On July 17, 2020, the Chief Medical Officer of Health released CMOH Order 29-2020.  This order outlined necessary changes to our visitor policies and procedures.  The order is somewhat complex and requires continuing input from residents, families, and staff.  Thank you to all who are participating in this process. 

NPHF Safe Visitation Policy
All visits must be pre-arranged with the respective lodge. 

• Manning - Del-Air Lodge: 780-836-3325
• Fairview - Harvest Lodge: (780) 835-2862
• Hines Creek - Homesteader Lodge: 780-494-3500
• Peace River - Heritage Tower Lodge: (780) 624-3919 

​The number of scheduled visits, both indoor and outdoor, will be dependent on size of the facility, the size of the indoor/outdoor shared space, and the number or residents requesting visits.
This policy was developed following CMOH Order 29-2020, effective July 23, 2020.
 
This principle-based policy was developed in collaboration with residents and families in consideration of their needs, preferences, and tolerance of risk.  The parameters outlined in this policy are flexible, supportive, and reflective of the voice of residents, where they are able to express their preferences regarding visiting.  Where there is a difference in desire for visits between a resident and their family/visitors, the resident’s preferences will be paramount.
 ​
Designated Family/Support Persons(s)

• Staff will work with residents, or alternate decision makers, to confirm up to two (2) designated family/support persons per resident, ensuring that each resident has the level of support they desire and/or require.
• A list of all designated family/support persons will be maintained at each site at all times for verification purposes.
• The designated family/support person(s) or resident will contact the site Manager to schedule the visit.
  • The designated family/support person(s) will be encouraged to develop a standing schedule (if desired) based on the needs and preferences of the resident, allowing for more consistent contact with the resident.
• Each Lodge site will determine the number of designated family/support persons(s) permitted to be within the facility at any one time, as each site differs in size and layout.

 
Designated Family/Support Persons(s) and Visitor Responsibilities

• At the time of the scheduled visit, designated family/support person(s) and visitors will:
  • Undergo Active Health Assessment Screening at the time of entry and self-check for symptoms throughout the visit.
  • Be educated on and adhere to Safe Visiting Practices and related site policies.
  • Proceed directly to the expected location of the visit (resident room, shared care area or designed indoor space).
  • Only visit with the resident(s) they are supporting.
  • Wear a mask continuously.
  • Disinfect touched surfaces upon leaving the resident’s room/area.
  • Notify NPHF of any symptoms that arise within 14 days of visiting with a resident.
• Entry may be refused if there is a reason to believe that an individual is not abiding by these responsibilities.

 
Indoor Visits

• In extenuating circumstances, designated family/support person(s) and visitors will be permitted in resident room up to two (2) at a time, space permitting.
  • Extenuating circumstances include end of life, change in health status or pressing circumstance situation.
  • In end of life situations, three (3) persons at one time will be permitted, unless all persons are from the same household in which case there is no maximum.
• Only one (1) designated family/support person will be allowed in a shared care area (e.g. dining room, bathing support) at a time.
• Social visits from others in a resident’s room may be accommodated in sites where the assessed risk of COVID-19 exposure is low, and site and resident directed risk tolerance is high.
•  Individual sites may designate shared indoor spaces for indoor visits:
  • Designation will be determined by the sites risk tolerance assessment
  • Visits in shared indoor spaces can be restricted to designated family/support person(s) only depending on the available space.
  • Limit of 3 people per visit (including the resident)
• A designated family/support person is not required to be present for an indoor visit.

 
Outdoor Visits

• NPHF supports residents desire to spend time outdoors and have outdoor visits, while observing physical distancing requirements.
• Outdoor visits with up to five (5) will be accommodated if there is adequate space and the ability to maintain physical distancing between all persons and groupings.
• Suitable outdoor spaces have been designated at each Lodge site.
• A designated family/support person is not required to be present for the outdoor visit.
• Continuous masking is not required unless safe physical distancing cannot be maintained.

