. The cost of this testing cannot be passed on to the visitor.
13. Essential caregiver visitors must wear Personal Protective Equipment (PPE) per facility’s Infection Control Policies. The PPE required must be consistent with the most recent CDC guidance for healthcare workers. At the essential caregiver visitors shall wear the same PPE that staff wear to provide care or services to the resident.
14. Any changes to essential caregiver visitor policies must be promptly communicated to affected residents and essential caregiver visitors.

II. To facilitate visits by Essential caregiver visitors upon a request from a resident or friend/family member:

1. The resident (or their representative) will read and sign the policy and procedures. The acknowledgement of the signature represents that the essential caregiver visitor will abide by the policies set forth in this document.
2. The essential caregiver visitor will complete training on infection prevention and control including the use of PPE, use of masks, hand sanitation, and social distancing.
3. The essential caregiver visitor must immediately inform the facility if they develop symptoms consistent with a communicable disease within 24 hours of their last visit at the facility. Sample policy provided by
4. Essential caregiver visits may take place in the resident’s room, or a designated area determined by the time the visitation scheduled is developed and agreed upon.

III. When an essential caregiver visitor is scheduled to visit, the facility will:

1. Thoroughly screen the visitor per the facility’s infection control policy and procedure and document the name of the individual, the date and time of entry, and the screening mechanism used, along with the screening employee’s name and signature. Just as with staff entering the building, if the visitor fails the screening, the visitor CANNOT be allowed entry.
2. Ensure that the required consents, and training and policy acknowledgements are in place.
3. Ensure that the caregiver visitor has appropriate PPE if applicable.
4. Jennifer Gardens will require the essential caregiver visitor to sign in and out on the visitor log.
5. Jennifer Gardens will monitor the essential caregiver visitor’s adherence to policies and procedures.
6. If the essential caregiver visitor fails to follow the facility’s infection prevention and control requirements, after attempts to mitigate concerns, shall restrict or revoke visitation.
7. In the event the essential caregiver visitor’s status is revoked due to the individual not following the facility’s policy and procedures, the resident may select a different essential caregiver visitor who will be granted visitation rights upon proper vetting and agreeing to Jennifer Gardens policies and procedures.