MorseLife’s Visitation Guidelines

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Joseph L. Morse Health Center
Tradition
Resnick
Memory Care

MorseLife Health System Facial Coverings Policy & Procedures for Joseph L. Morse Health Center, Tradition, MorseLife Memory Care Residence, and Resnick Assisted Living

Guidelines and Protocols

Title: Facial Coverings Policies and Procedures
Origination Date: 06/2023
Revision Date: 07/2023

Policy Statement:

In accordance with the Florida Statutes §408.824 and the standards set forth in the Florida Administrative Code 59AER23-1 and -2, Morselife Health System has adopted the following policy regarding the use of facial coverings for infection control by its residents, visitors, staff members and others coming into the facility.

Definitions:

Common Area – refers to areas in a health care setting where patients are not treated, diagnosed, or examined.

Employee – refers to any person under employment or contract of a health care setting, including health care practitioners, administrative staff, maintenance staff, aides, contractors, students, and volunteers.

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

Patient – refers to a person receiving services from a health care practitioner or health care provider. (For the purposes of this policy, the term “residents” is used to indicate persons residing in the skilled nursing.)

Sterile Areas – refers to locations where surgery is conducted or where procedures that require aseptic techniques are performed.

Sterile Procedure – refers to aseptic procedures with the goal of minimizing the risk of microbial contamination to reduce the rate of invasive or surgical site infection

Visitor – refers to any person in a health care setting who is not an employee or patient (resident) of the health care setting.

Policy Interpretation and Implementation:

MorseLife Health System does not require the universal use of facial coverings by persons in order to gain access to, entry upon, service from, or admission to the facility or otherwise discriminate against persons based on their refusal to wear a facial covering.
Persons who freely choose to wear facial coverings while within MorseLife Health System may do so based upon their personal preference.
Facial coverings remain an important intervention in preventing respiratory bacterial and viral transmission. MorseLife Health System and its health care practitioners may choose to require a resident to wear a facial covering only when the resident is in a common area of the facility and is exhibiting signs or symptoms of or has been diagnosed as having an infectious disease that can be spread through droplet or airborne transmission.
MorseLife Health System and its health care practitioners may choose to require a visitor to wear a facial covering only when the visitor is:

1. exhibiting signs or symptoms of or has a diagnosed infectious disease that can be spread through droplet or airborne transmission.
2. in sterile areas of the facility or an area where sterile procedures are being performed.
3. in a resident or clinical room with a resident 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 resident whose 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 to the resident’s safety.

Opt-out Requirements of 59AER23-2 when facial coverings are being required.

MorseLife Health System will follow the regulations of 59AER23-2 for persons requesting to opt-out of wearing a facial covering.
MorseLife Health System and its health care practitioners who choose to require a facial covering for any resident will provide for the opting-out of wearing a facial covering that is in accordance with the Florida Patient Bill of Rights and Responsibilities, section 381.026, F.S., including the following:
1. 381.026 (5) Responsibilities of Patients. – Each patient of a health care provider or health care facility shall respect the health care provider’s and health care facility’s right to expect behavior on the part of patients which, considering the nature of their illness, is reasonable and responsible.
2. 381.026 (4)(b)3. Rights Of Patients – A patient has the right to be given by his or her health care provider information concerning diagnosis, planned course of treatment, alternatives, risks, and prognosis, unless it is medically inadvisable or impossible to give this information to the patient, in which case the information must be given to the patient’s guardian, or a person designated as the patient’s representative. A patient has the right to refuse this information.
3. 381.026 (4)(b)4. Rights Of Patients – A patient has the right to refuse any treatment based on information required by this paragraph, except as otherwise provided by law. The responsible provider shall document any such refusal.
4. 381.026 (4)(b)5. Rights Of Patients – A patient in a health care facility has the right to know what facility rules and regulations apply to patient conduct.
MorseLife Health System and its health care practitioners who choose to require a facial covering for any visitor will provide for the opting-out of wearing a facial covering when requested by the visitor if an alternative method of infection control or infectious disease prevention is available based upon the individual resident’s and visitor’s circumstance.
As a health care provider, MorseLife Health System will allow an employee to opt out of facial covering requirements unless an employee are:
1. Conducting sterile procedures,
2. Working in a sterile area,
3. Working with a patient whose 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,
4. With a patient on droplet or airborne isolation, or
5. Engaging in non-clinical potentially hazardous activities that require facial coverings to prevent physical injury or harm in accordance with industry standards.

