LTC Home Visitors Policy

The health and safety of our residents, their family members, and our team members are the primary concern of Jarlette Health Services, each and every day. The following LTC Home Visitors policy applies to long-term care homes operated by Jarlette Health Services. You are encouraged to reach out directly to a home prior to your visit for up-to-date information, including the outbreak status and any other questions you may have.

LTC Home Visitors Policy

(Effective June 10, 2022)

The home is open to residents, their family members, and significant others seven days a week.

Visitors provide important mental, emotional, spiritual, and physical benefits to residents. A resident’s right to determine and receive visitors will only be altered in outbreak conditions or due to other risks impacting workforce availability, personal protective equipment availability (PPE), or other events affecting the health and safety of residents, staff, and visitors.

Generally accepted visiting hours to ensure the rights of all residents will be set by the individual home. For ill or palliative/end of life residents, visiting by family members or significant others 24 hours per day will be supported. To ensure safety, no individual other than a resident, employee, Ministry of Long-Term Care (MLTC) Inspector or designated physician/RN (EC) may enter the home between the hours of 12 midnight and 5:30 a.m. unless prior arrangements have been made with the Administrator or designate.

The Administrator or designate reserves the right to alter the visiting practices of the home during an outbreak and at other times under the direction of the local Medical Officer of Health, Chief Medical Officer of Health or other provincial directives.

Homes will maintain the required visitor logs for a minimum of 30 days.

DEFINITIONS

Not Considered Visitors

● Long-term care home staff (as defined under the Fixing Long-Term Care Act, 2021), volunteers,and student placements are not considered visitors as their access to the home is determined by the licensee.

● Infants under the age of 1 year are not considered visitors and are excluded from testing requirements.


Types of Visitors

● Essential Visitors - There are no limits on the total number of essential visitors allowed to come into a home at any given time. Essential visitors are the only type of visitors allowed when there is an outbreak in a home or area of a home or when a resident has failed screening, is symptomatic or in isolation.

As per O. Reg. 246/22 under the Fixing Long-Term Care Act, 2021, there are four types of essential visitors: (a) a caregiver, as defined under section 4 of O. Reg. 246/22, (b) a support worker who visits a home to provide support to the critical operations of the home or to provide essential services to residents, (c) a person visiting a very ill resident for compassionate reasons including, but not limited to, hospice services or end-of-life care, or (d) a government inspector with a statutory right to enter a long-term care home to carry out their duties.

Under O. Reg. 246/22 s. 4, a caregiver is defined as an individual who:

(a) is a family member or friend or a resident or a person of importance to a resident,

(b) is able to comply with all applicable laws including any applicable directives, orders, guidance, advice or recommendations issued by the Chief Medical Officer of Health or a medical officer of health appointed under the Health Protection and Promotion Act,

(c) provides one or more forms of support or assistance to meet the needs of the resident, including providing direct physical support such as activities of daily living or providing social, spiritual or emotional support, whether on a paid or unpaid basis,

(d) is designated by the resident or the resident’s substitute decision-maker with authority to give that designation, if any, and

(e) in the case of an individual under 16 years of age, has approval from a parent or legal guardian to be designated as a caregiver.

● Designated Caregivers – Four caregivers may be designated per resident. A resident may have more than 4 caregivers if there were designations made prior to December 15, 2021. Homes will not require scheduling or restrict the length or frequency of visits by caregivers. However, in the case where a resident resides in an area of the home in outbreak, is symptomatic or isolating under additional precautions, only one caregiver may visit at a time. This restriction does not apply to residents receiving end of life care. A caregiver should not visit any other home for 10 days after visiting: an individual with a confirmed case of COVID-19 and or an individual experiencing COVID-19 symptoms. Recognizing there are caregivers who want to volunteer to support more than one resident, in the event of an outbreak, caregivers may support up to two residents who are COVID-19 positive, provided the home obtains consent from all involved residents (or their substitute decision makers). Caregivers may also support more than one resident in non-outbreak situations, with the same expectation regarding resident consent.

● General Visitors - A general visitor is a person who is not an essential visitor and is visiting to provide non-essential services related to either the operations of the home or a particular resident or group of residents. General visitors include those persons visiting for social reasons as well as visitors providing non-essential services such as personal care services, entertainment, or individuals touring the home. This would include hairdressers and or barbers.

General visitors, including children under 5, can enter the home to a maximum of 4 visitors including caregivers for indoor visits. All visitors will be encouraged to stay up to date with vaccinations. All individuals, whether or not they have received a COVID-19 vaccine and/or are up to date with COVID-19 vaccines, must continue to practice the recommended public health measures and comply with all applicable laws for the ongoing prevention and control of COVID-19 infection and transmission.

There are no limits on the number of visitors permitted for outdoor visits regardless of vaccination status. Visits between groups will maintain a 2 metre or 6 foot distance between groups.

General visitors are not permitted to visit when (a) a home is in outbreak; (b) to visit an isolating resident; and (c) when the local public health unit so directs.


PROCEDURE

Upon admission to the home, the resident, family members and significant others will be provided with a copy of the home’s LTC Home Visitors Policy.

