No Patient Left Behind

 

Policy Name: In-Person Visitation Policy
Facility Name: Lantern Senior Care
Category: Operations
Applies to: Assisted Living

Effective Date: 5/6/2022
Revision Dates:

Exhibit
A) Florida Law Chapter 2022-34 Committee Substitute for Senate Bill No.988
B) Resident Essential Caregiver Designation Form
C) Essential Caregiver Acceptance Form
Purpose
In-Person Visitation bill has been signed into law, creating Chapter 408.823, which
is subject “In-person visitation.” This policy and these and procedures are intended promote resident
visitation, while maintaining prudent infection control practices in an attempt to reduce the probability of
transmission of COVID within the Community, in compliance with the regulations set forth in Chapter
408.823, Florida Statutes. A resident may designate a visitor who is a family member, friend,
guardian, or other individual as an Essential Caregiver.
Policy
The following are the procedures to be followed relating to visitation and to identify
Essential Caregivers for residents as well as the expectations of both General Visitors and
Essential Caregivers. These procedures will be administered equally to all residents that
request to have an Essential Caregiver, without regard to race, color, religion, sex (including
gender identity and transgender status), age, national origin, disability, or veteran status.
Essential Caregiver visitors provide emotional support to help a resident deal with a
difficult transition or loss, upsetting event, making major medical decisions, needs cueing to
eat and drink, stops speaking, or end-of-life (“Essential Caregiver”). Essential Caregiver
visitors may be allowed entry into facilities on a limited basis for these specific purposes.
At a minimum, the Community must allow an Essential Caregiver in-person visitation for
at least 2-hours daily under the above referenced circumstances. At Lantern Senior Care
communities, the 2-hour visitation will be between 9:00a.m. – 9:00p.m.
The Executive Director of the Community may make exceptions to the 2-hour visitation
on a case-by-case basis for end-of-life situations. These exceptions will be discussed
and agreed upon in writing by the Community’s Executive Director and the Resident
and/or Resident’s responsible party in advance.
All visitors who do not meet the requirements of an Essential Caregiver shall be
considered General Visitors (“General Visitors”).

Procedures:
I. For compliance with Florida Statute Chapter 408.823, designation and utilization of
essential caregiver visitors and rules of visitation.
1. The community will provide the Agency for Health Care Administration (AHCA)
with a copy of the Community’s visitor policy and procedure, with the initial
licensure application, renewal application and/or change of ownership application.
2. The visitation policy and procedure for the Community, including Essential Caregiver
designation and visitation, shall be available on
the home page of Community website.
3. Unless otherwise designated by the Executive Director, the Director of
Nursing of the Community shall be responsible for infection prevention and
control training.
4. The Executive Director will set a limit on the total number of visitors allowed in
the Community at any given time based on the ability of staff to safely screen
and monitor and the space to accommodate General Visitors and/or the
Essential Caregiver visitors. When there are no known cases of COVID among
residents currently residing in the Community, visitation will be generally
unrestricted. However, in the event Residents currently residing in the
Community are known to be infected with COVID, restrictions will be placed
upon General Visitors to reduce the possible spread of COVID. Visitation by
Essential Caregivers will always be allowed to occur as detailed herein. Efforts
to continue General Visitation even when a COVID positive resident is residing
in the community shall be made, and protocols shall be implemented at the
discretion of the Executive Director along the lines of the following (when
practical):
a. Identify locations for visitation/care to occur planning for residents in
shared spaces and facilities with minimal common space to identify
maximum time availability.
b. Provide outdoor visitation spaces that are protected from weather
elements, such as porches, courtyards, patios, or other covered areas that
are protected from heat and sun, with cooling devices, if needed
c. Create indoor visitation spaces for residents in a room that is not accessible
by other residents or in a resident’s private room if the resident is
bedbound and for health reasons cannot leave his or her room
5. All residents and/or POA/Guardian, if appropriate, will be asked if they want to
identify an Essential Caregiver.
6. All new residents will be asked if they would like to identify an Essential
Caregiver upon move-in.
7. All residents will be allowed to update as requested the named Essential Caregiver
of record within 2 business days of request.
8. Residents are allowed in-person visitation by the Essential Caregiver in all
the following circumstances, unless the resident, client, or patient objects:
a) End-of-life situations.

