submitted by Bria Lewis, Esq, Staff Attorney
With the recently updated guidelines for visitation from the New York State Department of Health (DOH), many residents living in nursing homes or adult care facilities (facility) and their loved ones have had many questions. The Center for Elder Law & Justice has prepared a fact sheet on the new guidelines and the impact on residents and visitors, which can be accessed here.
In addition to questions surrounding visitation, many residents and their loved ones have been wondering how the guidelines impact residents who want to leave the facility for short periods of time. All guidelines that were issued prior to March 25, 2021 are no longer in effect. Currently, each facility is required to have appropriate policies and procedures in place to address infection control and prevention after outings. “Outings” refers to short leaves (<24 hours) such as medical appointments, visits with family/friends, and other activities, and longer periods of time. The DOH states its guidelines are consistent with the Centers for Medicare & Medicaid Services (CMS) guidance issued on March 10, 2021 and are consistent with Centers for Disease Control and Prevention (CDC) infection prevention protocols.
The CDC recommends that residents who leave the facility should be reminded to follow all recommended infection control and prevention practices including source control, physical distancing, and hand hygiene and to encourage those around them to do the same. Family members accompanying residents on outings should also be educated on the recommended infection control and prevention practices and assist the residents with adhering to them.
For residents going to medical appointments, regular communication between the medical facility and the nursing home is essential to help identify residents with potential exposures or symptoms of COVID-19 before they enter the facility so that proper precautions can be implemented.
Quarantining a resident depends on, how long the resident has been out of the facility, the resident’s vaccination status, whether the resident had COVID-19 within the past three months, or if the resident had prolonged close contact with someone with COVID-19. In most cases, quarantine is not recommended for residents who leave the facility for less than 24 hours (e.g., for medical appointments, community outings with family or friends) and do not have close contact with someone with COVID-19. The CDC states that quarantining residents who regularly leave the facility for medical appointments would result in indefinite isolation of the resident and that likely outweighs any potential benefits of quarantine.
Facilities are allowed to quarantine residents who leave the facility if, based on an assessment of risk, uncertainty exists about the resident, and those around the residents’ adherence to the recommended infection prevention and control measures. According to the guidance, residents who leave the facility for 24 hours or longer should generally be managed the same as newly admitted residents or those seeking readmission. These residents should be placed in a 14 day quarantine, even if they test negative. Exceptions include residents who are within 3 months of a COVID-19 infection and fully vaccinated residents.*
*Fully vaccinated refers to a person who is at least 2 weeks following receipt of the second dose in a 2-dose series, or at least 2 weeks following receipt of one does of a single-dose vaccine, per CDC’s Public Health Recommendations for Vaccinated Persons.
Facilities are required to have infection control and prevention policies and procedures pertaining to visitation and when residents briefly leave the facility. These policies and procedures should be consistent with DOH and CDC guidelines. Residents and visitors have the right to know what these policies and procedures are and facilities should be able to provide its policy and procedures to residents and visitors.
The Center for Elder Law & Justice is here to help. If you are a resident or family member of a resident in a long-term care facility, and have questions or concerns about residents leaving the facility, visitation, or communications, contact us at (716) 853-3087.
The above content is for informational purposes only and should not be construed as legal advice.