COVID-19: VISITATION AND REOPENING POLICY

Purpose:


The purpose of this policy is to provide Jamaica Hospital Nursing Home with visitation guidelines during the Coronavirus (COVID-19) pandemic. To protect our residents, visitors, and staff and help prevent the spread of the Novel Coronavirus (COVID-19), the Leadership Team of Jamaica Hospital Nursing Home will enact visitation as per the Centers for Medicare and Medicaid Services (CMS) and the New York State Department of Health (NYSDOH) and will make changes to the visitation policy as deemed necessary. Visitation will take place outdoors weather permitting or on the first floor Lobby area or Garden Rooms. Families / Friends will be notified of any changes via letter, telephone call e-mail. Residents will be notified by room visits and robocalls made to their individual room telephones.

General Information:

The information contained in this directive supersedes and replaces previously issued guidance and recommendations regarding general nursing home (“NH”) visitation and is consistent with the U.S. Centers for Medicare & Medicaid Services (“CMS”) memorandum QSO-20-39-NH and Centers for Disease Control and Prevention (“CDC”) guidelines on such topics. Nothing in this directive will be construed as limiting or eliminating the NH’s responsibility to ensure that resident and family communication is ongoing and supported by virtual visits, whenever possible, nor does it change the guidance previously issued relative to visitation for medically necessary or end-oflife services.

While both New York State and CMS guidance have focused on protecting nursing home 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. Additionally, since the release of prior iterations of visitation directives, several COVID-19 vaccines have received Emergency Use Authorization from the Food and Drug Administration (“FDA”). Millions of vaccinations have since been administered to NH residents and staff across the country, and these vaccines have shown pronounced efficacy in helping to prevent symptomatic spread of SARS-CoV-2 infection (i.e., COVID-19). The nursing home in New York State will be committed to ensuring all eligible and consenting residents and staff have the opportunity to be vaccinated.

As such, and aligning with CMS, the DOH has revising the guidance regarding visitation in NHs during the COVID-19 Public Health Emergency (“PHE”).

The information contained in this directive supersedes and replaces previously issued guidance and recommendations regarding visitation, including the recent February 24, 2021 and the November 24th Holiday Guidance. Each facility is required to have appropriate policies and procedures in place to address infection control and prevention during and after visits and outings.

Given the continued risk of COVID-19 transmission, the DOH continues to emphasize the importance of maintaining infection prevention practices and strongly encourages that all NHs continue testing visitors to help reduce any such risk of COVID-19 transmission.

Guidance


Visitation can be conducted through different means based on a facility’s structure and residents’ needs, such as in resident rooms, dedicated visitation spaces, outdoors, and for circumstances beyond compassionate care situations. Regardless of how visits are conducted, there are certain core principles and best practices that reduce the risk of COVID-19 transmission including, but not limited to:

  • Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions about and observations of signs or symptoms), and denial of entry of those with signs or symptoms or those who have had close contact with someone with COVID-19 infection in the prior 14 days (regardless of the visitor’s vaccination status);
  • Hand hygiene (use of alcohol-based hand rub is preferred);
  • The use of face coverings or masks (covering mouth and nose);
  • Social distancing at least six feet between persons;
  • Instructional signage throughout the facility and proper visitor education on COVID- 19 signs and symptoms, infection control precautions, other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene);
  • Cleaning and disinfecting high frequency touched surfaces in the facility often, and designated visitation areas after each visit;
  • Appropriate staff use of Personal Protective Equipment (PPE);
  • Effective cohorting ofresidents (e.g., separate areas dedicated to COVID-19 care);
  • Resident and staff testing conducted as required at 42 CFR 483.8o(h) (see QS0-20-38-NH).

These core principles are consistent with CDC guidelines for the nursing home and will be adhered to at all times. Additionally, visitation will be person-centered and will consider the residents’ physical, mental, and psychosocial well-being, and support their quality of life.

The risk of transmission can be further reduced through the use of physical barriers (e.g., clear Plexiglass dividers, curtains). Also, the nursing home will enable visits to be conducted with an adequate degree of privacy. Visitors who are unable to adhere to the core principles of COVID-19 infection prevention will not be permitted to visit or will be asked to leave. By following a person-centered approach and adhering to these core principles, visitation can occur safely based on the below guidance.