 
Coordination of Visits

• NPHF will coordinate all visits to ensure safe presence and movement of people and equitable access to visits for all residents.
  • All visits will be scheduled between the hours of 10:00 am and 7:00 p.m. (special circumstance will be accommodated on a case by case basis, as necessary).
  • Individual sites will maintain a daily/weekly schedule for indoor and outdoor visits.
  • The number of scheduled visits, both indoor and outdoor, will be dependent on size of the facility, the size of the indoor/outdoor shared space, and the number or residents requesting visits.

  
Risk Tolerance

• Risk tolerance is the ability of each site to accept increased potential of exposure to COVID-19, to inform of situations where restricted access may be necessary, and where more visits are desired.
  • Risk tolerance is dynamic and is dependent on the number of people on site and the layout of the site, the collective health status of the residents, the number of residents actively leaving the site for outings, any disclosed resident directed assessment of risk tolerance, any disclosed staff directed assessment of risk tolerance, and an up to date understanding of the incidence of COVID-19 in the community.
  • NPHF will consider all factors, in consultation with residents, family, and staff, to ultimately inform a sites risk tolerance.
  • Risk tolerance may vary from site to site depending on the results of the consultations.

​Safe Visiting Practices

• Risk of Unknown Exposure
  • All persons must understand their risk of unknown exposure to COVID-19, based on their behavior in the last 14 days and modify their behavior accordingly.
  • All persons will be required to complete Active Health Assessment Screening upon entry of any site. 
    • Anyone with symptoms or recent known exposure to COVID-19 will not be allowed entry into the site.
    • Individual are not required to disclose their assessed risk of unknown exposure, but they are required to make the resident aware and behave accordingly.
    • Individuals are required to limit the number of different sites that they enter and provide in-person visits to only one site per day.
• Hand Hygiene
  • All persons visiting, as well as residents, are required to wash their hands often with soap and water for at least 20 seconds or use an alcohol-based hand sanitizer (greater than 60% alcohol content) before, during as appropriate, and after all visits.
  • NPHF will have hand sanitizer available for all visits.
  • NPHF requires that visitors bring their own hand sanitizer to use during the room visit as necessary.
• Use of PPE (General Practices)
  • All designated family/support persons and visitors are required to wear a mask continuously throughout the visit indoors.
  • NPHF will educate visitors on proper donning and doffing of masks and other necessary PPE as required.
  • Designated family/support persons and visitors are required to supply their own masks
    • Single use masks may be removed and disposed of for indoor visits in a resident room if physical distancing can be maintained.  A new mask must be worn in transit through the site.
  • Continuous use of mask is not required for outdoor visits unless physical distancing cannot be maintained.
  • NPHF will supply all required PPE in the instance of a newly admitted resident or a resident on isolation precautions; staff will ensure that the designated family/support person or visitor is trained to use and has practiced the appropriate use of PPE.

​PPE and Safe Physical Touch

• The risk of transmission of COVID-19 increases with close proximity.  If a resident and their designated family/support person(s) or visitor(s) understand this and wish to include physical touch in their visits, this may be done by following these guidelines:
  • Immediately STOP close contact with the resident and inform staff for further direction if they become symptomatic during the visit.
  • Continuously wear a mask that covers the nose and mouth while within 2 metres of the resident.
  • Residents are not required to wear a mask but will be provided with one if they desire.
  • Perform hand hygiene both before and after direct physical contact with the resident.
  • If a resident is isolated due to symptoms of COVID-19, NPHF will provide the designated family/support persons and/or visitors with the required PPE, ensure that they are trained and have practiced the appropriate use of PPE.
  • Individuals at low risk of unknown exposure may engage in safe physical touch.
  • Individuals at medium risk of unknown exposure may engage in safe physical touch, where resident risk tolerance is high.
  • Individuals at high risk of unknown exposure will not be permitted to physically touch the resident unless they are providing direct resident care with all required PPE.

