Retirement Home (Lodge) 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 Retirement Home (Lodge) Visitors policy applies to retirement homes (which we refer to as lodges!) 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 with any questions you may have.


Retirement Home COVID-19 Visitor Policy

Each lodge has a responsibility to ensure residents receive visitors safely to help protect against the risk of COVID-19. This policy balances mitigating measures to protect the health and safety of residents, staff and visitors, with the physical, mental, emotional, and spiritual needs of residents for their quality of life and in consideration of the mental health and emotional well-being of residents and their loved ones. All visitors must comply with the requirements set out in this policy.

This policy complies with current ministry requirements per Directive #3 (December 24, 2021), the Reopening Ontario Act, applicable legislation and regulations, and is guided by the policies of the Ministry for Seniors and Accessibility (MSAA) and the Retirement Homes Regulatory Authority (RHRA), including the Retirement Homes Policy to Implement Directive #3 (March 14, 2022).

If anything in the policy conflicts with guidance, recommendations or advice from the Chief Medical Officer of Health (CMOH), the CMOH guidance prevails, and the lodge will take all reasonable steps to follow them. Additionally, if anything in this policy conflicts with applicable legislation or regulations or any other provincial requirements, including any applicable emergency orders, directives or directions issued by the CMOH, those requirements prevail, and the lodge will follow all applicable provincial legislation, regulations and requirements.

For the purposes of this policy, “fully vaccinated” refers to an individual having received:

  • The full series of a COVID-19 vaccine authorized by Health Canada, or any combination of such vaccines,
  • One or two doses of a COVID-19 vaccine not authorized by Health Canada, followed by one dose of a COVID-19 mRNA vaccine authorized by Health Canada, or
  • Three doses of a COVID-19 vaccine not authorized by Health Canada; and
  • They received their final dose of the COVID-19 vaccine at least 14 days ago

The above definition is based on the Ministry of Health’s COVID-19 Fully Vaccinated Status in

Ontario document.

Guiding Princples

In addition to the requirements established in the Retirement Homes Act, 2010 and O. Reg 166/11, the Reopening Ontario Act, 2020, and Directive #3, this policy is guided by the following principles:

  • Safety: Any approach to visiting, absences, and activities must balance the health and safety needs of residents, staff, and visitors, and ensure risks of infection are mitigated.
  • Mental Health and Emotional Well-Being: Allowing visitors, absences, and activities is intended to support the overall physical, mental and emotional wellbeing of residents by reducing any potential negative impacts related to social isolation.
  • Equitable Access: All residents must be given equitable access to receive visitors and participate in activities consistent with their preferences and within restrictions that safeguard residents, staff and visitors.
  • Flexibility: The physical characteristics /infrastructure of the home, its staffing availability, whether the home is in outbreak or in an area of widespread community transmission, and the current status of the home with respect to infection prevention and control (IPAC) including personal protective equipment (PPE) are all variables to take into account when administering home-specific policies for visiting, absences, and activities.
  • Autonomy: Residents have the right to choose their visitors. Residents also have the right to designate their caregivers. If a resident is unable do so, substitute decision-maker(s) may designate caregivers.
  • Visitor Responsibility: Visitors have a crucial role to play in reducing risk of infection for the safety of residents and staff by adhering to visitor policy requirements related to screening, IPAC and PPE and any precautions described in this policy.
  • COVID-19 Vaccinatiion: The goal of the provincial COVID-19 vaccination program is to protect Ontarians from COVID-19. Homes are highly encouraged to continue to promote vaccinations and boosters to all eligible residents, staff, and visitors. Vaccines help reduce the number of new cases and, most importantly, severe outcomes including hospitalizations and death due to COVID-19. All individuals, whether or not they have received a COVID-19 vaccine, 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. Visitors should not be denied entry to retirement homes based on their COVID-19 vaccination status.

Co-Located Home (If applicable)

In a co-located long-term care and retirement home that is not physically and operationally independent ( (i.e. there are separate entrances and no mixing of residents or staff between the retirement home and the LTC home), the policies for the LTC home and the retirement home shall align where possible or follow the more restrictive requirements, unless otherwise instructed by the local public health unit (PHU) based on COVID-19 prevention and containment. The exceptions to this requirement are the policies regarding absences, testing, and vaccinations. For guidance on absences, testing, and vaccinations, retirement homes should follow the guidance in the Policy to Implement Directive #3 and applicable directives or directions issued by the Minister of Health or the CMOH.