Visitation


The nursing home will expand visitation and/or activities under this revised guidance and continue following the core principles of infection control and prevention, under the following conditions:

  • Full compliance with both state and federal reporting requirements including COVID-19 focus surveys, daily HERDS, weekly staff testing surveys, and the federally required weekly submission of COVID-19 data to the National Healthcare Safety Network (NHSN).
  • A copy of the facility’s visitation plan shall be kept where it is easily accessible and immediately available upon request of the Department or local health department. The plan will clearly articulate the space(s) to be used for visitation (outdoors and indoors) including the number of
  • visitors and residents which could be safely socially distanced within the space(s). The plan will reference relevant infection control policies for visitors.
  • Visitors must be able to adhere to the core principles, including infection prevention and control policies, and staff are expected to provide monitoring for those who may have difficulty adhering to core principles.
  • Policies will be widely communicated to residents, staff and visitors that limit the number of visitors per resident at one time and limit the total number of visitors in the facility at one time (based on the size of the building and physical space). Visits will be limited to thirty (30) minutes.
  • Movement of visitors in facility will be limited, including limiting visitors from walking around different halls of the facility. Visitors will go directly to the designated visitation area.
  • Adherence to written screening protocols for all staff during each shift, each resident daily, and all persons entering the facility or grounds of such nursing home, including visitors, vendors, students and volunteers.
  • Visitors are encouraged to provide a negative COVID-19 test result from within the past seventy­ two hours (72), or may be tested with rapid testing to meet the testing requirement.
  • The number of visitors to the nursing home will not exceed twenty percent (20%) of the resident census at any time and the number of visitors.
  • Policies and procedures will be revised to afford every opportunity for visits in a safe and thoughtful manner. Policies will contemplate the need for adequate supervision and strict adherence to the core principles of infection prevention and control.
  • Visitors under the age of 16 must be accompanied by an adult 18 years of age or older.
  • Current COVID-19 positive residents, residents with COVID-19 signs or symptoms, and new admissions in the observation period remain ineligible for in-person visits. In these instances, every effort will be made to accommodate visits using electronic devices and alternative visitation techniques.
  • The nursing home will create accessible and safe outdoor spaces for visitation, such as in courtyards, patios, or parking lots, including the use of tents, if available. When conducting outdoor visitation, the nursing home will have a process to limit the number and size of visits occurring simultaneously to support safe infection prevention actions (e.g., maintaining social distancing). A reasonable limit will be placed on the number of individuals visiting with any one resident at the same time.
  • The nursing home will follow the following additional guidelines outlined below which include ensuring each of the following:
    • The facility will have adequate staff present to allow for personnel to help with the transition of residents, monitoring of visitation, and cleaning and disinfecting of areas used for visitation after each visit using an EPA-approved
    • The facility will have appropriate signage regarding facemask or face covering utilization and hand hygiene, and applicable floor markings to cue social distancing delineations must be in place at all
    • Screening for signs and symptoms of COVID-19 will occur prior to resident
    • The facility will maintain documentation of screening onsite in an electronic format and available upon the Department’s request for purposes of inspection and potential contact
    • Documentation must include the following for each visitor:
      • First and last name of the visitor;
      • Physical (street) address of the visitor;
      • Daytime and Evening telephone number;
      • Date and time of visit; and
      • Email address if available
    • Documentation of supervision of visit shall include:
      1. Supervising facility staff member; and
      2. Location of visit – visit conducted in a common area or outdoor area that does not require the visitor to enter a resident unit; and
      3. Compliance by visitor with all COVID-19 precautions including hand hygiene and appropriate use of a face mask or face covering, and
      4. Visitor and the resident maintained at least 6 feet of distance from each other for the entire duration of the visit; and
      5. Visitor maintained at least 6 feet of distance from all other visitors, residents, and staff for the entire duration of the
  • Adequate PPE will be made available by the nursing home to ensure residents wear a face mask, if medically able to utilize a face covering during visitation. Visitors will be required to wear a face mask or face covering at all times when on the premises of the nursing home and maintain social distancing. The nursing home will have adequate supply of masks on hand for visitors and make available to visitors who lack an acceptable face covering.
  • Alcohol-based hand rub will be provided to visitors or representatives of the long-term care ombudsman visiting residents and those individuals are able demonstrate appropriate use.
  • The nursing home will provide a quick, easy to read fact sheet outlining visitor expectations including appropriate hand hygiene and face coverings to all visitors.
  • The fact sheet will be provided upon initial screening to all visitors.
  • Weather permitting, residents will also be assisted to go outdoors with staff supervision and the appropriate infection control, safety and social distancing requirements maintained.
  • Any students and trainees enrolled in programs to become licensed, registered, certified, board eligible or otherwise to complete a program for health care professionals to receive training and otherwise participate in duties relevant to their program of training provided the nursing home environment is appropriate to the student’s education, training and experience will be allowed. Students will be required to follow the guidelines established in their agreement between the nursing home and academic institution.