b) A resident, client, or patient who was living with family before being admitted
to the provider’s care is struggling with the change in environment and lack of
in- person family support.
c) The resident, client, or patient is making one or more major medical decisions.
d) A resident, client, or patient is experiencing emotional distress or grieving the
loss of a friend or family member who recently died.
e) A resident, client, or patient needs cueing or encouragement to eat or drink
which was previously provided by a family member or caregiver.
f) A resident, client, or patient who used to talk and interact with others is
seldom speaking.
9. The Community shall maintain a visitor log for signing in and out.
10. No more than three Essential Caregiver visitors may be designated per resident.
11. Essential Caregiver visitor visits may still continue even if the specific resident to
be visited is quarantined, tested positive for COVID, or is showing symptoms of a
communicable disease so long as the visits can be conducted safely, and all
infection control protocols are followed by the Essential Caregiver and resident.
Visits in these circumstances will likely require a higher level of PPE than
standard surgical masks. The general visitation requirement that the facility has
no new facility-onset cases of a communicable disease (for example COVID-19)
is not applicable to visitation by Essential Caregiver visitors.
12. The Community is not required to provide for “facility-provided” COVID-19
testing. However, the Community may choose to conduct COVID testing of
residents, visitors, and staff, and said testing shall be in accordance with the
most recent CDC and FDA guidance. The cost of this testing cannot be passed on
to the visitor.
13. Essential Caregiver visitors must wear Personal Protective Equipment (PPE)
per Community’s Infection Control Policies. The PPE required must be
consistent with the most recent CDC guidance for healthcare workers. At
Lantern Senior Care communities the Essential Caregiver visitors shall wear
the same PPE that staff wear to provide care or services to the resident.
14. General Visitors must wear Personal Protective Equipment (PPE) per the
Community’s Infection Control Policies at the time of their visit.
15. Any changes to Lantern Senior Care Essential Caregiver visitor policies must
be promptly communicated to affected residents and Essential
Caregiver visitors.

II. To facilitate visits by General Visitors and Essential Caregiver visitors upon a
request from a resident or friend/family member:
1. The resident (or their representative) will read and sign the visitation policy and
procedures. The acknowledgement of the signature represents that the resident (or
their representative) understands that both General Visitors and Essential
Caregiver visitor must abide by the policies set forth in this document.
2. The Essential Caregiver visitor will sign an acknowledgement of their receipt and

understanding of the visitation policies and procedures. The Essential Caregiver’s
signature represents that they have received the policies and procedures, they
understand the policies and procedures, and they agree to abide by said policies
and procedures.
3. The Essential Caregiver visitor will complete training on infection prevention and
control including the use of PPE, use of masks, hand sanitation, and social
distancing.
4. The Essential Caregiver visitor must immediately inform the facility if they
develop symptoms consistent with a communicable disease within 24-hours of their
last visit at the facility.
5. Essential Caregiver visits may take place in the resident’s room or a designated
area determined by the Executive Director at the time the visitation scheduled is
developed and agreed upon.
6. General Visitor visits may take place in accordance with the infection control
protocols at the time of the visit. Visits by General Visitors may be significantly
limited when a resident residing in the Community is infected with COVID-19.

III. When an Essential Caregiver visitor is scheduled to visit, the Community will:
1. The Community designee will thoroughly screen the visitor per the Community’s
infection control policy and procedure and document the name of the individual, the
date and time of entry, and the screening mechanism used, along with the screening
employee’s name and signature. Just as with staff entering the building, if the
visitor fails the screening, the visitor CANNOT be allowed entry.
2. The Executive Director will ensure that the required consents, and training and
policy acknowledgements are in place.
3. The Community designee will ensure that the Essential Caregiver visitor has
appropriate PPE if applicable.
4. The Community designee will require the Essential Caregiver visitor to sign in and
out on the visitor log.
5. The Community staff will monitor the Essential Caregiver visitor’s adherence to
policies and procedures.
6. If the Essential Caregiver visitor fails to follow the Community’s infection prevention
and control requirements, after attempts to mitigate concerns, the Executive Director shall
restrict or revoke visitation.
7. In the event the Essential Caregiver visitor’s status is revoked due to the individual
not following the Community’s policy and procedures, the resident may select a
different Essential Caregiver visitor who will be granted visitation rights upon
proper vetting and agreeing to policies and procedures.