Requirements for Home Visits

  1. Procedures for visits including but not limited to IPAC, scheduling, and any setting-specific policies.
  2. Communication of clear visiting procedures with residents, families, visitors and staff, including sharing an information package with visitors with:
  1. This Retirement Homes Policy to Implement Directive #3 (e.g., a digital link, or a copy upon request);
  2. Details on any visitor or visiting restrictions (e.g., number of visitors permitted based on any capacity considerations);
  3. Details regarding IPAC, masking, and physical distancing (2 metres separation);
  4. Information about how to escalate concerns about homes to the RHRA via the RHRA email address and/or phone number; and
  5. Other health and safety procedures such as limiting movement around the home, if applicable, and ensuring visitors’ agreement to comply with visiting procedures.
  1. A process for complaints about the administration of visiting policies and a timely process for resolving complaints.
  2. Requirements for visitor compliance with visiting policies and a process to notify residents and visitors that failure to comply with their visiting policies may result in discontinuation of visit(s) when risk of harm from continual non-compliance is considered too high. This must include a way to assess refusal of entry on a case-by-case basis.
  3. A process for recording all visits, including the name, contact information, date and time of visit, and resident visited for each visitor, to be kept for at least 30 days.
  4. Dedicated areas for both indoor and outdoor visits to support physical distancing (2 metres separation) between residents and visitors.
  5. Protocols to maintain best practices for IPAC measures prior to, during and after visits.

The lodge will ensure the following are put in place to facilitate safe visits:

  • Adequate Staffing: The lodge has sufficient staff to implement the policies related to visitors and to ensure safe visiting as determined by the home’s leadership.
  • Access to adequate Personal Protective Equipment (PPE): The lodge has adequate supplies of PPE required to support visits.
  • Infection Prevention and Control (IPAC) standards: The lodge has appropriate cleaning and disinfection supplies and adhere to IPAC standards, including enhanced cleaning.
  • Physical Distancing: The lodge can facilitate visits in a manner aligned with physical distancing protocols (2 meters separation).

If the lodge restricts visits based on any of the above factors, the decision will be communicated to residents, including the reasons for the decision.

Types of Visitors

There are 3 categories of visitors: Essential Visitors, General Visitors, and Personal Care Service Providers.

Retirement home staff, students and volunteers as defined in the Retirement Homes Act, 2010 are not considered visitors.

1. Essential Visitors

Essential Visitors are persons performing essential support services (e.g., food delivery, inspectors, maintenance, or health care services (e.g., phlebotomy) or a person visiting a very ill or palliative resident).



There are two categories of Essential Visitors: Support Workers and Essential Caregivers.



External Care Providers (ECPs): ECPs are employees, staff or contractors of Home and Community Care Support Services (HCCSS) (formerly LHINs) and provide services to residents. They are considered Essential Visitors to retirement homes and must comply with the requirements under CMOH’s Directive #3 and RHRA’s Retirement Homes Policy to Implement Directive #3.

A. Support Workers

A Support Worker is a type of Essential Visitor who is brought into the home to perform essential services for the home or for a resident in the home, including the following individuals:

  • Regulated health care professionals under the Regulated Health Professions Act, 1991 (e.g., physicians, nurses);
  • Unregulated health care workers (e.g., PSWs, personal/support aides, nursing/personal care attendants), including external care providers and Home and Community Care Support Service Providers (formerly LHIN providers);
  • Authorized third parties who accommodate the needs of a resident with a disability;
  • Health and safety workers, including IPAC specialists;
  • Maintenance workers;
  • Private housekeepers;
  • Inspectors; and
  • Food delivery.

B. Essential Caregivers

Essential Caregivers provide care to a resident including supporting feeding, mobility, personal hygiene, cognitive stimulation, communication, meaningful connection, relational continuity and assistance in decision-making. Essential Caregivers may be family members, a privately hired caregiver, paid companions and translators even if the person would also be considered a Support Worker.

Essential Caregivers must be designated by the resident, or if the resident is unable to do so, their substitute decision-maker. The designation should be made in writing to the home, and the home should have a procedure for documenting Essential Caregiver designations. The necessity of an Essential Caregiver is determined by the resident or the SDM.

Essential Caregivers will not be denied access to residents, provided that they pass the active screening and PPE requirements

In order to limit the spread of infection, a resident and/or their SDM will only be encouraged to change the designation of their Essential Caregiver in limited circumstances, including in response to:

  1. A change in the resident’s care needs that is reflected in the plan of care;
  2. A change in the availability of a designated Essential Caregiver; and/or
  3. Due to the vaccination status of the designated Essential Caregiver

2. General Visitors

A General Visitor is a person who is not an Essential Visitor and visits:

  • To provide non-essential services (may or may not be hired by the home or the resident and/or their SDM);
  • For social reasons (e.g., family members and friends of the resident); and/or
  • As a prospective resident taking a tour of the home.