Outdoor Visitation


While taking a person-centered approach and adhering to the core principles of COVID-19 infection prevention, 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. Visits will be held outdoors whenever practicable.

However, weather considerations or an individual resident’s health status (e.g., medical condition(s), COVID-19 status) may hinder outdoor visits. For outdoor visits, Jamaica Hospital Nursing Home will create accessible and safe outdoor spaces for visitation. When conducting outdoor visitation, all appropriate infection control and prevention practices will be adhered to.

*Note: 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 dose of a single dose vaccine, per the CDC’s Public Health Recommendations for Vaccinated Persons.

Indoor Visitation


Jamaica Hospital Nursing Home will allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation will be limited due to a high risk of COVID-19 transmission (exception- compassionate care visits will be permitted at all times). These scenarios include limiting indoor visitation for:

  • Unvaccinated residents if the nursing home’s COVID-19 county positivity rate is >10% AND <70% of residents in the facility are fully vaccinated;
  • Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue Transmission-Based Precautions; OR
  • Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.

Note: For county positivity rates go to: https://data.cms.gov/stories/s/COVID-19-NursingHome­ Data/bkwz-xpvg

Jamaica Hospital Nursing Home will consider how the number of visitors per resident at one time and the total number of visitors in the facility at one time may affect the ability to maintain the core principles of infection prevention. In addition, the nursing home will:

  • Schedule visits for a specified length of time to help ensure all residents are able to receive
  • Limit visitor movement in the
  • For residents who share a room, visits will not be conducted in the resident’s
  • For situations where there is a roommate and the health status of the resident prevents leaving the room, Jamaica Hospital Nursing Home will attempt to enable in- room visitation while adhering to the core principles of COVID-19 infection
  • Allow for, if the resident is fully vaccinated, for them to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after. Regardless, visitors will physically distance from other residents and staff in the facility

Indoor Visitation During an Outbreak


An outbreak exists when a new nursing home onset of COVID-19 occurs (i.e., a new COVID-19 case among residents or staff). With the appropriate safeguards, visitation can still occur when there is an outbreak, but there is evidence that the transmission of COVID-19 is contained to a single area (e.g., unit) of the facility. To swiftly detect cases, the nursing home are reminded to adhere to CMS regulations and guidance for COVID-19 testing including routine staff testing, testing of individuals with symptoms, and outbreak testing, including but not limited to 42 CFR 483.So(h) and QS0-20-38-NH. The nursing home will also comply with NYS executive orders, regulations, and applicable Department guidance governing testing.

When a new case of COVID-19 among residents or staff is identified, the nursing home will immediately begin outbreak testing and suspend all visitation (except that required under federal disability rights law), until at least one round of facility-wide testing is completed. Visitation can resume based on the following criteria:

  • If the first round of outbreak testing reveals no additional COVID-19 cases in other areas (e.g., units) of the facility, then visitation can resume for residents in areas/units with no COVID-19 However, the facility will suspend visitation on the affected unit until the facility meets the criteria to discontinue outbreak testing.
  • For example, if the first round of outbreak testing reveals two more COVID-19 cases in the same unit as the original case, but not in other units, visitation can resume for residents in areas/units with no COVID-19
  • If the first round of outbreak testing reveals one or more additional COVID-19 cases in other areas/units of the facility (e.g., new cases in two or more units), then Jamaica Hospital Nursing Home will suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak

While the above scenarios describe how visitation can continue after one round of outbreak testing, Jamaica Hospital Nursing Home will continue all necessary rounds of outbreak testing. In other words, this guidance provides information on how visitation can occur during an outbreak but does not change any expectations for testing and adherence to infection prevention and control practices.

