RESIDENTS LEAVING AND RETURNING TO THE HOME
Q: Can my loved one leave their retirement home?
A: Retirement homes residents in Green and Yellow Level are permitted to leave the home for an absence that does not include an overnight stay (e.g., absences with friends or family, shopping, medical appointments, filling prescriptions, taking walks, etc.), with the exception of single-night emergency room visits, provided the following requirements are met:
- The retirement home is NOT in an outbreak in or in a PHU under Orange (Restrict), Red (Control) or Grey (Lockdown) at the time the absence is to commence.
- If a home allows absences but enters into an outbreak there should be a hold on starting new absences until the home is no longer in outbreak.
- The local PHU has not directed the home to cease all short absences.
- The home is compliant with all CMOH Directives and follow directions from the local PHU.
- Upon return to the home, residents are actively screened and monitored for symptoms but are not required to be tested or self-isolate.
- Residents must always wear a mask when outside of the home (if tolerated) and be reminded about the importance of public health measures including physical distancing. The resident is responsible for supplying a face covering/mask while they are on absences. The home may, at its discretion, supply face covering/masks for absences.
- The home provides education on all required protocols for short absences, such as IPAC and PPE.
Retirement home residents in a home in a PHU under Orange (Restrict), Red (Control) or Grey (Lockdown) may be permitted to leave the home for walks or essentials (e.g., groceries, medical appointments, filling prescriptions), with the exception of also being permitted to leave for single-night emergency room visits. They must also meet the screening, face covering/masking, physical distancing and education requirements outlined above.
Homes in outbreak will put a hold on starting new absences.
For an absence that includes at least one overnight stay:
Retirement homes residents in Green and Yellow Level are permitted to leave the home for an absence that includes an overnight stay provided the following requirements are met:
| · The retirement home is NOT in an outbreak.o Homes must establish compliance with all CMOH Directives for homes in outbreak and follow directions from the local PHU.
· Residents must wear a face covering/mask at all times when outside of the home (if tolerated) and be reminded about the importance of public health measures including physical distancing. The resident is responsible for supplying a face covering/mask while they are on absences. The home may, at its discretion, supply face coverings/masks for absences.
· Education on all required protocols for short-term absences, such as IPAC and PPE, will be provided by the home to the resident prior to their absence.
· Upon return to the home, residents must self-isolate for 14 days under Droplet and Contact Precautions but are not required to be tested upon re-entry to the home.
· Residents who are self-isolating for 14-days following an overnight stay may not receive general visitors, leave the home for short-term absences or for overnight stays. |
For homes in outbreak, Orange, Red and Grey level, overnight absences not allowed and there is a hold on new absences.
Q: I/my loved one has gone to the hospital. Can the Retirement Home refuse take me/my loved one back to manage the risk of COVID-19 transmission in the home?
A: Hospitals may discharge patients to retirement homes where:
- The receiving home is NOT in a COVID-19 outbreak
- The resident has been tested for COVID-19 at point of discharge, has a negative test result and is transferred to the home not more than 24 hours of receiving the result
- The receiving home has sufficient staffing and a plan to ensure that the resident being readmitted can complete 14-days of self-isolation and continue with other COVID-19 preparedness measures
Residents being admitted who have previously has lab-confirmed COVID-19 and have been cleared by the local PHU within the last 90 days prior to admission do not need to be re-tested and are exempted from self-isolation.
There are no restrictions on residents returning to the home from outpatient visits, but the home is encouraged to consult with the hospital about whether a more appropriate arrangement may be to keep residents with frequent hospital visits in hospital. Residents returning from outpatient visits to hospitals (e.g. visit for broken bone, medical appointment within the hospital, dialysis appointment) should undergo the required screening and monitoring when returning to the retirement home. Further, a COVID-19 test is not required in these circumstances.
For example, there may be a resident going to hospital for dialysis three times a week. Upon returning to the home, the resident must be screened. The retirement home would continue to actively screen the resident for signs and symptoms of COVID-19 twice daily, including the atypical signs and ensuring the home has a very high suspicion for the development of any signs in the resident. The home could also have good dialogue with the dialysis unit to see if there are any concerns on their end. The home would also want to ensure that the resident is performing hand hygiene, and the resident could wear a mask when going to appointments.
NEW RESIDENT ADMISSIONS
For new resident admissions requirements and recommendations, please see the Retirement Homes Policy to Implement Directive #3.
Q: Are homes allowed to admit new residents?
A: Homes currently in outbreak are NOT allowed to admit new residents. Under exceptional circumstances admissions may take place during an outbreak if it is approved by the local public health unit and there is concurrence between the home, public health and hospital.
For homes not in an outbreak, Alert or High Alert areas:
For homes not in an outbreak, Green*, Yellow, Orange and Red level:
- The home must have a plan to ensure the resident being admitted (except for those who have cleared COVID-19) can complete 14 days of self-isolation, under Droplet and Contact Precautions and is tested again at the end of self-isolation, with a negative result.
- Individuals must be placed in a single room on admission to complete their 14-day self-isolation
- Other COVID-19 preparedness measures
*If in Green, an admission from the hospital may occur without the required 14-day self-isolation period provided that neither the hospital and the home are experiencing an outbreak and both the hospital and the home are located in Green (Prevent) areas. This transfer may occur if the individual has had a negative COVID-19 test within 24 hours of transfer. In the event that the test result is not available within the 24-hour period, the transfer can occur but the individual must remain in isolation at home until a negative test result is received. If this test result is positive, the individual must continue their self-isolation and the home must contact their local public health unit.
A new admission still must isolate for 14 days but are not required be tested with negative result at the end of 14 days. A negative result does not rule out the potential for incubating illness. Residents being admitted who have previously has lab-confirmed COVID-19 and have been cleared by the local PHU within the last 90 days prior to admission do not need to be re-tested and are exempted from self-isolation.
Under all circumstances, the home must have sufficient staffing and a plan to ensure the resident being admitted (except for those who have been cleared of COVID-19) can complete 14-days of self-isolation under Droplet and Contact Precautions.
The resident must be placed in a room with no more than one other resident after self-isolation.
Q: Can family members help with move-in of new residents?
A:The Chief Medical Officer of Health has directed that retirement homes can allow visits for retirement home residents. The home must NOT be in outbreak.
RHRA understands that there are varying circumstances that surround moving resident’s belongings. In these cases, the home should consult with the local public health unit. Public health can provide guidance that considers factors specific to the situation, such as location and amount of the individual’s belongings, the risk of outbreak in the home and the community, etc.