 
PPE and Cognitive/Sensory Impairment

• Residents who have sensory deficiencies or cognitive impairments will be supported to have safe and meaningful visits to support their overall health and wellbeing.
  • Where the use of PPE is disruptive, it is acceptable for PPE to be removed if physical distancing can be maintained.
  • Where PPE use causes distress to the resident due to cognitive impairment, and physical distancing cannot be maintained, adaptation to existing PPE will be considered on a case by case basis.

Visiting Animals

• One animal will be permitted to accompany a visitor for outdoor visits ONLY.
  • The animal must not be displaying signs of illness, such as diarrhea or vomiting.
  • The animal will not be permitted if it comes from a household with individuals at high risk of unknown exposure to COVID-19.

Gifts

• Designated family/support persons and visitors will be permitted to bring gifts, including homemade or purchased food or flowers/plants if the item(s).
  •  Items that can be disinfected with wipes will be given to the resident immediately.
  • Items that cannot be disinfected will be quarantined for 24 hours before being delivered to the resident.
  • In the event of an outbreak, gifts will no longer be accepted.

Restricted Access

• Duration and frequency limits on visits will only happen after reasonable attempts have been made to consider and alternative options have been offered.
  • Limits will be determined in consultation with the resident or alternative decision maker and family.
  • If limits conflict with a person’s schedule, alternative options will be provided.
• NPHF will temporarily restrict access for visitors to outside visits only, in situations of increased risk of exposure to COVID-19, such as an increase in local community cases.  In the event of a confirmed site outbreak, no visitors other than designated family/support persons will be allowed for inside or outside visits.
  • All restrictions will be made in collaboration with residents and families and may include consultation with the North Zone MOH.
  • All restrictions will be monitored and re-evaluated within 14 days of implementation, as required.
  • Designated family/support persons(s) will not be overly restricted in their access to the resident(s) and will not be prohibited altogether, even in the event of a site-outbreak. (In the event the resident has a confirmed case of COVID-19, viable and feasible options for continued access to the resident will be arranged following all Public Health guidance.)
  • Restricted access may include allowing only one (1) designated family/support persons(s) at one time, in an attempt to limit the number of additional people on site at any one time.
• NPHF will continue to support virtual connections at all times, but particularly in times of restricted access when the physical presence of a designated family/support person is not possible. Virtual connections include Zoom Calls, Facetime, or the resident’s preferred method.

 
Non-Compliance

• In the event a designated family/support person(s) or visitor does not comply with NPHF’s Safe Visitor Policy or any guidelines establish in Order 29-2020, the Lodge Manager will speak to the individual to ensure that there is a clear understanding of the policy and to clarify their responsibilities while on site. 
  • A written warning will be issued that if the non-compliance continues, all future visits will be cancelled.
• In the event the non-compliant behavior continues, the family/support person(s) or visitor will be asked to leave the site immediately, and all future scheduled visits will be cancelled at that time.
• Future requests for scheduled visits will be denied.

 
​Dispute Resolution

• NPHF will document all disputes as per the existing concern/complaints process under Accommodation Standards.
• Lodge Managers will work with the resident or designated family/support person(s) or visitor to address any concerns that arise regarding the site policy and process for safe visiting, and the interpretation and implementation of Order 29-2020.
• If the concern remains unresolved at the site level, the Lodge Managers will consult with the Director of Operations and Special Projects and/or the Executive Director, depending on the level of concern.
• Should the concern remain unresolved, NPHF will consult with Alberta Health Accommodation Standards and Licensing to find a resolution.  

 
North Peace Housing Foundation’s Safe Visiting Policy will be evaluated every 3 weeks, or as risk conditions change, or when residents or families indicate a need to re-evaluate.  All updates or changes will be communicated to residents, staff, and designated family/support person(s).