A copy of the LTC Home Visitors Policy will be provided to both the Resident and Family Councils, posted in a public location within the home for ease of reference and posted on the home’s website.

All visitors to the home will complete required education and training on Infection Prevention and Control, Personal Protective Equipment use, respiratory etiquette, hand hygiene and physical distancing as directed. See Education Resources.

All visitors to the home will be required to sign in and sign out of the Home on the Visitor Log sheet and provide their name, contact information, time and date of the visit, purpose of the visit and the name of the resident visited. This information will be asked for at time of screening upon entry into the home. Visitor logs will be maintained by the home for a minimum of 30 days.

ALL visitors, doing an INDOOR visit will be required to complete a rapid antigen test (RAT), in accordance with the direction from the MLTC. (Exception: Those under the age of 1, outdoor visits, proof of a confirmed positive COVID-19 PCR result within 90 days of visit, a Ministry inspector).

Support Workers, General Visitors, and Designated Caregivers:

Testing will be done at a frequency in accordance with the staff of the long-term care home.

All visitors (regardless of type) will be required to wear a surgical/procedure mask for indoor visits at all times. Non-medical masks or other forms of face coverings are strongly encouraged for outdoor visits.

The process for designating an essential caregiver by a resident or SDM must be made in writing and is entirely the decision of the resident/SDM. The home will maintain a current list of designated essential caregivers to the home. The home reserves the right to investigate the designation of an essential caregiver if it does not meet the definition of caregiver as identified in this policy.

Caregivers and general visitors may accompany a resident for meals in designated areas to assist a resident with eating, however the visitor should always remain masked while in the home and not eat with the resident.

All visitors may join in activities where space permits.


RESTRICTION OF VISITORS

Staff will respect the resident’s right to have privacy during visits.

Staff who have concerns regarding a visitor to the home are to immediately inform their Supervisor/Manager.

The Supervisor/Manager is to immediately inform the home’s Administrator or designate of the expressed concern.

Following investigation of a concern should the home’s Administrator or designate determine that there are safety risks associated with a person visiting the home, visitation to the home can be either restricted or terminated. Visiting will only be restricted or terminated where there is risk or safety concerns for residents, other visitors or staff and is a last resort if no other options to safe visiting can be determined or negotiated.

Restrictions that may be imposed include but are not limited to:

● Visitation during the hours that the Administrator is in the home;

● Supervised visitation with another family member being present;

● Set hours for visitation; or

● Other visitation restrictions as decided by the Administrator or designate in consultation with the Regional Manager.

When restricting visitation, the Administrator or designate will consult with the Regional Manager and inform the MLTC. A copy of the letter restricting visiting will be forwarded to the MLTC Service Area Office.

The Administrator or designate will meet with persons who are having visitation restricted to outline the reason for the restriction and the home’s expectation regarding their visitation.

The Administrator or designate will inform all Supervisors and Managers of people who have visitation restrictions.

Visitation restrictions will be reassessed by the Administrator or designate on a weekly basis.

In the event a restricted visitor violates the conditions of visitation, the Administrator or designate will contact police for assistance.

The home will comply with all current MLTC, Chief Medical Officer of Health and Public Health Directives, guidance documents and communications relating to access to the home by visitors at all times.


****If the home is in a declared outbreak
of a reportable communicable disease,
please refer to the table below
for the differences in policy****

General Visitors

(INDOOR VISITS)

All general visitors, including children under the age of 5, can enter the long-term care home. All visitors shall be encouraged to stay up to date with vaccinations and all individuals, whether or not they have received a COVID-19 vaccine and/or are up to date with COVID-19 vaccines, must continue to practice the recommended public health measures and comply with all applicable laws for the ongoing prevention and control of COVID-19 infection and transmission. Up to four visitors (including caregivers) per resident may visit at a time for indoor visits.

General visitors are not permitted:

• when a home or area of a home is in outbreak

• to visit an isolating resident • when the local public health unit so directs.

No restrictions on number if the resident is receiving end of life care.

General Visitors (OUTDOOR VISITS)

There are no limits on the number of visitors permitted at outdoor visits, and homes can return to their regular practices on use of their available outdoor spaces. Homes should not restrict individuals from outdoor visits based on vaccination status. Homes should ensure physical distancing (a minimum of two metres or six feet) is maintained between groups.

General visitors are not permitted:

• when a home or area of a home is in outbreak

• to visit an isolating resident • when the local public health unit so directs.

Designated Caregivers

Caregivers must be at least 16 years of age.

There is a limitation of 4 caregivers and/or 4 visitors at one time (total = 4) for indoor visits. Homes will have a procedure for documenting caregiver designations. The decision to designate an individual as a caregiver is entirely the decision of the resident and/or their substitute decision-maker and not the home.

Only one designated caregiver may visit at a time if the resident resides in an area of the home in outbreak, is symptomatic or is isolating under additional precautions.

No restrictions on number if the resident is receiving end of life care.


Education Resources

Public Health Ontario Resources

Education for PPE Donning and Doffing

Donning PPE Video

Doffing PPE Video

How to Wash Your Hands Video

How to Hand Rub Video

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