Purpose

In-Person Visitation bill has been signed into law, creating Chapter 408.823, which is subject “In-person visitation.” This policy and these procedures are intended to serve assisted living facilities to comply with the regulations set forth in Chapter 408.823, Florida Statutes. 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 and General Visitors for residents and their 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 caregivers and general visitors provide emotional support to help a resident deal with a difficult transition or loss, upsetting event, making major medical decisions, need cueing to eat and drink, stops speaking, or end-of-life. Essential caregivers and general 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 ALL visitors at least 2 hours daily under these circumstances. At Jennifer Gardens, the 2-hour visitation should be conducted between 9:00 a.m. – 9:00 p.m. Jennifer Gardens 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:

1. For designation and utilization of essential caregivers and general 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 and general visitor’s policy and procedure is available on jennifergardens.com homepage.
   3. Jennifer Gardens will designate the Administrator as key staff to support infection prevention and control training.
   4. Jennifer Gardens will designate the Administrator to make sure staff adhere to visitation policies and procedures.
   5. 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.
   6. Identify locations for visitation/care to occur planning for residents in shared spaces and facilities with minimal common space to identify maximum time availability.
   7. 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.
   8. Jennifer Gardens will 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.
   9. All residents and/or POA/Guardian if appropriate will be asked to identify an Essential Caregiver.
   10. All new residents will be asked to identify an Essential Caregiver upon move-in.
   11. All residents will be allowed to update as requested the named Essential Caregiver of record.
   12. Residents are allowed in-person visitation in all the following circumstances, unless the resident 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 in person 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.
   13. Maintain a visitor log for signing in and out.
   14. No more than one essential caregiver visitor may be designated per resident.
   15. No more than four general visitors may visit the resident in the room.
   16. 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. 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.
   17. Essential caregiver visitors will be screened, prior to visiting the resident, to ensure the essential caregiver visitor does not have symptoms of a communicable disease that could be spread to the resident.
   18. Essential caregiver and general visitors will be allowed to visit the resident without being compelled to provide proof of vaccination or immunization status.
   19. 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 Jennifer Gardens the essential caregiver visitors shall wear the same PPE that staff wear to provide care or services to the residents.
   20. Any changes to Jennifer Gardens essential caregiver and general visitors’ policies must be promptly communicated to affected residents, essential caregiver and general visitors.
2. To facilitate visits by Essential caregiver visitors upon a request from a resident or friend/family member:
   • 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.
   • The essential caregiver visitor will complete training on Jennifer Gardens infection prevention and control including the use of PPE, use of masks, hand sanitation, and social distancing.
   • 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 to the facility.
   • Essential caregiver visits may take place in the resident’s room, or a designated area determined by Jennifer Gardens at the time the visitation scheduled is developed and agreed upon.
3. When an essential caregiver visitor is scheduled to visit, the facility will:
   • Essential caregivers will be allowed to visit the residents at Jennifer Gardens regardless of the screening outcome.
   • Jennifer Gardens will ensure that the required consents, and training and policy acknowledgements are in place.
   • Jennifer Gardens will ensure that no more than one essential caregiver visitor may be designated per resident.
   • Jennifer Gardens will allow essential caregivers to visit with the resident without being compelled to provide proof of vaccination or immunization status.
   • Jennifer Gardens will ensure that the essential caregiver has appropriate PPE if applicable.
   • Jennifer Gardens will require the essential caregiver sign in and out on the visitor log.
   • Jennifer Gardens will ensure to screen all essential caregivers prior to visiting with the resident, to ensure the essential caregiver visitor is free from symptoms of a communicable disease, which could be spread to the resident.
   • Jennifer Gardens will ensure that the essential caregiver visitors are given at least a minimum of 2 hours of daily visitation.
   • Jennifer Gardens will monitor the essential caregiver’s adherence to policies and procedures.
   • If the essential caregiver fails to follow the facility’s infection prevention and control requirements, after attempts to mitigate concerns, Jennifer Gardens shall restrict or revoke visitation.
   • In the event the essential caregiver’s status is revoked due to the individual not following the facility’s policy and procedures, the resident may select a different essential caregiver who will be granted visitation rights upon proper vetting and agreeing to Jennifer Garden’s policies and procedures.
   • Jennifer Gardens will allow consensual physical contact between a resident and visitor (resident and visitor must be respectful of other residents and staff).
4. When a General Visitor is scheduled to visit, the facility will:
   • Visitors will be allowed to visit the residents at Jennifer Gardens regardless of the screening outcome.
   • Jennifer Gardens will ensure that the required consents, and policy acknowledgements are in place.
   • Jennifer Gardens will require the visitor to sign in and out on the visitor log.
   • Jennifer Gardens will ensure that there are no more than four visitors at a time in residents room.
   • Jennifer Gardens will ensure that the visitors are given at least a minimum of 2 hours of daily visitation.
   • Jennifer Gardens will allow visitors to visit with the resident without being compelled to provide proof of vaccination or immunization status.
   • Jennifer Gardens will ensure to screen all visitors prior to visiting with the resident, to ensure the visitor is free from symptoms of a communicable disease, which could be spread to the resident.
   • Jennifer Gardens will monitor the visitors adherence to policies and procedures.
   • If the visitor fails to follow the facility’s visitation policy and procedure requirements, after attempts to mitigate concerns, Jennifer Gardens shall restrict or revoke visitation.
   • Jennifer Gardens will allow consensual physical contact between a resident and visitor (resident and visitor must be respectful of other residents and staff).