3. Personal Care Service Providers

A Personal Care Service Provider is a person who is not an Essential Visitor and visits to provide non-essential personal services to residents.

Personal Care Services include those outlined under the Reopening Ontario Act, 2020 regulations O. Reg. 82/20, O. Reg. 263/20 and O. Reg. 364/20, such as hair salons and barbershops, manicure and pedicure salons, aesthetician services, and spas, that are not being provided for medical or essential reasons (e.g., foot care to support mobility or reduce infections).

  1. Designated Essential Caregivers and any subsequent changes will be documented through the Essential Caregiver designation form (See Appendix B)
  2. Residents/SDMs will be encouraged to change the designation of their Essential Caregiver in limited circumstances, as noted in the above chart, in order to limit the spread of infection.

Access to Lodge

  1. The local PHU may require restrictions on visitors in part or all of the residence, depending on the specific situation. The residence and visitors must abide by any restrictions imposed by the PHU, which override any requirements or permissions in this policy and the Retirement Homes Policy to Implement Directive #3 if there is a conflict.
  2. All visitors to the residence must follow public health measures (e.g., active screening, wearing a medical mask, IPAC and maintaining physical distancing) for the duration of their visit in the home.
  3. If an area of the home is in outbreak, eye protection is required when providing direct care to residents.
  4. Only fully vaccinated visitors will be permitted to participate in dining, social gatherings and organized events.
  5. Residents who are not isolating may receive Essential Visitors, General Visitors and Personal Care Service Providers if they are not living in the outbreak area of a home.
  6. Residents who are isolating under Contact and Droplet Precautions may only receive Essential Visitors.
  7. When a resident is isolating, the home must provide support for their physical and mental well-being to mitigate any potential negative effects of isolation. This includes individualized mental and physical stimulation that meet the abilities of the individual. Homes should use sector best practices wherever possible.

1. Essential Visitors

Support Workers & Essential Caregivers:

Essential Visitors are permitted regardless of vaccination status if they pass active screening

Essential Visitors may visit a resident who is isolating, but must follow public health measures (e.g., hand hygiene and masking) for the duration of visit.

External Care Providers (ECPs): ECPs are employees, staff or contractors of Home and Community Care Support Services (HCCSS) (formerly Local Health Integration Networks (LHINs)) and provide services to residents. They are considered Essential Visitors to retirement homes and must comply with the requirements under CMOH’s Directive #3 and this policy.

2. General Visitors

General Visitors are permitted regardless of vaccination status if they pass active screening.

General Visitors are permitted unless a resident is isolating and on Droplet and Contact Precautions, or the home is advised by the local PHU to stop general visits (e.g., during an outbreak).

To further limit risk to residents, General Visitors who have symptoms of COVID19, have tested positive for it or who are close contacts of someone with COVID19, including those with a household member who is symptomatic, should avoid visiting homes for 10 days from the onset of symptoms or from receiving a positive test result or from the date of their last exposure (whichever is earlier).

The number of General Visitors should be based on the capacity of the location where the visit will take place and should allow sufficient space for physical distancing.

For all visits, sufficient space must be available to allow for physical distancing. In addition, contact visits are allowed for all General Visitors regardless of vaccination status.

For all visits with General Visitors, homes should have the following measures in place:

  • Homes should ensure equitable visitor access for those residents who are not isolating.
  • Visits should be booked in advance.
  • General Visitors should wear a medical mask, maintain physical distancing, and perform hand hygiene.
  • Residents should be strongly encouraged to wear a mask for the duration of the visit.
  • Opening windows should be considered for indoor and in-suite visits to allow for air circulation.

3. Personal Care Service Providers

Personal Care Service Providers who are visiting or work in a retirement home are permitted to provide services in alignment with provincial requirements if they pass active screening

When providing services, Personal Care Service Providers must:

  • Follow required public health and IPAC measures for Personal Care Service Providers and those of the home;
  • Wear a medical mask for the duration of their time at the home;
  • Only provide services to residents who are wearing a medical mask, except for where this is not tolerated by residents, or in the case of dental procedures;
  • Practice hand hygiene and conduct environmental cleaning after each appointment; and
  • Document all residents served and maintain this list for at least 30 days to support contact tracing.

The number of Personal Care Service Providers should be based on the capacity of the location where the service will take place and should allow for sufficient space for physical distancing between providers.