References

Florida Administrative Code 59AER23-1 and 2 Definitions and Standards for the Appropriate Use of Facial Coverings for Infection Control

Florida Statutes §408.824

Chapter 2023-43, Laws of Florida

Joseph L. Morse Health Center

Guidelines and Protocols

Title: Visitation policy
Origination Date: 06/2020
Revision Date: 03/2022, 2/6/2023, 7/12/2023, 3/2026

Purpose: Describe visitation guidelines

Definitions:

“Essential caregiver” – A resident, client, or patient may designate a visitor who is a family member, friend, guardian, or other individual as an essential caregiver. An essential caregiver is not required to provide necessary care to a resident, client, or patient of a provider, and providers may not require an essential caregiver to provide such care. The essential caregiver can visit at least 2 hours daily in addition to other visitors.

“Up to Date” – means a person has received all recommended COVID-19 vaccines, including any booster dose(s) when eligible.

Policy:

MorseLife will allow visitation of all visitors and non-essential health care personnel and can be conducted through different means based on the facility’s structure and residents’ needs, such as in resident rooms, dedicated visitation spaces, and outdoors. The visitation will be person-centered, consider the resident’s physical, mental, and psychosocial well-being, and support their quality of life. Exceptions will be in accordance with current CMS directives and CDC recommendations, or as directed by state government (whichever is more stringent).

Guidelines:

Visitation and Access

The guardhouse Is staffed 24 hours a day, seven days a week.
Joseph L Morse Health Center Maintains an open visitation policy. Visitation is available 24 hours a day, seven days a week.
The main Morse building entrance and the Mack Pavilion entrance are open daily from 7:00 a.m. to 7:00 p.m. After 7:00 PM, visitors may enter through the ambulance entrance in the Mack pavilion or through the employee entrance in the Goldsmith building.
All visitors must present valid Identification at the guardhouse and sign in-and-out at the main Morse reception desk or the Mack Pavilion receptionist desk depending on the building being visited.
Residents have the right to receive visitors of their choosing, including but not limited to, a spouse, domestic partner, another family member, friend, guardian, essential caregiver, or designated individual(s). Residents also have the right to deny, refuse, or withdraw consent to visitation at any time.
Because the facility maintains open visitation, there is no predetermined limit on the length of a visit.
The number of visitors is not routinely restricted. Reasonable limitations may be implemented when necessary to honor the resident’s preference; protect the privacy and rights of the roommates or other residents; accommodate available space; or address documented clinical, infection-control, or safety concerns.
Any clinical or safety-related restrictions shall be based on individual circumstances and shall not be more stringent than comparable requirements for the staff.
Visitors will receive infection-control education, through posted signage, written materials, verbal instruction, or other educational methods. Education may include hand hygiene, respiratory etiquette, appropriate use of personal protective equipment (PPE), and precautions necessary to protect residents, visitors, and staff.
Visitors who are experiencing symptoms of a potentially communicable illness should postpone non-essential visitation until symptoms have resolved. When necessary, due to an outbreak, public-health recommendation, or a resident’s transmission-based precautions, the facility may implement symptom screening and additional infection-control measures.
PPE will be may available and may be required when clinically indicated, including when visiting a resident who is subject to transmission-based precautions. Facility staff will provide instructions regarding the proper use and disposal of required PPE.
Infection-control and safety requirements imposed upon visitors shall not be more stringent than comparable requirements established for facility staff.

Visitors shall not be required to provide proof of vaccination or immunization as a condition of visitation.

Consensual physical contact between a resident and visitor is permitted.

A resident may designate a family member, friend, guardian, or other individual as an essential caregiver. An essential caregiver is not required to provide necessary care to the resident. Essential caregivers may visit at any time under the facility’s 24-hour open-visitation practice.

