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Ministry Status: Activation Status

Update to Visits at Long-Term Care Homes

Frequently Asked Questions

July 15, 2020

Resident Visiting Policy Questions

What updated directive and guidance are being introduced in regard to family visits?

Following consultation with operators and family, resident and caregiver associations, we are pleased to issue an updated visitor policy that will further facilitate the re-introduction of family visits to residents in long-term care homes that are not currently in outbreak.

The updated policy will advance that provided in Directive #3 and address conditions to be in place to allow indoor visits and update outdoor visits, effective July 22, 2020.

When can homes drop the condition that individuals seeking outdoor visits must attest to obtaining a negative COVID-19 test result prior to visiting a resident?

Effective July 15, 2020, visitor testing is no longer required for outdoor visits.

Such visits will still follow safety protocols, such as employing social distancing measures, and no outdoor visits are permitted at homes in outbreak.

When can homes resume supporting non-essential indoor visits for residents?

Indoor visits at long-term care homes can resume as of July 22, 2020 with conditions to protect residents, visitors and staff, including visitor testing.

These visits will not be permitted at homes in outbreak.

Long-term care homes that are not in an outbreak must work to meet the requirements for homes outlined in the policy as soon as possible.

What requirements must the home meet to be able to welcome indoor visitors?

The resumption of indoor visits can begin on July 22, 2020.

For a long-term care home to resume these visits, they must first meet the following conditions:

Homes must:

What requirements must the visitor meet to be able to participate in an indoor visit?

The visitor must:

Prospective visitors should consider their personal health and susceptibility to the virus in determining whether visiting a long-term care is appropriate.

If a visitor does not comply with these requirements, it will be the basis for the discontinuation of their visits.

Are visitors required to bring their own PPE?

Visitors are responsible for bringing their own non-medical mask (for example: cloth masks, bandanas or other face coverings) for outside visits.

The home is responsible for supplying surgical/procedural masks to outdoor visitors who do not have a face covering. Homes should avoid accessing the provincial pandemic stockpile for this purpose.

How often can a visitor come to visit a loved one in a long-term care home?

This will depend on the home's ability to schedule in an equitable manner.

The policy allows for a resident to have up to two visitors a time for outdoor visits, and up to two visitors a time for indoor visits.

However, these scheduled visits do not preclude "window" visits, which can continue according to long-term care homes' individual practices.

Are in-room visits allowed?

Yes, provided there is no overcrowding and the home can accommodate this request.

If a couple live on the same campus (one spouse in LTC and one spouse in retirement home), should a spouse in the retirement home side require a COVID-19 test every two weeks in order to visit their spouse in LTC?

Yes, the spouse in the retirement home side must still get tested every two weeks for an indoor visit with their spouse in the long-term care home side. However, they do not need to be tested to visit their spouse at a scheduled outdoor visit.

What is the policy for visits by multiple visitors such as a group of relatives seeking to see a loved-one at the same time?

The policy allows for a resident to have up to two visitors a time for outdoor visits, and up to two visitors a time for indoor visits.

Will residents need to wear surgical/procedural masks, or just visitors?

If physical distancing can be achieved and maintained, just visitors. If physical distancing cannot be achieved or maintained all individuals should wear masks within reason. As an example, for essential family caregivers involved in feeding having a resident wear a mask is not feasible. Visitors will be required to wear face coverings for outdoor visits.

Can residents and family members make contact? For example, hug?

Visitors and residents are encouraged to practice physical distancing for the duration of their visit.

However, for indoor visits only and for non-essential and essential visitors who have verbally attested to not testing positive within the last 14 days physical contact that reduces risk to the resident and does not involve directly facing the resident can be considered if it will help with the social and emotional well being of the resident. Please note: essential visitors who have not verbally attested to not testing positive within the last 14 days must employ the rules associated with essential visiting.

Will visiting hours need to change to accommodate this change?

We are not requesting that homes make any changes to their regular visiting hours. However, we do ask that homes make every effort to accommodate scheduling of visitors so that each resident may receive visitors in a timely fashion.

Visits can be time-limited to allow the home to accommodate more residents/visitors — however, visits must be no less than 30 minutes.

What about residents who have cognitive issues and may not be able to physically distance? How can they get visits?

This should be reviewed on a case by case basis to determine what strategies can be implemented to support a visit.

Do visits need to be supervised?

The successful resumption of visits in homes is dependent on trust. Similar to the verbal attestations that are given at the time of active screening, homes will be trusting that visitors will comply with all rules and that there is no need for supervision. In some cases, though, homes may need to supervise visits, and this is allowed.

Can residents now leave their home to visit with family and friends?

Long-term care homes must not permit residents to leave the home for short-stay absences to visit family and friends.

Residents who wish to go outside of the home must remain on the home's property and maintain safe physical distancing.

What about long-term care homes that might not have outdoor space, or a big enough space, to accommodate these visits?

Homes must create a dedicated area outside the building where visitors can meet residents. These spaces could include repurposed, protected outdoor space, or a parking lot. Staff must support the transfer of residents out of and back into the home.

Can there be more than one resident outside visiting at a time with their loved ones?

Yes, up to two. This will be dependent on the size of the space and the ability to maintain physical distancing between the parties.

