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Helen Greathouse Manor – Vogel Center

 Visitation Guidance

Download Acknowledgment of Visitation Guidance Form

 

Assisted Livings facilities have been severely impacted by COVID-19, with outbreaks causing high rates of infection, morbidity, and mortality.  The vulnerable nature of the assisted living population combined with the inherent risks of congregate living in a healthcare setting have required aggressive efforts to limit COVID-19 exposure and to prevent the spread of COVID-19 within assisted living facilities.

While Texas Health and Human Services (THHSC) guidance has focused on protecting assisted living residents from COVID-19, we recognize that physical separation from family and other loved ones has taken a physical and emotional toll on residents and their loved ones.  Residents may feel socially isolated, leading to increased risk for depression, anxiety, and other expressions of distress.  Residents living with cognitive impairment or other disabilities may find visitor restrictions and other ongoing changes related to COVID-19 confusing or upsetting.  THHSC understands that assisted living residents derive value from the physical, emotional, and spiritual support they receive through visitation from family and friends.  In light of this, THHSC is revising the guidance regarding visitation in assisted living during the COVID-19 Public Health Emergency.

Since September 17, 2020, vaccines have received Emergency Use Authorization from the Food and Drug Administration.  Millions of vaccinations have since been administered to assisted living residents and staff, and these vaccines have been shown to help prevent symptomatic SARS-CoV-2 infection (i.e., COVID-19).  Therefore, THHSC in conjunction with the Centers for Disease Control and Prevention (CDC), is updating its visitation guidance accordingly, but emphasizing the importance of maintaining infection prevention practices, given the continued risk of COVID-19 transmission.
While continuing to follow all protocols to mitigate the spread of COVID-19 including wearing a face mask, Texas Assisted Living facilities can now permit:

Assisted Living facilities no longer need to:

Core Principles of COVID-19 Infection Prevention

Visitors who are unable or unwilling to adhere to the core principles of COVID-19 infection prevention should not be permitted to visit or should be asked to leave.  By following a person-centered approach and adhering to these core principles, visitation can occur safely.

Cough and Sneeze Etiquette

Covering coughs and sneezes and washing hands are especially important for infection control measures in healthcare settings, such as emergency departments, doctor’s offices, and clinics.

Remember to immediately wash your hands after blowing your nose, coughing, or sneezing.
Washing your hands is one of the most effective ways to prevent yourself and your loved ones from getting sick, especially at key times when you are likely to get and spread germs.

 

Outdoor Visitation

Outdoor visitation is preferred even when the resident and visitor are fully vaccinated* against COVID-19.  Outdoor visits generally pose a lower risk of transmission due to increased space and airflow.  Therefore, visits should be held outdoors whenever practicable.  However, weather conditions and health status of residents may hinder outdoor visits.
If the resident is fully vaccinated*, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after.
Core Principles for Infection Prevention must be used.

Indoor Visitation

The facility will allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission. 

As a facility, we must consider the number of visitors per resident at one time and the total number of visitors in the facility at one time and how that may affect the ability to maintain the core principles of infection prevention.  In light of this, please continue to schedule your visits at this time.  We must also ensure that all residents have the opportunity to have visits, so the time may be limited.

Visitors must limit their movement around the facility.  Please go directly to the visitation area and when leaving go directly out of the building.  Please do not stop and talk to other residents, no matter how tempting that can be.
Social distancing continues to be the safest way to prevent the spread of COVID-19, particularly if either party has not been fully vaccinated*.  However, we acknowledge the toll that separation and isolation has taken.  We also acknowledge that there is no substitute for physical contact, such as the warm embrace between a resident and their loved one.  Therefore, if the resident is fully vaccinated*, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after.

Core principles for Infection Prevention must be used. 

Indoor Visitation During an Outbreak

An outbreak is defined as when there is a new onset of one or more COVID-19 cases among residents or staff.
The facility must immediately limit visitation to one visitor at a time and institute outbreak testing.  If the new outbreak is isolated to one area, visitation may continue as before in other areas.  The affected area will continue outbreak testing until there has been 14 days without a new case.  If COVID-19 is found in more than one area, then the whole facility will have limited visitation until the facility has met the criteria to stop outbreak testing.
Core Principles for Infection Prevention must be used.

Visitor Testing and Vaccination

\ While not required, we encourage visitors to continue to test for COVID-19.  We also encourage visitors to become vaccinated when they have the opportunity.  While visitor testing can help prevent the spread of COVID-19, it is no longer a requirement for visitation, nor is proof of vaccination.

If you are exhibiting any of the signs or symptoms of COVID-19 or are feeling even slightly ill, please reschedule your visit.  This is imperative for the safety of your loved ones and our staff.

Compassionate Care Visits

Compassionate care visits are not just for “end of life” situations.  Other examples include:

Compassionate care visits can be conducted, in addition to family members, by any individual that can meet the resident’s needs, such as clergy or lay persons.  These visits should be socially distanced visits.  If the resident is fully vaccinated*, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after.

These types of visits are allowed at any time, regardless of the resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak.

Core principles for Infection Prevention must be used.

 

Residents on Transmission Based Precautions

Residents who are on transmission-based precautions for COVID-19 should only receive visits that are virtual, through windows, or in-person for compassionate care situations, with adherence to transmission-based precautions. 

Essential Caregivers

*Fully vaccinated refers to a person who is > 2 weeks following receipt of the second dose in a 2-dose series, or > 2 weeks following receipt of one done of a single-dose vaccine, per the CDC’s Public Health Recommendations for Vaccinated Persons.

 

References
Centers for Medicare and Medicaid Services (March 10, 2021).  Nursing Home Visitation –
            COVID-19: QSO-20-39-NH
Texas Health and Human Services Commission (March 22, 2021) COVID-19 Response-
            Expansion of Reopening Visitation: PL 21-08