Visitation Guidelines

The resident has a right to receive visitors of his or her choosing at the time of his or her choosing subject to the resident’s right to deny visitation when applicable, and in a manner that does not impose on the rights of another resident.

The facility will encourage resident visits with family and friends, if the resident wishes to accept visitors.
The resident may entertain family and visitors in their rooms or may have guests in designated common areas.
The residents with visitors will have privacy respected during visits.
If the resident with visitors has a roommate(s), visits should be planned so as not to infringe upon the privacy of the roommate.
The personal safety of all residents and staff will be a priority.
Consensual physical contact is allowed between a resident and a visitor.

The facility will provide immediate access to any resident by the following:

Any representative of the Secretary
Any representative of the State
Any representative of the Office of the State Long Term Care Ombudsman
The resident’s physician
Any representative of the protection and advocacy systems as designated by the State.
Any representative of the agency responsible for the protection and advocacy system for individuals with a mental disorder
The resident representative
Immediate family and other relatives, subject to the resident’s right to deny or withdraw consent at any time.
Others who are visiting the resident 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.

The facility will allow in-person visitation in all of 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 needs cueing or encouragement to eat or drink which was previously provided by a family member or caregiver.

Procedure

1. Visitors will be encouraged to visit during the facility’s usual business hours out of consideration for the privacy of all residents and so as not to interfere with the scheduled personal care, sleep time, and activities of all residents. The resident has a right to receive visitors of his or her choosing at the time of his or her choosing subject to the resident’s right to deny visitation when applicable, and in a manner that does not impose on the rights of another resident.
2. Visitors will enter the facility through the designated main entrance during business hours and will sign in according to facility protocol.
3. Visitors who enter the facility after usual business hours will use the designated and secured “off hours” entrance.
4. There will be no time limit placed on the length of a visit except by the resident. Out of consideration for other residents and their privacy - visitors or family may not spend the night. However, under special circumstances and if the resident’s room is a private room, the Administrator may give permission for the resident’s family member(s) to spend the night for a limited period.
5. The number of visitors allowed at a time will not be restricted unless this number interferes with the rights of others or causes any disruption. The Administrator will ask any unruly or disruptive visitors or groups of visitors in sufficient numbers to infringe upon the rights of other residents to leave the premises.
6. The facility Infection Preventionist will be designated as the person responsible for the ongoing adherence to policies and procedure related to Infection Control and the IP/designee will provide staff, residents and visitors with any education as needed related to Infection Control policies or practices. Visitors who are unwilling to adhere to the applicable Core Principles of Infection Control may be asked to leave. Screening, personal protective equipment and other infection control protocols will be in accordance with State and Federal Infection Control guidelines. Standard precautions are used when caring for residents at all times regardless of their suspected or confirmed infection status.
The Infection Preventionist or nurse on duty responsible for the patient will provide education to any visitors on the types of transmission-based precautions that are in place and all required PPE will be provided. The visitors will be assisted by the nurse in donning and doffing any PPE and where to place soiled PPE.
Transmission-based precautions are additional measures that protect staff, visitors and other residents from becoming infected. These measures are determined by the specific pathogen and how it is spread from person to person. The three types of transmission-based precautions are contact, droplet and airborne.
The Centers for Disease Control and Prevention (CDC) maintains a list of diseases, modes of transmission and recommended precautions.
The facility makes every effort to use the least restrictive approach to managing individuals with potentially communicable infections. Transmission-based precautions are used only when the spread of infection cannot be reasonably prevented by less restrictive measures. When a resident is placed on transmission-based precautions, appropriate notification is placed on the room entrance door and on the front of the chart so that personnel and visitors are aware of the need for and the type of precaution.
The signage informs the staff of the type of CDC precaution(s), instructions for use of PPE, and/or instructions to see a nurse before entering the room.
Signs and notifications comply with the resident’s right to confidentiality or privacy.
When transmission-based precautions are in effect, non-critical resident-care equipment items such as a stethoscope, sphygmomanometer, or digital thermometer will be dedicated to a single resident (or cohort of residents) when possible.
If re-use of items is necessary, then the items will be cleaned and disinfected according to current guidelines before use with another resident.