IV. When a General Visitor is scheduled to visit, the Community will:
1. The Community designee will thoroughly screen the visitor per the Community’s
infection control policy and procedure and document the name of the individual, the
date and time of entry, and the screening mechanism used, along with the screening
employee’s name and signature. Just as with staff entering the building, if the
visitor fails the screening, the visitor CANNOT be allowed entry.
2. The Community designee will ensure that the General Visitor has appropriate PPE
(if applicable).
3. The Community designee will require the General Visitor to sign in and out on the
visitor log.
4. The Community designee will notify the General Visitor of any restrictions in
place relating to visitation, or requirements relating to infection control, at that time
of the visit.
5. The Community staff will monitor the General Visitor’s adherence to policies and
procedures.
6. If the General Visitor fails to follow the Community’s infection prevention and control
requirements, after attempts to mitigate concerns, the Executive Director shall restrict or revoke
visitation.

Exhibit A:

CHAPTER 2022-34
Committee Substitute for
Committee Substitute for Senate Bill No. 988

An act relating to in-person visitation; providing a short title; creating s.
408.823, F.S.; providing applicability; requiring certain providers to
establish visitation policies and procedures within a specified timeframe;
providing requirements for such policies and procedures; authorizing the

resident, client, or patient to designate an essential caregiver; establish-
ing requirements related to essential caregivers; requiring in-person

visitation in certain circumstances; providing that the policies and
procedures may require visitors to agree in writing to follow such policies
and procedures; authorizing providers to suspend in-person visitation of
specific visitors under certain circumstances; requiring providers to
provide their policies and procedures to the Agency for Health Care
Administration at specified times; requiring providers to make their
policies and procedures available to the agency for review at any time,
upon request; requiring providers to make their policies and procedures
easily accessible from the homepage of their websites within a specified
timeframe; requiring the agency to dedicate a stand-alone page on its
website for specified purposes; providing a directive to the Division of Law
Revision; providing an effective date.
Be It Enacted by the Legislature of the State of Florida:
Section 1. This act may be cited as the “No Patient Left Alone Act.”
Section 2. Section 408.823, Florida Statutes, is created to read:
408.823 In-person visitation.—
(1) This section applies to developmental disabilities centers as defined
in s. 393.063, hospitals licensed under chapter 395, nursing home facilities
licensed under part II of chapter 400, hospice facilities licensed under part
IV of chapter 400, intermediate care facilities for the developmentally
disabled licensed and certified under part VIII of chapter 400, and assisted
living facilities licensed under part I of chapter 429.
(2)(a) No later than 30 days after the effective date of this act, each
provider shall establish visitation policies and procedures. The policies and
procedures must, at a minimum, include infection control and education
policies for visitors; screening, personal protective equipment, and other
infection control protocols for visitors; permissible length of visits and
numbers of visitors, which must meet or exceed the standards in ss.
400.022(1)(b) and 429.28(1)(d), as applicable; and designation of a person
responsible for ensuring that staff adhere to the policies and procedures.
Safety-related policies and procedures may not be more stringent than those
established for the provider’s staff and may not require visitors to submit

Ch. 2022-34 LAWS OF FLORIDA Ch. 2022-34
proof of any vaccination or immunization. The policies and procedures must
allow consensual physical contact between a resident, client, or patient and
the visitor.
(b) A resident, client, or patient may designate a visitor who is a family
member, friend, guardian, or other individual as an essential caregiver. The
provider must allow in-person visitation by the essential caregiver for at
least 2 hours daily in addition to any other visitation authorized by the
provider. This section does not require an essential caregiver to provide
necessary care to a resident, client, or patient of a provider, and providers
may not require an essential caregiver to provide such care.
(c) The visitation policies and procedures required by this section must
allow in-person visitation in all of the following circumstances, unless the
resident, client, or patient objects:
1. End-of-life situations.
2. A resident, client, or patient who was living with family before being
admitted to the provider’s care is struggling with the change in environment
and lack of in-person family support.
3. The resident, client, or patient is making one or more major medical
decisions.
4. A resident, client, or patient is experiencing emotional distress or
grieving the loss of a friend or family member who recently died.
5. A resident, client, or patient needs cueing or encouragement to eat or
drink which was previously provided by a family member or caregiver.
6. A resident, client, or patient who used to talk and interact with others
is seldom speaking.
7. For hospitals, childbirth, including labor and delivery.
8. Pediatric patients.
(d) The policies and procedures may require a visitor to agree in writing

to follow the provider’s policies and procedures. A provider may suspend in-
person visitation of a specific visitor if the visitor violates the provider’s

policies and procedures.
(e) The providers shall provide their visitation policies and procedures to
the agency when applying for initial licensure, licensure renewal, or change
of ownership. The provider must make the visitation policies and procedures
available to the agency for review at any time, upon request.
(f) Within 24 hours after establishing the policies and procedures
required under this section, providers must make such policies and
procedures easily accessible from the homepage of their websites.

