OHCA The Oregon Caregiver Fall Winter 2020

The Oregon Caregiver FALL/WINTER 2020 www.ohca.com 20 LEGAL & REGULATORY Inside Visitation: Important Measures to Protect Your Community and Your Residents By Gwen Dayton, J.D., Oregon Health Care Association T he COVID-19 pandemic has been difficult for all Oregonians, but it has been particularly hard on residents in long term care facilities and families. Faced with extreme vulnerability in this population, facilities partnered with the state to restrict visitation from outside the facility to limit spread of the virus. This effort, which began in March, is one of the tools that enabled Oregon facilities to maintain relatively low levels of COVID-19, compared to other states with less restrictive visitation policies. While this policy has helped protect residents from COVID-19 and facilities have worked tirelessly to offer alternative visitation options, we have seen increased resident isolation and mental health strains. In response, the Centers for Medicare and Medicaid Services (CMS) issued new visitation guidance in September, allowing indoor visitation with safe practices. The Oregon Department of Human Services (ODHS) then adopted the CMS guidance for nursing facilities, assisted living, and residential care facilities to keep safe practice standards consistent across all long term care settings. With the surge of cases, Oregon experi- enced in November, however, indoor visi- tation was again shut down on November 18 for two weeks (compassionate care exempt). As of the date of publication of this article, it is unknown if this freeze on visitation will be extended beyond the initial two-week period and what indoor visitation might look like post-freeze. Assuming indoor visitation resumes at some point, communities will need to review and update their policies and procedures to safely implement the new visitation. Remember, the facility is responsible for the care provided regard- less of whether visitation is allowed. Consider the following steps: • Review the facility’s infection control and other policies to determine if any changes are necessary to continue to ensure resident safety with the expanded visitation. • In addition to the screening required in the DHS guidance, adopt a policy requiring visitors to have adequately protected themselves in the surrounding community before entering the facility, including such measures as masking and quarantining. • In communications with families, advise them of the risks associated with expanded visitation. • Ensure staff is continuously monitoring the positivity rate in your community and have procedures to immediately shut down visitation if the facility no longer qualifies. • Ensure staff has communication lines to resident families to advise them if and why the community needs to shut down. • While visitation may be allowed, it is not required should visitors not adhere to proper infection control practices. Monitor visitors to ensure they are complying with the facility’s infection control requirements. While long term care communities want residents to visit with their loved ones, no one wants residents to contract COVID-19. Responsible implementation of expanded visitation opportunity is critical to that effort. The COVID-19 pandemic has been difficult for all Oregonians, but it has been particularly hard on residents in long term care facilities and families.