Clarification from MSAA: The number of visitors attending to a palliative resident should be decided on a case-by-case basis; homes should be communicating with families to come to a safe and supportive decision together.

Screening Visitors for COVID-19

1. Active Screening

All Visitors must be actively screened to be permitted entry including for outdoor visits.

Any staff or visitor who fails active screening must not be allowed to enter the home, must be advised to follow current case and contact recommendations, and must be encouraged to be tested.

Visitors are not permitted access if they do not pass screening, but homes should have a protocol in place that assesses entry on a case-bycase basis which includes the assurance that resident care can be maintained if entry is refused.

Exemptions to active screening apply to first responders, visitors for imminently palliative residents and individuals with post-vaccination symptoms, who are not required to pass screening but must remain masked and maintain physical distance from other residents and staff

Homes will document entry of all persons to the home and their screening results. Documentation must be retained for at least 30 days to support contact tracing. This should include screening results based on the requirements under Directive #3 and the safety review outlined below in sections 3.3.3 and 3.3.4.

2. Asymptomatic Testing

Testing requirements outlined in the Letter of Instructions issued by the Chief Medical Officer of Health were lifted effective March 14, 2022.

3. Safety Review - General Visitors and Personal Care Service Providers

  1. Prior to visiting any resident for the first time, and at least once every month thereafter, the lodge may ask General Visitors and Personal Care Service Providers ,regardless of vaccination status to verbally attest that they have:
    1. Read/Re-Read the following documents:
      1. The lodge’s visitor policy; and
      2. Public Health Ontario’s document entitled Recommended Steps: Putting on Personal Protective Equipment (PPE).
    2. Watched/Re-watched the following Public Health Ontario videos:
      1. Putting on Full Personal Protective Equipment;
      2. Taking off Full Personal Protective Equipment; and
      3. How to Hand Wash.

4. Safety Review - Essential Visitors

  1. Prior to visiting any resident in a home declared in outbreak for the first time, the home should provide training to Essential Caregivers and Support Workers who are not trained as part of their service provision or through their employment.
  2. Training must address how to safely provide direct care, including putting on (donning) and taking off (doffing) required PPE, and hand hygiene. If the home does not provide the training, it must direct Essential Caregivers and Support Workers to appropriate resources from Public Health Ontario to acquire this training.
  3. For homes not in outbreak, prior to visiting any resident for the first time, and at least once every month thereafter, homes must ask Essential Caregivers and Support Workers to verbally attest to the home that they have:
    1. Read/Re-Read the following documents:
      1. The lodge’s visitor policy; and
      2. Public Health Ontario’s document entitled Recommended Steps: Putting on Personal Protective Equipment (PPE).
    2. Watched/Re-watched the following Public Health Ontario videos:
      1. Putting on Full Personal Protective Equipment;
      2. Taking off Full Personal Protective Equipment; and
      3. How to Hand Wash.
  4. Safety review screening will be documented and retained for at least 30 days (See Appendix D).

Personal Protective Equipment

Visitors must wear PPE as required in Directive #3, which requires retirement homes to follow Directive #5 for Hospitals and Long-Term Care Homes.

Essential Visitors

Support Workers are responsible for bringing their own PPE to comply with requirements for Essential Visitors as outlined in Directive #3. Retirement homes should provide access to PPE to Essential Caregivers if they are unable to acquire PPE independently, including to medical (surgical/procedure) masks, eye protection (e.g., face shields or goggles) and any additional PPE when providing care to residents who are isolating on Droplet and Contact Precautions. Homes must intervene and reinforce appropriate uses of PPE if improper practices are alleged or observed. Essential Visitors must also follow staff reminders and coaching on proper use of PPE.


General Visitors and Personal Care Service Providers

All General Visitors and Personal Care Service Providers must wear either a medical mask for indoor visits or a non-medical mask for outdoor visits and are responsible for bringing their own mask.


General Visitors and Personal Care Service Providers must attest to having read the documents and watched the videos on PPE, as described in Section 3.3.4. Homes must intervene and reinforce appropriate uses of PPE if improper practices are alleged or observed. General Visitors must also follow staff reminders and coaching on proper use of PPE.

Requirements for Retirement Home Tours

Prospective residents may be offered in-person, targeted tours of suites at any time. These tours must adhere to the following precautions:

  • All tour participants are subject to the General Visitor screening and PPE requirements outlined in this document (e.g., active screening, wearing a medical mask, IPAC, maintaining physical distancing).
  • The tour groups should not exceed the number of permitted indoor visitors.