If subsequent rounds of outbreak testing identify one or more additional COVID-19 cases in other areas/units of the facility, then Jamaica Hospital Nursing Home will suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak testing.

NOTE: In all cases, visitors will be notified about the potential for COVID-19 exposure in the facility (e.g., appropriate signage regarding current outbreaks), and adhere to the core principles of COVID-19 infection prevention, including effective hand hygiene and use of face-coverings.

Visitor Testing and Vaccination


DOH strongly recommends that all facilities offer testing to visitors. CMS encourages facilities in medium­ or high-positivity counties to offer testing if feasible. The nursing home will prioritize visitors that visit regularly (e.g., weekly), although any visitor can be tested and also encourage visitors to be tested on their own prior to coming to the facility (e.g., within 2-3 days). Point of care testing is available for all visitors.

In addition, the DOH encourages visitors to become vaccinated when eligible. While visitor testing and vaccination can help prevent the spread of COVID-19, visitors will not be required to be tested or vaccinated (or show proof of such) as a condition of visitation.

This also applies to representatives of the Office of the State Long-Term Care Ombudsman and protection and advocacy systems, as described below.

Potential Visit Related Exposures


In addition and consistent with DOH policy, if a visitor to a nursing home tests positive for SARS-CoV-2 by a diagnostic test and the visit to the NH occurred from two days before the visitor’s symptom onset (or in the 2 days before the date of collection of the positive sample for visitors who remained asymptomatic) to the end of the visitor’s isolation period, there is a potential for exposure. Exposures among visitors and residents will be evaluated using community contact tracing guidelines, meaning exposure is defined by the proximity of the individuals and duration of the visit (contact within 6 feet and duration 10 minutes or more) regardless of personal protective equipment (PPE) or face covering used by the visitor or the resident.

The following will be evaluated to determine the appropriate follow-up when there is identification of a visitor who tests positive for COVID-19. If the following are confirmed by the facility:

  1. the visit was supervised by an appropriate facility staff member; and
  2. the visit was conducted in a common area or outdoor area that does not require the visitor to enter a resident unit; and
  3. the visitor complied with all COVID-19 precautions including hand hygiene and appropriate use of a face mask or face covering, and
  4. the visitor and the resident maintained at least 6 feet of distance from each other for the entire duration of the visit; and
  5. the visitor maintained at least 6 feet of distance from all other visitors, residents, and staff for the entire duration of the

Then, the appropriate action will be taken with respect to residents only, if all of the above are confirmed, the resident who received the visit will be placed on a 10-day, 14- day, or 20-day quarantine in a single room in the designated observation area using Contact plus Droplet precautions and eye protection. The resident will be monitored for symptoms and have temperature checks every shift. Testing for SARS-CoV- 2 could be considered for greater assurance of the resident’s COVID-19 status, every 3 to 7 days for at least 14 days.

If all of the above cannot be confirmed by the facility, the nursing home will proceed as they would after identification of a COVID-19 positive staff member, including conducting contact tracing to determine the extent of the exposure within the facility. On affected units (or entire facility, depending on the amount of contact), the nursing home will initiate testing every 3 days to 7 days until testing identifies no new cases of COVID-19 infection among staff or residents for a period of at least 14 days since the most recent positive result, use of transmission based precautions and testing for influenza (as per 10 NYCRR 415.33).

Facility staff who are exposed according to CDC HCP exposure guidance will be furloughed. See: https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html.If contacts include other visitors, those visitors will be considered exposed if contact was within 6 feet for more than 10 minutes to the COVID -19 positive visitor, regardless of PPE or face covering worn. Facility staff or visitors who identified as exposed at the facility will be reported by the facility to the local health department where the individual resides.

Compassionate Care Visits


While end-of-life situations have been used as examples of compassionate care situations, the term “compassionate care situations” does not exclusively refer to end-of-life situations.

Compassionate care visits, and visits required under federal disability rights law, will be allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak. Using a person-centered approach, the nursing home will work with residents, families, caregivers, resident representatives, and the Ombudsman program to identify the need for compassionate care visits.

