Essential Caregiver Visitation Procedures

Overview

Florida Law Chapter 2022-34 (Senate Bill No. 988) was signed into law creating an “In-Person Essential Caregiver Visitation” Bill. This is intended to serve as a procedure for compliance with 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.

Detail

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 Communities 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 Tuscan Gardens, the 2-hour visitation will be between 8:30 a.m. – 7:00 p.m. Exceptions may be made 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 with the Executive Director or Designee and the resident’s responsible party.

1. Tuscan Gardens will provide the Agency for Health Care Administration (AHCA) with a copy of the Community’s Essential Caregiver visitor’s procedure with the initial licensure application, renewal application and/or change of ownership application.
2. Tuscan Gardens Essential Caregiver visitor’s procedure is available on the Tuscan Garden’s homepage.
3. Tuscan Gardens will designate the Executive Director or Designee as key associate to support infection prevention and control training.
4. Tuscan Gardens will set a limit on the total number of visitors allowed in the Community at any given time based on the ability of associates to safely screen and monitor and the space to accommodate the essential caregiver visitors.

a) Identify locations for visitation/care to occur planning for residents in shared spaces and Communities with minimal common space to identify maximum time availability.

b) 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.

c) Create indoor visitation spaces for residents in a room that is not accessible by other residents or in a resident’s private suite if the resident is bedbound and for health reasons cannot leave his or her suite.

5. All residents and/or POA/Guardia, when 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 (in writing) 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, or when appropriate POA/Guardian, objects:

a) End-of-life situations.

b) A resident 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.

c) The resident is making one or more major medical decisions.

d) A resident is experiencing emotional distress or grieving the loss of a friend or family member who recently died.

e) A resident needs cueing or encouragement to eat or drink which was previously provided by a family member or caregiver.

f) A resident who used to talk and interact with others is seldom speaking.

9. Use of the Accushield sign in/out device for signing in and out of the Community.

10. No more than one essential caregiver visitor may be designated per resident.

11. The guide 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 Community has no new Community-onset cases of a communicable disease (for example COVID-19) is not applicable to visitation by essential caregiver visitors.

12. Tuscan Gardens is not required to provide for “Community-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 Community’s Infection Control Policies. The PPE required must be consistent with the most recent CDC guidance for healthcare workers. All the Essential Caregiver visitors shall wear the same PPE that associates wear to provide care or services to the resident.

14. Any changes to Essential Caregiver visitor procedure must be promptly communicated to affected residents and Essential Caregiver visitors.

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 standard operating procedures. An Essential Visitor Designation form will be completed and signed. The signed Essential Visitor Acknowledgement form represents that the Essential Caregiver Visitor will abide by the standard operating procedures 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 Community if they develop symptoms consistent with a communicable disease within 24-hours of their last visit at the Community.
4. Essential Caregiver visits may take place in the resident’s suite or a designated area determined by at the time the visitation scheduled is developed and agreed upon.

When an Essential Caregiver visitor is scheduled to visit, the Community will:

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

Related Document:

(Chapter 2022-34) Committee Substitute for Senate Bill No. 988