Contact Precautions

1. Contact Precautions may be implemented for residents known or suspected to be infected with microorganisms that can be transmitted by direct contact with the resident or indirect contact with environmental surfaces or resident-care items in the resident’s environment.
2. The decision on whether contact precautions are necessary will be evaluated on a case by case basis.
3. The individual on contact precautions will be placed in a private room if possible. If a private room is not available, the Infection Preventionist will assess various risks associated with other resident placement options (e.g., cohorting, placing with a low risk roommate).
4. Staff and visitors will wear gloves (clean, non-sterile) when entering the room.
5.While caring for a resident, staff will change gloves after having contact with infective material (for example, fecal material and wound drainage).
6.Gloves will be removed and hand hygiene performed before leaving the room.

7. Staff will avoid touching potentially contaminated environmental surfaces or items in the resident’s room after gloves are removed.
8. Staff and visitors will wear a disposable gown upon entering the room and remove before leaving the room and avoid touching potentially contaminated surfaces with clothing after gown is removed.
When transporting individuals with skin lesions, excretions, secretions, or drainage that is difficult to contain, contact precautions will be taken during resident transport to minimize the risk of transmission.

Droplet Precautions

1. Droplet Precautions may be implemented for an individual documented or suspected to be infected with microorganisms transmitted by droplets (large-particle droplets [larger than 5 microns in size] that can be generated by the individual coughing, sneezing, talking, or by the performance of procedures such as suctioning).
2. Residents on droplet precautions will be placed in a private room if possible.
3. When a private room is not available, residents may share a room with a resident infected with the same microorganism or with limited risk factors.
4. When a private room is not available and cohorting is not achievable, a curtain will be used and a distance of at least 3 feet of space will be maintained between the infected resident his or her roommate.
5.Special air handling and ventilation are unnecessary and the door to the room may remain open.
6.Masks will be worn when entering the room.
7. Gloves, gown and goggles should be worn if there is risk of spraying respiratory secretions.

Resident Transport

Airborne Precautions

1. Airborne precautions are indicated when an individual is infected with a pathogen that is very small (5 microns or smaller in size) and can be transmitted long distances through the air.
2. Preventing the spread of airborne pathogens requires a room with special air handling and ventilation called an airborne infection isolation room (AIIR).
3. If an AIIR is not available, a resident suspected of having an airborne infectious disease shall be masked and transported to a facility with an AIIR.
4. Any individuals who enter the room of a resident placed on airborne precautions must wear approved respiratory protection.
5.A resident on airborne precautions will wear a mask when leaving the room or coming into contact with others. Depending on the organism, a special filtration mask may be necessary. continues on next page
6.If the resident is transported to another unit within the facility or to another facility, the Infection Preventionist (or designee) will notify the unit or facility of the type of precautions the resident is on and the resident’s suspected or confirmed type of infection. The facility is also responsible for notifying transport staff of residents that require special care due to infectious conditions
Visitors will not be compelled to show or provide proof of any vaccination or immunization status to gain entry into the facility or visit any resident.
7. Resident visitation may be limited only under the following circumstances:

a. With a specific request by the resident or resident representative (on behalf of an incapacitated resident) is made.
b. If a physician order has been received to temporarily limit visitation due to medical necessity.
c. Upon guidance from the Florida Department of Health.
Compassionate Care visits to include end-of-life visits, will always be allowed.

8. Staff will refuse entry to a visitor and will immediately notify local law enforcement (call 911) and the Administrator if there is a concern for resident or staff safety or a threat has been made by a visitor toward staff or residents.
9. If a visitor is already inside the facility and there becomes a concern for resident or staff safety related to this visitor or a threat has been made by this visitor toward staff or residents, staff will immediately notify local law enforcement (call 911) and the Administrator.
10. The Administrator is responsible for staff adherence to visitation policies and procedures.

Visitation Guidelines

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