Required In-Person Visitation Circumstances

- - Unless the resident objects, the facility will permit in-person visitation in all of the following circumstances:
    - End-of-life situations.
    - When a resident who lived with family before admission is struggling with the change in environment and lack of in-person family support.
    - When a resident is making one or more major medical decisions.
    - When a resident is experiencing emotional distress or grieving the recent death of a friend or family member.
    - When a resident needs cueing or encouragement to eat or drink that was previously provided by a family member or caregiver.
    - When a resident who previously talked and interacted with others is seldom speaking.
    - For hospitals, childbirth, including labor and delivery, when applicable.

Tradition

Guidelines and Protocols

Title: Visitation & Access policy
Origination Date: 05/2022
Revision Date: 2/17/2023

Purpose:

MorseLife Health System is instituting the following visitation policies at Tradition of the Palm Beaches for the safety and well-being of all the residents.

Plan:

All visitors may access Tradition through the gatehouse located at 4920 Loring Drive. The guardhouse is manned 24/7.
Tradition of the Palm Beaches has open in person visitation which is available 9:00 a.m. to 9:00 p.m. Overnight visitation is allowed per resident contract for up to 14 days so long as front desk is notified by resident.
Resident has right to have visitors stay as long as they want.
Resident has right to have as many visitors at a time as they want.
Consensual physical contact is allowed between resident and visitor.
All visitors must show a valid ID and at the security gate. Visitors must be approved by residents or responsible parties by utilizing the gate call system.
All visitors will receive facility required PPE from the reception desk or nurses station.
All visitors must sign in the visitor log at the reception desk.
Visitors will not be required to provide any proof of immunization or vaccination status of any kind.
Visitors with signs and symptoms of a transmissible infection will be educated and asked to defer visitation until they are no longer potentially infectious according to CDC guidelines, and/or local health department recommendations.
Signs are posted educating visitors on infection control practices according to CDC guidelines at the main entrance and reception desk.
Nurse floor supervisors will be responsible for ensuring staff adhere to policies and procedures.
Resident has the right to receive the visitors whom he or she designates, including but not limited to a spouse, domestic partner, another family member, or a friend.
Disruptive persons will be denied access into the facility.
Resident has the right to deny, refuse or withdraw consent regarding visitations to any family member, any other individual or any entity.
Reasonable clinical and safety restrictions may be exercised by facility as applicable to protect the security of other facilities/residents/and staff, i.e., medical reasons, criminal acts, etc.
Alternate visiting areas are available for visitors to minimize disruptions to other residents.
Facility will Deny access or provide supervised visitation to individuals who have a history of bringing illegal substances into the facility which places residents’ health and safety at risk.
All visitors can enjoy full and equal visitation privileges consistent with patient/resident preferences.

Guidelines and Protocols

Title: Resnick ALF Visitation policy
Origination Date: 06/2020
Revision Date: 9/20/2020, 5/3/2022, 2/17/2023

Purpose:

MorseLife Health System is instituting the following visitation policies at MorseLife Memory Care Residence for the safety and well-being of all the residents. This includes both the Goldsmith and Resnick buildings.

Definitions:

“Up to Date” – means a person has received all recommended COVID-19 vaccines, including any booster dose(s) when eligible.

Guidelines:

All visitors may access MorseLife through the gatehouse located at 4847 David S Mack Drive. The guardhouse is manned 24/7.
MorseLife Memory Care Residence has open in person visitation which is available 9:00 a.m. to 9:00 p.m. No overnight visitation is allowed per resident contract unless a resident is eminent, and administration has been notified.
Visitation duration will not be limited to any length within visitation hours.
Resident has right to have as many visitors at a time as they want within visitation hours.
Consensual physical contact is allowed between resident and visitor.
All visitors must show a valid ID and at the security gate.
All visitors will receive facility required PPE from the reception desk.
All visitors must sign in the visitor log at the reception desk.
Visitors will not be required to provide any proof of immunization or vaccination status of any kind.
Visitors with signs and symptoms of a transmissible infection will be educated and asked to defer visitation until they are no longer potentially infectious according to CDC guidelines, and/or local health department recommendations.
Signs are posted educating visitors on infection control practices according to CDC guidelines at the main entrance and reception desk.
Nurse floor supervisors will be responsible for ensuring staff adhere to policies and procedures.
Resident has the right to receive the visitors whom he or she designates, including but not limited to a spouse, domestic partner, another family member, or a friend.
Disruptive persons will be denied access into the facility.
Resident has the right to deny, refuse or withdraw consent regarding visitations to any family member, any other individual or any entity.
Reasonable clinical and safety restrictions may be exercised by facility as applicable to protect the security of other facilities/residents/and staff, i.e., medical reasons, criminal acts, etc.
Alternate visiting areas are available for visitors to minimize disruptions to other residents.
Facility will deny access or provide supervised visitation to individuals who have a history of bringing illegal substances into the facility which places residents’ health and safety at risk.
All visitors can enjoy full and equal visitation privileges consistent with patient/resident preferences.

References:

Centers for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic. Located at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html. Accessed February 2, 2022.

Centers for Disease Control and Prevention. Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes. Located at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html#new-admissions. Accessed February 2, 2022.

Centers for Medicare and Medicaid Services. Nursing Home Visitation Frequently Asked Questions (FAQs). March 10, 2022.

Centers for Medicare & Medicaid Services. (March 10, 2022) QSO-20-39-NH: Nursing Home Visitation – COVID-19 (REVISED).

State of Florida senate bill (2022, April 5). Retrieved May 4, 2022, from https://www.flsenate.gov/Session/Bill/2022/988/BillText/er/HTML

Guidelines and Protocols

Title: Memory Care ALF Visitation policy
Origination Date: 06/2020
Revision Date: 9/20/2020, 5/3/2022. 2/17/2023

Purpose:

Definitions:

“Up to Date” – means a person has received all recommended COVID-19 vaccines, including any booster dose(s) when eligible.

Guidelines:

All visitors may access MorseLife through the gatehouse located at 4847 David S Mack Drive. The guardhouse is manned 24/7.
MorseLife Memory Care Residence has open in person visitation which is available 9:00 a.m. to 9:00 p.m. No overnight visitation is allowed per resident contract unless a resident is eminent, and administration has been notified.
Visitation duration will not be limited to any length within visitation hours.
Resident has right to have as many visitors at a time as they want within visitation hours.
Consensual physical contact is allowed between resident and visitor.
All visitors must show a valid ID and at the security gate.
All visitors will receive facility required PPE from the reception desk.
All visitors must sign in the visitor log at the reception desk.
Visitors will not be required to provide any proof of immunization or vaccination status of any kind.
Visitors with signs and symptoms of a transmissible infection will be educated and asked to defer visitation until they are no longer potentially infectious according to CDC guidelines, and/or local health department recommendations.
Signs are posted educating visitors on infection control practices according to CDC guidelines at the main entrance and reception desk.
Nurse floor supervisors will be responsible for ensuring staff adhere to policies and procedures.
Resident has the right to receive the visitors whom he or she designates, including but not limited to a spouse, domestic partner, another family member, or a friend.
Disruptive persons will be denied access into the facility.
Resident has the right to deny, refuse or withdraw consent regarding visitations to any family member, any other individual or any entity.
Reasonable clinical and safety restrictions may be exercised by facility as applicable to protect the security of other facilities/residents/and staff, i.e., medical reasons, criminal acts, etc.
Alternate visiting areas are available for visitors to minimize disruptions to other residents.
Facility will deny access or provide supervised visitation to individuals who have a history of bringing illegal substances into the facility which places residents’ health and safety at risk.
All visitors can enjoy full and equal visitation privileges consistent with patient/resident preferences.

References:

Centers for Medicare and Medicaid Services. Nursing Home Visitation Frequently Asked Questions (FAQs). March 10, 2022.

Centers for Medicare & Medicaid Services. (March 10, 2022) QSO-20-39-NH: Nursing Home Visitation – COVID-19 (REVISED).

State of Florida senate bill (2022, April 5). Retrieved May 4, 2022, from https://www.flsenate.gov/Session/Bill/2022/988/BillText/er/HTML