Are long-term care homes being given enough time to implement the shift to permit conditional indoor visits?

To support long-term care home residents, the Ministry of Long-Term Care is implementing a gradual, phased resumption of visits guided by principles of safety, emotional well-being and flexibility. Though indoor visits are permitted as of July 22, 2020, homes don't have to begin those immediately should they require more time to safely implement these changes.

Will these changes be revoked in the winter if COVID-19 is still ongoing?

As the COVID-19 outbreak evolves in Ontario, the visitor policy will be continually updated, keeping the safety and emotional wellbeing of residents and staff at the forefront. If a second wave of COVID-19 occurs, the government will revert to restricting visitors, to protect residents and staff.

Is it up to individual homes whether or not to implement this? Or will this be mandatory?

It will be mandatory — this policy applies to all homes.

How will homes get the additional staff they will need to supervise and assist with these visits, including the cost of appropriate PPE for both staff and visitors? Will there be funding for this?

Homes are encouraged to establish scheduling practices that consider the staffing and space capacity available to the home to maintain the safety of residents, staff and visitors. This includes staff capacity to support the transfer of residents out of an into the home in the case of outdoor visits.

The Ministry of Long-Term Care does not require home staff to supervise visits.

Visitors are responsible for bringing their own face covering for outside visits. The home is responsible for supplying surgical/procedure masks to indoor visitors and to outdoor visitors who do not have a face covering. Homes should avoid accessing the provincial pandemic stockpile for this purpose.

Will this new change in policy place any additional responsibilities on staff working in long-term care homes? How will physical distancing and PPE protocols be ensured/enforced? How can people report non-compliance?

The following baseline requirements for the home must be met prior to the home being able to accept any visitors:

  1. The LTC home must not be currently in outbreak.
    1. In the event that a home has begun resuming non-essential visits and enters into an outbreak, the home must end all non-essential visits. Homes must comply with all Chief Medical Officer of Health directives pertaining to outbreaks and follow directions from the local public health unit.
  2. Homes must develop procedures for the resumption of non-essential visits and a process for communicating these procedures with residents, families, visitors and staff, including but not limited to infection prevention and control (IPAC), scheduling and any home-specific policies.
    1. The process must include sharing an information package with visitors on IPAC, masking and other operational procedures such as limiting movement around the home, if applicable, and ensuring visitors' agreement to comply. Home materials must include an approach to dealing with non-adherence to home policies and procedures, including the discontinuation of visits.
    2. Protocols in place to maintain the highest of IPAC standards prior to, during and after visits.
    3. Each home should create and maintain a list of visitors. The list will be available for relevant/appropriate staff members to access.

If individuals believe that a home has not complied with the requirements in the LTCHA and/or Regulation, they may call the ministry's Family Support and Action Line at 1-866-434-0144 between 8:30 am and 7:00 pm, seven days a week to make a formal complaint.

What if a visitor does not comply with IPAC protocols? What can a home do?

Long-term care homes are required to follow directives issued by the Chief Medical Officer of Heath under the Health Protection and Promotion Act. As a result, homes should ensure that they take steps to enforce the rules around visitors, including restricting access to their properties as appropriate.

A home's process for communicating with residents, families and staff must include information that includes an approach to dealing with non-adherence to home policies and procedures. Any non-adherence to visitor rules will be the basis for discontinuation of visits.

To confirm: according to the indoor visitor requirements, should homes expect visitors to have COVID-19 negative results within the previous two weeks?

Correct. The home is also not responsible for providing the testing.

Have there been changes to the definition of "essential visitors"? How must their visits proceed?

No, there has not been a change to the definition of "essential visitors". Essential visitors include a person performing essential support services (e.g., food delivery, phlebotomy, maintenance, family or volunteers providing care services and other health care services required to maintain good health) or a person visiting a very ill or palliative resident.

A non-essential visitor is defined as any family member or close friend who is not an essential visitor.

Any visitor, including essential visitors must use a surgical/procedure mask while in the home, including while visiting a resident that does not have COVID-19 in their room.

Essential visitors who are in contact with a resident who is suspected or confirmed with COVID-19, must wear appropriate PPE in accordance with Directive #5 and Directive #1.

Essential visitors are the only type of visitors allowed when a resident is self-isolating or symptomatic, or a home is in outbreak.

What about non-essential services, such as occasional services for residents (for example, hair services)?

Non-essential occasional services (for example, hair services) can be introduced back to the LTC homes in a manner that is consistent with the provisions of the regional approach of reopening the province and restarting the economy.

A risk reduction approach should be established about how these services are introduced, including:

What if a home goes back into outbreak?

In the event that a home has begun resuming non-essential visits and non-essential services and enters into an outbreak, the home must end all non-essential visits and non-essential services

Homes must comply with all Chief Medical Officer of Health directives pertaining to outbreaks and follow directions from the local public health unit.

 

For More Information

Call ServiceOntario, Infoline at:
1–866–532–3161 (Toll–free)
In Toronto, (416) 314–5518
TTY 1–800–387–5559.
In Toronto, TTY (416)327–4282
Hours of operation: Monday to Friday, 8:30am – 5:00pm

 
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