Facility Updates

The CDC has a website that shows the ups and downs of community positivity.  This website gives suggestions to prevent yourself from getting COVID and has links to more information beyond the basic information.  This website is https://covid.cdc.gov/covid-data-tracker/#county-view?list_select_state=all_states, which will show the community positivity of any county in the United States.  This is just another way to try and protect yourself and those you love from COVID.

FOUNDATION PARK IS COVID FREE!!

At Foundation Park Alzheimer’s Care Center, our highest priority has always been, and always will be, the safety and well-being of our residents – and we know that your visits with them are important to their health and happiness. 

At Foundation Park Alzheimer’s Care Center, we have finished “outbreak” testing as in accordance with state and federal requirements.  An “outbreak” is currently defined as a single instance of an employee, resident, volunteer, or other “staff” having tested positive.  We currently have no active COVID in the facility.

Please keep in mind that we will continue screening all residents per protocol and will continue testing all staff according to State and Federal guidelines. 

PLEASE DO NOT VISIT IF YOU ARE NOT FEELING WELL!  The resident who tested positive had visitors recently and while we cannot say with 100% surety that this was the source for their COVID infection, it is being considered with significant suspicion.  

• Visits may be facilitated regardless of the center or resident’s COVID-19 status. Visitors to a resident on transmission-based precautions for COVID-19 should adhere to the PPE requirements.  Depending on your loved one’s vaccination status and symptoms as well as your vaccination status, additional precautions may be necessary.

• Visits can occur indoors or outdoors depending on the resident’s needs.

• All visitors will undergo screening prior to each visit to ensure that no one enters with a fever or other condition that could create a possible risk to our residents.  Visitors must notify the center if they develop any symptoms of COVID-19 within 72 hours after their visit.

• We strongly encourage visitors to receive the COVID-19 vaccine.

• Visitors will receive information regarding hand hygiene, mask wearing, and social distancing.

• Visits may be facilitated regardless of the center or resident’s COVID-19 status. Visitors to a resident on transmission-based precautions for COVID-19 should adhere to the PPE requirements.  Depending on your loved one’s vaccination status and symptoms as well as your vaccination status, additional precautions may be necessary.

• Visits can occur indoors or outdoors depending on the resident’s needs.

We know some of these requirements will present a challenge, but they are necessary to protect your loved ones under our care. We appreciate your cooperation in complying with the requirements for visitation. Our residents, staff, and management are thrilled to welcome you back! 

Please feel free to reach out to the center’s Administrator with any questions.

Due to some recent confusion related to our visitation practices (which is understandable with how much has changed in the last 3 years) below is a FAQ that was published earlier last year by the Centers for Medicare and Medicaid Services.  This provides some answers to questions that you may have.  Remember we are a dementia facility and so while you may have the ability to maintain a safe distance in a common area, our residents may not, which may prevent visitation in that area.  

Nursing Home Visitation Frequently Asked Questions (FAQs) 

CMS is providing clarification to recent guidance for visitation (see CMS memorandum QSO-20-39NH REVISED 11/12/2021). While CMS cannot address every aspect of visitation that may occur, we provide additional details about certain scenarios below.  However, the bottom line is visitation must be permitted at all times with very limited and rare exceptions, in accordance with residents’ rights.  In short, nursing homes should enable visitation following these three key points: 

•       Adhere to the core principles of infection prevention, especially wearing a mask, performing hand hygiene, and practicing physical distancing;

•       Don’t have large gatherings where physical distancing cannot be maintained; and

•       Work with your state or local health department when an outbreak occurs.

1. What is the best way for residents, visitors, and staff to protect themselves from the Omicron variant?

A: The most effective tool to protect anyone from the COVID-19 Omicron variant (or any version of COVID-19) is to become fully vaccinated AND receive booster shots per CDC recommendations. Also, we urge all residents, staff, and visitors to follow the guidelines for preventing COVID-19 from spreading, including wearing a well-fitting mask at all times while in a nursing home, practicing physical distancing, and performing hand hygiene by using an alcohol-based hand rub or soap and water. Residents do not have to wear a mask while eating or drinking, or in their rooms alone or with their roommate.

2. How should nursing homes address visitation when they expect a high volume of visitors, such as over the holidays?

A: In general, visitation should be allowed for all residents at all times. However, as stated in CMS memorandum QSO-20-39-NH REVISED 11/12/2021, “facilities should ensure that physical distancing can still be maintained during peak times of visitation,” and “facilities should avoid large gatherings (e.g., parties, events).”  This means that facilities, residents, and visitors should refrain from having large gatherings where physical distancing cannot be maintained in the facility. In other words, if physical distancing between other residents cannot be maintained, the facility may restructure the visitation policy, such as asking visitors to schedule their visit at staggered time-slots throughout the day, and/or limiting the number of visitors in the facility or a resident’s room at any time. Note: While these may be strategies used during the holidays or when a high volume of visitors is expected (especially in light of the uncertain impact of the Omicron variant in facilities), we expect these strategies to only be used when physical distancing cannot be maintained. Also, there is no limit on length of visits, in general, as long as physical distancing can be maintained and the visit poses no risk to or infringes upon other residents’ rights. If physical distancing cannot be maintained or infringes on the rights and safety of others, the facility must demonstrate that good faith efforts were made to facilitate visitation. 