All in-person tours should be paused if a home goes into outbreak, unless permitted by the local PHU.

Accessibility Considerations

The lodge is required to meet all applicable laws such as the Accessibility for Ontarians with Disabilities Act, 2005.


Appendix A - Information Package for visitors: Utilize the following link for the Information Package for Visitors

Appendix B - Essential Caregiver Designation Form

Designation of Essential Caregiver(s) Under COVID-19 Visitor Policy

Essential Visitors are persons performing essential support services (e.g., food delivery, inspectors, maintenance, or health care services (e.g., phlebotomy) or a person visiting a very ill or palliative resident).

In addition to a person visiting a very ill or palliative resident, there are two categories of Essential Visitors: Support Workers and Essential Caregivers.

An Essential Caregiver is a type of Essential Visitor who is designated by the resident or, if the resident if unable to do so, their substitute decision-maker (SDM). Essential Caregivers visit to provide care to a resident. This includes supporting feeding, mobility, personal hygiene, cognitive stimulation, communication, meaningful connection, relational continuity and assistance in decision-making. Examples of Essential Caregivers include family members who provide care, a privately hired caregiver, paid companions, and translators.

A resident may designate an external care provider as an Essential Caregiver even though that individual would also be considered a Support Worker.

Essential Caregivers may be designated per resident in writing using this form. Any subsequent changes will also be documented using this form.

Note: In order to limit infection spread, a resident and/or their SDM may be encouraged to change the designation of their Essential Caregiver in limited circumstances, including in response to:

  • A change in the resident’s care needs that is reflected in the plan of care; and/or
  • A change in the availability of a designated Essential Caregiver, either temporary (e.g., illness) or permanent.
  • Due to the vaccination status of the designated Essential Caregiver

Caregiver Responsibilities:

  • All visitors must comply with the lodge’s visiting policy and procedures. Failure to comply with the visiting policy may result in the discontinuation of visit(s) when risk of harm from continual non-compliance is considered too high.
  • Prior to visiting any resident, visitors must follow screening requirements, testing and PPE requirements including a safety review as applicable.
  • If improper PPE practices are alleged or observed, the Essential Visitor must follow staff reminders and coaching on proper use of PPE.

Name: ________________________________________________


Essential Caregiver #1: _________________________ Relationship to Resident: _________________

Phone #: ______________________________Email: _________________________________



Essential Caregiver #2: _________________________ Relationship to Resident: _________________

Phone #: ______________________________Email: _________________________________

Designated By: [ ] Resident / [ ] SDM

Resident’s Signature (if applicable): _______________________________________

SDM’s Signature (if applicable): __________________________________________

Date Signed: ___________________________________________

CHANGE OF DESIGNATED CAREGIVER(S): (if applicable)

Essential Caregiver #1: _________________________ Relationship to Resident: _________________

Phone #: ______________________________Email: _________________________________

Essential Caregiver #2: _________________________ Relationship to Resident: _________________

Phone #: ______________________________Email: _________________________________

Designated By: [ ] Resident / [ ] SDM

Resident’s Signature (if applicable): _______________________________________

SDM’s Signature (if applicable): __________________________________________

Date Signed/Changes Take Effect: ___________________________________________


Appendix C - Visiting Schedule

Name of Lodge:



Date:



Visiting Hours:

From:

To:

Time

Resident Name

Suite #

Name of Visitor

Phone Number

Relationship to Resident

Name of Visitor

Phone Number

Relationship to Resident

Name of Visitor

Phone Number

Relationship to Resident

9:00 – 9:45 am









Clean and Disinfect

10:00-10:45 am









Clean and Disinfect

11:00 – 11:45 am









Clean and Disinfect

12:00-12:45 pm









Clean and Disinfect

1:00 – 1:45 pm









Clean and Disinfect

2:00 – 2:45 pm









Clean and Disinfect

3:00 – 3:45 pm









Clean and Disinfect

4:00 – 4:45 pm









Clean and Disinfect

5:00-5:45 pm









Clean and Disinfect

6:00 – 6:45 pm









Clean and Disinfect

Guidelines for Outdoor Visits During COVID-19

Practice Physical Distancing

Keep at Least 2 Metres or 6 Feet Apart

Wearing a Mask (Medical or Non-Medical) at All Times is a MUST

Wash or Sanitize your Hands Before and After your Visit

Appendix G – MSAA Visitor Signage

All signs can be downloaded and printed here:

https://www.orcaretirement.com/wp-content/uploads/RetirementHomes-Visitors_Posters-EN-FINAL-july172020-FINAL-ua.pdf

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