Ch. 2022-34 LAWS OF FLORIDA Ch. 2022-34
(3) The agency shall dedicate a stand-alone page on its website to explain
the visitation requirements of this section and provide a link to the agency’s
webpage to report complaints.
Section 3. The Division of Law Revision is directed to replace the phrase
“30 days after the effective date of this act” wherever it occurs in this act with
the date 30 days after this act becomes a law.
Section 4. This act shall take effect upon becoming a law.
Approved by the Governor April 6, 2022.
Filed in Office Secretary of State April 6, 2022.

Exhibit B:

Essential Caregivers Designation

I, designate _as Essential
Caregiver for . In making this designation, I consent and understand that:
• Visits by essential caregivers are subject to the Community’s policies and
procedures and ability to screen visitors and monitor visits.
• All Essential Caregiver visits may be scheduled, based on current facility conditions and
are at will be set for a minimum of 2 hours daily.
• Limited to one visitor at a time, and are limited to designated areas only. (Please speak
with the Executive Director regarding possible exceptions for end-of-life situations)
• has the ability to object to a visit at any time, even under the following
circumstances:
1. End-of-life situations.
2. A resident, client, or patient who was living with family before being admitted to the
provider’s care is struggling with the change in environment and lack of in-person
family support.
3. The resident, client, or patient is making one or more major medical decisions.
4. A resident, client, or patient is experiencing emotional distress or grieving the loss of a
friend or family member who recently died.
5. A resident, client, or patient needs cueing or encouragement to eat or drink which was
previously provided by a family member or caregiver.
6. A resident, client, or patient who used to talk and interact with others is seldom
speaking.
• Essential Caregivers will need to follow the Community’s infection control and education
policies and procedures and agree to such. At no time will they be more stringent than
those for staff and at no time require to submit proof of vaccination.
• Essential Caregivers must sign an acknowledgement of completion of required trainings
and adherence to infection prevention and control policies.
• Visits by a specific Essential Caregiver may be suspended for failure to follow
infection prevention and control requirements or other related rules of the Community
. At that time the resident or resident’s representative can designate a new Essential
Caregiver.
Resident or Legal Representative Signature Date

Resident or Legal Representative Printed Name

Community Representative Signature Date
Community Representative Printed Name

Exhibit C:

Essential Caregivers Acknowledgement

I, accept the designation as an Essential Caregiver for
I understand that:
• My visits as an Essential Caregiver are subject to the Community’sinfection
control and education policies and procedures. I acknowledge receiving the
policies and procedures and agree to abide by them at all times.
• My visits as an Essential Caregiver may be scheduled, and may be no less than two
hours per day.
• Essential Caregiver visits cannot occur if the resident personally objects/declines your
visit no matter the circumstance per 408.823 of F.S.
“(c) The visitation policies and procedures required by this section must allow in-person visitation in all of the following
circumstances, unless the resident, client, or patient objects:
1. End-of-life situations. 2. A resident, client, or patient who was living with family before being admitted to the
provider’s care is struggling with the change in environment and lack of in-person family support. 3. The resident, client,
or patient is making one or more major medical decisions. 4. A resident, client, or patient is experiencing emotional
distress or grieving the loss of a friend or family member who recently died. 5. A resident, client, or patient needs cueing
or encouragement to eat or drink which was previously provided by a family member or caregiver. 6. A orperidasetinetn, tclwi eh not s,u
ed to talk and interact with others is seldom speaking. “
• When visiting as an Essential Caregiver, I will utilize personal protective equipment
(PPE) as determined by facility policies and procedures related to current Community
status and current medical condition of .
• I acknowledge having received training on infection prevention and control, use of PPE,
use of masks, hand sanitation, and social distancing. I am satisfied with the training
provided and do not have any questions regarding any of these topics.
• I acknowledge my obligation and agree to immediately notify if I
experience symptoms of a respiratory infection, cough, fever, shortness of breath or
difficulty breathing, congestion or runny nose, sore throat, chills, headache, muscle pain,
repeated shaking with chills, new loss of taste or smell, nausea or vomiting, diarrhea,
symptoms possibly related to a contagious infection, or if I test positive for COVID-19
within fourteen (14) days of a visit.
• Visits by Essential Caregivers may be restricted or revoked for failure to follow infection
prevention and control procedures of the Community.
.
Designated Essential Caregiver Signature Date

Designated Essential Caregiver Printed Name

Community Representative Signature Date

Community Representative Printed Name