3. Can residents have close contact with their visitor(s) during a visit and visit without a mask? 

A:  Visitors, regardless of vaccination status, must wear masks and physically distance themselves from other residents and staff when in a communal area in the facility. Separately, while we strongly recommend that visitors wear masks when visiting residents in a private setting, such as a resident’s room when the roommate isn’t present, they may choose not to.  Also, while not recommended, if a resident (or responsible party) is aware of the risks of close contact and/or not wearing a mask during a visit, and they choose to not wear a mask and choose to engage in close contact, the facility cannot deny the resident their right to choose, as long as the residents’ choice does not put other residents at risk. This would occur only while not in a communal area. Prior to visiting, visitors should also be made aware of the risks of engaging in close contact with the resident and not wearing a mask during their visit.  

4. Can visits occur in a resident’s room if they have a roommate? 

A: Yes. Ideally an in-room visit would be conducted when the roommate is not present, however if that is not an option and as long as physical distancing can be maintained, then a visit may be conducted in the resident’s room with their roommate present. If physical distancing cannot be maintained, the visit should occur in a different area of the facility, or the visit should occur at a time when the roommate is not in the room, or the visitors should be asked to limit the number of visitors that are in the room at one time. Also, visitors and residents should adhere to the principles of infection control, including wearing a mask and performing frequent hand hygiene.  

5. Can a visitor share a meal with or feed the resident they are visiting? 

A: Visitors may eat with a resident if the resident (or representative) and the visitor are aware of the risks and adhere to the core principles of infection prevention.  Eating in a separate area is preferred, however if that is not possible, then the meal could occur in a common area as long as the visitor, regardless of their vaccination status, is physically distanced from other residents and wears a mask, except while eating or drinking.  If the visitor is unable to physically distance from other residents, they should not share a meal with the resident in a common area.  Visitors, regardless of vaccination status, must wear masks and physically distance from other residents and staff when in a communal area in the facility. 

6. With COVID-19 cases spiking due to the Omicron variant, should facilities continue to permit visitation? 

A:  Yes. While CMS is concerned about the rise of COVID-19 cases due to the Omicron variant, we’re also concerned about the effects of isolation and separation of residents from their loved ones. Earlier in the pandemic we issued guidance for certain limits to visitation, but we’ve learned a few key things since then. Isolation and limited visitation can be traumatic for residents, resulting in physical and psychosocial decline. So, we know it can lead to worse outcomes for people in nursing homes. Furthermore, we know visitation can occur in a manner that doesn’t place other residents at increased risk for COVID-19 by adhering to the practices for infection prevention, such as physical distancing, masking, and frequent hand hygiene. There are also a variety of ways that visitation can be structured to reduce the risk of COVID-19 spreading.  So, CMS believes it is critical for residents to receive visits from their friends, family, and loved ones in a manner that does not impose on the rights of another resident. Lastly, as indicated above, facilities should consult with their state or local public health officials, and questions about visitation should be addressed on a case by case basis. 

7. Why can a resident choose to have a visit even when COVID-19 cases are increasing? 

A: It is important to note that federal regulations explicitly state that residents have the right to make choices about significant aspects of their life in the facility and the right to receive visitors, as long as it doesn’t infringe on the rights of other residents (42 CFR 483.10(f)(2) and (4), respectively). In this case, as long as a visit doesn’t increase the risk of COVID-19 for other residents (i.e., by using the guidance for conducting safe visits), the resident still has the right to choose to have a visitor. Therefore, if the resident is aware of the risks of the visit, and the visit is conducted in a manner that doesn’t increase the risk of COVID-19 transmission for other residents, the visit must still be permitted in accordance with the requirements. 

8. Are there any suggestions for how to conduct visits that reduce the risk of COVID-19 transmission? For example, should facilities have different policies for vaccinated and unvaccinated visitors? 

A:  While we strongly encourage everyone to get vaccinated, visitation can occur regardless of the visitor’s vaccination status. There are ways facilities can and should take extra precautions, such as hosting the visit outdoors, if possible; creating dedicated visitation space indoors; permitting inroom visits when the resident’s roommate is not present; and the resident and visitor should wear a well-fitting mask (preferably those with better protection, such as surgical masks or KN95), perform frequent hand-hygiene, and practice physical distancing. Some other recommendations include: 

•       Offering visitors surgical masks or KN95 masks. 

•       Restricting the visitor’s movement in the facility to only the location of the visit. 

•       Not conducting visits in common areas (except those areas dedicated for visitation). 

•       Increasing air-flow and ventilation. 

•       Cleaning and sanitizing the visitation area after each visit.  

•       Providing reminders in common areas (e.g., signage) to maintain physical distancing, perform hand-hygiene, and wear well-fitting masks. 

VIDEO & SOUND RECORDING / ELECTRONIC MONITORING

Common Areas. In order to protect the privacy of all residents and staff at our facility, we do not permit video or sound recordings to be made in the common areas of our facility. This policy applies to all forms of video and sound recording devices.