Examples of other types of compassionate care situations include, but are not limited to:

  • A resident, who was living with their family before recently being admitted to a nursing home, is struggling with the change in environment and lack of physical family
  • A resident who is grieving after a friend or family member recently passed
  • A resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), is experiencing weight loss or
  • A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).
  • Visits by any individual that can meet the resident’s needs, such as clergy or lay persons offering religious and spiritual

Required Visitation


Consistent with 42 CFR § 483.10(±) (4) (v) the nursing home shall not restrict visitation without a reasonable clinical or safety cause. The nursing home must facilitate in-person visitation consistent with the applicable CMS regulations, which can be done by applying the guidance stated above. Failure to facilitate visitation, without adequate reason related to clinical necessity or resident safety, would constitute a potential violation of 42 CFR § 483.10(±) (4), and the facility would be subject to citation and enforcement actions.

Residents who are on transmission-based precautions for COVID-19 will only receive visits that are virtual, through windows, or in-person for compassionate care situations, with adherence to transmission-based precautions as referenced throughout this guidance document. This restriction will be lifted once transmission- based precautions are no longer required per CDC guidelines and other visits may be conducted as described above.

Access to the Long-Term Care Ombudsman


Regulations at 42 CFR § 483.10(f)(4)(i)(C) require that a Medicare and Medicaid- certified nursing home provide representatives of the Office of the State Long-Term Care Ombudsman with immediate access to any resident. During this PHE, in-person access may be limited due to infection control concerns and/or transmission of COVID19, such as the scenarios stated above for limiting indoor visitation; however, in­ person access may not be limited without reasonable cause. CMS requires representatives of the Office of the Ombudsman to adhere to the core principles of COVID- 19 infection prevention as described above. If in-person access is deemed inadvisable (e.g., the Ombudsman has signs or symptoms of COVID-19), facilities must, at a minimum, facilitate alternative resident communication with the ombudsman, such as by phone or through use of other technology.

Also required under 42 CFR § 483.10(h)(3)(ii) is the allowance of the Ombudsman to examine the resident’s medical, social, and administrative records as otherwise authorized by State law.

Federal Disability Rights Laws and Protection & Advocacy (P&A) Programs Section 483.10(f)(4)(i)(E) and (F) requires the facility to allow immediate access to a resident by any representative of the protection and advocacy systems, as designated by the state, and as established under the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (DD Act), and of the agency responsible for the protection and advocacy system for individuals with a mental disorder (established under the Protection and Advocacy for Mentally Ill Individuals Act of 2000).

Protection and Advocacy programs authorized under the DD Act protect the rights of individuals with developmental and other disabilities and are authorized to “investigate incidents of abuse and neglect of individuals with developmental disabilities if the incidents are reported to the system or if there is probable cause to believe the incidents occurred.” 42 U.S.C. § 15043(a)(2)(B). Under its federal authorities, representatives of Protection and Advocacy programs are permitted access to all facility residents, which includes “the opportunity to meet and communicate privately with such individuals regularly, both formally and informally, by telephone, mail and in person.” 42 CFR § 51.42(c); 45 CFR § 1326.27.

Additionally, the facility will comply with federal disability rights laws such as Section 504 of the Rehabilitation Act and the Americans with Disabilities Act (ADA). For example, if a resident requires assistance to ensure effective communication (e.g., a qualified interpreter or someone to facilitate communication) and the assistance is not available by onsite staff or effective communication cannot be provided without such entry (e.g., video remote interpreting), the facility must allow the individual entry into the nursing home to interpret or facilitate, with some exceptions. This would not preclude the nursing home from imposing legitimate safety measures that are necessary for safe operations, such as requiring such individuals to adhere to the core principles of COVID-19 infection prevention.

Any questions about or issues related to enforcement or oversight of the non-CMS requirements and citations referenced above under this section subject heading will be referred to the HHS Office for Civil Rights, the Administration for Community Living, or other appropriate oversight agency.

Survey Considerations


Federal and state surveyors are not required to be vaccinated and will be permitted entry unless they exhibit signs or symptoms of COVID-19. Surveyors will also adhere to the core principles of COVID-19 infection prevention and adhere to any COVID-19 infection prevention requirements set by state law.