Resident Rooms. We allow our residents to install a fixed position video camera and/or sound recording device in a resident room. 

Who Can Authorize. Because electronic monitoring can present a significant invasion of the resident’s privacy, under the law, only one of three individuals can authorize the use of video and sound recording devices in the resident’s room:

1. Resident. The resident themselves. The resident should be competent and able to understand the effects of authorizing electronic monitoring.
2. Attorney-in-fact. Some residents execute a power of attorney (POA) designating someone to make health care decisions for them, called an “attorney-in-fact”. When a resident’s attending physician determines that the resident has lost the capacity to make decisions, the attorney-in-fact can authorize electronic monitoring. If a resident still has capacity to make their own decisions, the resident, and not an attorney-in-fact, makes the decision whether to allow electronic monitoring.
3. Guardian. Sometimes a probate court will appoint an individual to make health care decisions for an individual when they are determined to be incompetent and therefore unable to make decisions on their own. Only a guardian of the person with letters of authority from the probate court evidencing their appointment can authorize electronic monitoring.

Electronic Monitoring Rules. Installation and use of video and sound recording devices for electronic monitoring is subject to the following rules:

1. Authorization Form. The resident, attorney-in-fact, or guardian must authorize the installation and use of the device for remote monitoring on our standard authorization form.
2. Withdrawing Authorization. The resident, attorney-in-fact, or guardian may withdraw their authorization for electronic monitoring at any time.
3. Who Can Install. The facility must prior approve any electronic monitoring devices to make sure that they are the type allowable by law, and only facility personnel may install the devices after they have been approved.
4. Responsibility for Cost. The resident, attorney-in-fact, or guardian is responsible for all costs associated with installing, operating, and maintaining the device (except electricity).
5. Roommate Consent. If the resident has a roommate, the roommate must also consent before any electronic monitoring device is installed and used. If the resident’s roommate does not consent, either resident can move to another room, if one is available.
6. Posting Notice. We may post notices in and outside the resident’s room that electronic monitoring is in use.
7. Who Can View/Listen. Only the resident, their attorney-in-fact, their guardian, and law enforcement personnel are permitted under the law to view or listen to recordings from the electronic monitoring device. However, the resident, their attorney-in-fact, or their guardian can choose to allow others access to view recordings.

Illustrative Examples

1. Resident is the decision maker. A resident’s son and daughter want to install a video camera in their mother’s room to monitor her remotely. The resident resides in a private room, she is competent to make the authorization, and she wishes to allow both her son and daughter to monitor through the video camera. The resident can authorize the installation and use of the video camera using our authorization form and identify that both her son and daughter are authorized to monitor recordings, and the family can proceed with installing and monitoring using the video camera.
2. Residents do not want electronic monitoring. A resident’s son and daughter want to install a video camera in their mother’s room to monitor her remotely. The resident is competent to make the decision, and she does not want to install a camera because she is concerned about her privacy. In this case, because the resident has authority over electronic monitoring, the children would not be permitted to install or use a video camera to monitor their mother.
3. Roommate does not want electronic monitoring. A resident wants to install a video camera in her room so that her son can monitor her remotely. The resident has a roommate, and the roommate does not wish to allow video camera recording in their room. If another room is available, we will allow either resident to transfer to the available room. However, if no other room is available, the resident would not be able to install or use the video camera.
4. The attorney-in-fact is the decisionmaker. A resident’s daughter wants to install a video camera to monitor her mother, but the resident has appointed her son as attorney-in-fact under a Durable Power of Attorney for Health Care. The resident’s attending physician has made the determination that the resident is incapacitated, and noted that in the resident’s medical record, so, in this case, the son has authority over electronic monitoring, not the daughter. Therefore, if the son does not want to authorize remote monitoring, or if he does not wish to allow his sister access to the recordings, he can refuse to sign the authorization or refuse to identify his sister as an individual authorized to view recordings. In that case, the sister would not be permitted to monitor their mother.
5. A guardian is needed. A resident’s daughter wants to install a video camera to monitor her mother. However, the attending physician determines that the resident is incapacitated, and the resident has not named an attorney-in-fact through a Durable Power of Attorney for Health Care. In this case, there is no individual with appropriate authority to authorize electronic monitoring. Therefore, before the daughter can authorize install and use of the video camera, she would need to petition the probate court to be named as guardian for her mother. If the probate court determines that the resident is incompetent and names the daughter as guardian, she could then authorize electronic monitoring.
6. A determination of incapacity is needed. A resident’s daughter wishes to install a camera to monitor her mother. The resident executed a Durable Power of Attorney for Health Care naming her daughter the attorney-in-fact. However, the resident’s attending physician has not determined that the resident is incapacitated. In that case, the DPAHC is not effective, and the resident still has authority over electronic monitoring, not the daughter. If the resident appears unable to make the authorization, the daughter can ask the attending physician to make a determination whether the resident is incapacitated. Once the attending physician has made the determination that the resident is incapacitated, the DPAHC goes into effect, and the daughter can now authorize electronic monitoring.