Entry of Healthcare Workers and Other Providers of Services


Health care workers who are not employees of the facility but provide direct care to the facility’s residents, such as hospice workers, Emergency Medical Services (EMS) personnel, dialysis technicians, laboratory technicians, radiology technicians, social workers, clergy, etc., will be permitted to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or showing signs or symptoms of COVID-19 after being screened.

EMS personnel do not need to be screened, so they can attend to an emergency without delay. The nursing home requires all staff, including individuals providing services under arrangement as well as volunteers, to adhere to the core principles of COVID-19 infection prevention and must comply with COVID-19 testing requirements.

Using a person-centered approach when applying this guidance will cover all types of visitors, including those who may have been previously categorized as “essential caregivers.”

Existing construction projects, and specifically, those projects directly impacting the lives of nursing home residents that were previously approved by the Department will move forward with submission of and approval by the Department of a revised mitigation/prevention plan outlining at a minimum, testing, screening, PPE use, distance from residents, etc.

Note: Under no circumstance, will the nursing home resume renovation or construction project(s) in or adjacent to a functioning and occupied dedicated COVID unit.

Communal Dining and Activities

Communal dining and activities may occur while adhering to the core principles of COVID-19 infection prevention. Residents may eat in the same room with social distancing (e.g., limited number of people at each table and with at least six feet between each person). The nursing home will consider additional limitations based on status of COVID-19 infections in the facility and the size of the room being used and the ability to socially distance residents (e.g. limit to 10 residents and staff in smaller spaces. Additionally, group activities may also be facilitated (for residents who have fully recovered from COVID-19, and for those not in isolation for observation, or with suspected or confirmed COVID19 status) with social distancing among residents, appropriate hand hygiene, and use of a face covering (except while eating). The nursing home may be able to offer a variety of activities while also taking necessary precautions. For example, book clubs, crafts, movies, exercise, and bingo are all activities that can be facilitated with alterations to adhere to the guidelines for preventing transmission.

Compliance:


  1. Jamaica Hospital Nursing Home will stay in compliance with the requirements listed in the Skilled Nursing Facility Visitation advisory. Failure to follow these guidelines may result in restriction or revocation of
  2. Jamaica Hospital Nursing Home understands that the guidelines set forth by the New York State Department of Health are intended to restart limited visitation, the New York State Department of Health reserves the right to restrict visitation at any

Procedure:

  1. Resident visitation schedule will be as follows:
    1. Schedule and coordinated by the Activities Director or designee – Window visits, video call (face time, zoom), outdoor visit
    2. Family Members / visitors will be required to have a Video visit if they are feeling
    3. The travel guidelines require all New Yorkers, as well as those visiting from out-of-state or another country, to take personal responsibility for compliance in the best interest of public health and safety.
        • Asymptomatic travelers entering New York from another country, U.S. state, or territory are no longer required to test or quarantine as of April 10, 2021. Quarantine, consistent with the CDC recommendations, is still recommended for all travelers who are not fully vaccinated or have not recovered from laboratory confirmed COVID-19 during the previous 3 months. Symptomatic travelers must immediately self-isolate and contact the local health department or their healthcare providers to determine if they should seek COVID-19 testing.
        • All travelers must complete the Traveler Health Form unless the traveler had left New York for less than 24 hours or is coming to New York from a contiguous state. Contiguous states to New York are Pennsylvania, New Jersey, Connecticut, Massachusetts and Vermont.

      Irrespective of quarantine, all travelers must:

      Monitor symptoms daily from day of arrival in New York through day 14;

      Continue strict adherence to all recommended non-pharmaceutical interventions, including hand hygiene and the use of face coverings, through Day 14 (even if fully vaccinated); and

      Must immediately self-isolate if any symptoms develop and contact the local public health authority or their healthcare provider to report this change in clinical status and determine if they should seek testing.

      • Fully vaccinated is defined as being 2 or more weeks after the final dose (e.g., first for Janssen/Johnson & Johnson, second for Pfizer and Moderna) of the vaccine approved by the FDA or authorized by the FDA for emergency use. Vaccines that are not authorized by the U.S. Federal Drug Administration (FDA) for emergency use or approved by the FDA do not satisfy this definition.
      • Recently recovered is defined as 1) recovered from laboratory-confirmed COVID-19 by meeting the criteria for discontinuation of isolation, 2) within the 3-month period between date of arrival in New York and either the initial onset of symptoms related to the laboratory confirmed COVID-19 infection or, if asymptomatic during the illness, the date of the laboratory confirmed test, and 3) asymptomatic after travel or new exposure.
      • Domestic TravelersDomestic travel is defined as travel lasting 24 hours or longer to states or US territories other than contiguous states (i.e., Pennsylvania, New Jersey, Connecticut, Massachusetts, and Vermont). Travelers must fill out the NYS Department of Health traveler health form.There are generally no quarantine, work furlough, or testing requirements for asymptomatic domestic travelers.All  unvaccinated  domestic  travelers who  have not  recovered from  COVID- 19 in the past 3 months are recommended to get tested 3-5 days after arrival in New York, consider non-mandated self-quarantine (7 days if tested on day 3-5, otherwise 10 days), and avoid contact with people at higher risk for severe disease for 14 days, regardless of test result.
      • International TravelersCDC and NYS recommend delaying international travel until the traveler is fully vaccinated.International travelers must comply CDC requirements, which currently include proof of negative test or recent COVID recovery in order to board airplanes headed to the US. Travelers must complete the NYS Department of Health traveler health form.

        Currently CDC does not require quarantine, work furlough, or testing requirements for asymptomatic international travelers.

      • New York follows that recommendation with the following exceptions:Fully vaccinated individuals who have not recovered from COVID-19 in the past 3 months are recommended to get tested 3-5 days after arrival in New York from international travel.All unvaccinated international travelerswho have not recovered from COVID-19 in the past 3 months are recommended to get tested 3-5 days after arrival in New York, consider non-mandated self-quarantine (7 days if tested on day 3-5, otherwise 10 days), and avoid contact with people at higher risk for severe disease for 14 days, regardless of test result.
      • CanadaTravelers from Canada, crossing at land borders subject to the agreement between the governments of the United States and Canada, are permitted to travel in accordance with said federal agreement and need not quarantine solely due to such federally authorized travel. Travelers flying between the US and Canada must follow the CDC guidance for international travel.
  2. Window visits:
    1. Scheduled for a 30 minute visit or as per the discretion of the Activity
    2. Visit during scheduled time – if the family member/ visitor is late, the visit will still have to end within scheduled
    3. Families will arrive 10 min prior to the visit, check in at main entrance and wait on the side of the building for the visit while maintaining social distancing;
    4. Families will be encouraged to have no more than 2 visitors to ensure social
    5. Resident will be transported to the designated area where there is a speaker phone to allow for communication with their loved ones .
    6. Windows will be closed at all times during these visits
    7. Masks must be worn at all times on premises
    8. After each visit, the designated area will cleansed with EPA-approved
    9. The facility reserves the right to suspend Window visits at any given
  3. In person Visits:
    1. Scheduled for a 30 minute visit or as per the discretion of the Activity
    2. Visit during scheduled time – if the family member / visitor is late, the visit will still have to end within scheduled
    3. Families will arrive 10 min prior to the visit, check in at main entrance and wait on the side of the building for the visit while maintaining social distancing;
    4. Families will be encouraged to have no more than 2 visitors to ensure social
    5. Every visitor must complete Visitor screening:
      1. Visitor will be encouraged to provide a negative COVID-19 test result taken within 72 hours of the visit or will be tested at time of
      2. Visitor will be provided with a screening form and /or asked screening questions
      3. Visitor temperature will be taken prior to visit at the entrance to the designated area
      4. Visitor will be provided with the Visitation guideline for review and signature at the time of visit
      5. Completed forms will be kept in a binder and available to NYSDOH upon
    6. Each visitor will be directed to use hand sanitizer prior to and after their
    7. Resident will be transported to the designated area with face covering in place and provide hand sanitizer prior to and after each
    8. At all times, visitors and residents must maintain 6 feet apart unless visitor is fully vaccinated, following all signage in
    9. There will be no physical contact during any In-Person Visits unless visitor is fully
    10. No food is allowed during In-Person Resident will not be allowed to remove their face masks;
    11. Upon completion of visit, visitor will be directed to use waste receptacle for the disposal of any
    12. After each visit, the designated area will cleansed with EPA-approved