COVID-19 (coronavirus) – Frequently Asked Questions (FAQs)
RETIREMENT HOME RESIDENTS AND THEIR FAMILIES
Current as of August 2021
Please refer to Directive #3, Retirement Homes Policy to Implement Directive #3, or our Scenario Matrix for more information.
VISITORS TO RETIREMENT HOMES AND ACTIVE SCREENING
Q: Can I visit a retirement home?
A: As of July 16, the Chief Medical Officer of Health has directed that retirement homes can allow visits for retirement home residents from all visitors, both general and essential.
If a home is in outbreak, general visitors are permitted if the resident they are visiting is not living in the outbreak area of a home. Homes must follow all CMOH directives for homes in outbreak and directions from their local PHU.
A general visitor is a person who is not an essential visitor and visits:
- To provide non-essential services (may or may not be hired by the home or the resident and/or their substitute decision maker);
- For social reasons (e.g., family members or friends); and/or
- A prospective resident taking a tour of the home.
If not in outbreak, a maximum of 2 general visitors per resident at a time may visit that resident.
According to direction from the Chief Medical Officer of Health, essential visitors:
- Are defined as including a person performing essential support services e.g. food delivery, inspector, maintenance, or health care services (e.g. phlebotomy testing), or a person visiting a resident who is very ill or requires end-of-life care.
- Providing direct care to a resident must use a surgical/procedure mask while in the home, including while visiting the resident that does not have COVID-19 in their room.
- Who are in contact with a resident who is suspect or confirmed with COVID-19, must wear appropriate PPE in accordance with CMOH directives.
Any number of support workers may visit a resident in a home, even if the home is in outbreak.
A maximum of two (2) Essential Caregivers per resident may visit at a time if a home is in outbreak. While the province remains in Stage 3, there is no maximum on number of Essential Caregivers designated per resident.
|The home must also first meet baseline requirements to allow any visitors:
- Protocols for record keeping of visitations for contact tracing purposes
Homes are required to develop visitor policies that reflect their unique circumstances, comply with CMOH Directive #3 and the Retirement Homes Policy to Implement Directive #3.
Q: What rules will visitors have to follow?
A: Prior to each visit, the visitor must:
- Pass active screening every time they are on the premises of or enter the home. They should not be allowed to visit if they do not pass the screening
- The visitor will comply with the home’s infection and prevention control protocols (IPAC), including proper use of masks.
- Visitors should use a mask which covers their face at all times if the visit is outdoors. If the visit is indoors, a surgical/procedure mask is required. Visitors are responsible for bringing their own masks.
- Education on all required protocols will be provided by the home.
- Any non-adherence to these rules could be the basis for discontinuation of visits.
Visitors do not need to attest (verbally or in writing) they have received a negative COVID-19 test.
Q: What do homes have to do to prepare for visitors?
A: The following baseline requirements must be met prior to the home being able to accept any visitors:
- Retirement homes are responsible for ensuring residents receive visitors safely to help protect against the risk of COVID-19. Homes are also responsible for establishing and implementing visiting practices that comply with applicable legislation and regulations including those referenced in provincial requirements, the guidance, recommendations, and advice of the CMOH, Directive #3, and ensuring that such visiting practices align with the requirements in this document.
- The home has developed procedures for the resumption of visits and a process for communicating these procedures with residents, families and staff.
- This process must include sharing an information package with visitors on Infection Prevention and Control (IPAC), masking, physical distancing and other operational procedures such as limiting movement around the home, if applicable, and ensuring visitors’ agreement to comply. Home materials must include an approach to dealing with non-adherence to home policies and procedures, including the discontinuation of visits.
- Dedicated areas for both indoor and outdoor visits to support physical distancing between residents and visitors.
- Protocols to maintain the highest of IPAC standards prior to, during and after visits.
- Each home should create and maintain a list of visitors available for staff to access.
Additional factors that will inform decisions about visitations in retirement homes include:
- Access to adequate testing: Home has a testing plan in place, based on contingencies informed by local and provincial health officials, for testing in the event of a suspected outbreak.
- Access to adequate Personal Protective Equipment (PPE): Home has adequate supplies of relevant PPE.
- Infection Prevention and Control (IPAC) standards: Home has essential cleaning and disinfection supplies and adheres to IPAC standards, including enhanced cleaning.
- Physical Distancing: Where appropriate, home is able to facilitate visits in a manner aligned with physical distancing protocols.
RESIDENTS LEAVING AND RETURNING TO THE HOME
Q: Can my loved one leave their retirement home?
A: Retirement home residents who wish to go outside of the home (e.g., absences with friends or family, shopping, medical appointments, etc.) are permitted to do so if the following requirements are met, according to the Retirement Homes Policy to Implement Directive #3:
For an absence that does NOT include an overnight stay:
- For short term (day) absences for social outings, ie. an absence other than for medical, compassionate/palliative, or essential outings that do not include an overnight stay, residents are permitted with the requirement to participate in active screening upon return. Testing or self-isolation is not required. In the case of an outbreak in the area of the home the resident is located, or the resident is experiencing symptoms, absences of this nature are not permitted.
- For temporary (overnight) absences, ie. An absence that involves two or more days and one or more nights away from the home for non-medical purposes, in Stage 3 are permitted:
- Fully immunized Resident: permitted.
- For fully immunized residents, no testing or self-isolation upon return. Partially immunized or unimmunized resident: permitted.
- For partially immunized or unimmunized residents, require a negative lab-based polymerase chain reaction (PCR) test upon return to the home. The individual must be placed in isolation on Droplet and Contact Precautions if their test result is pending. If their test result is negative, isolation on Droplet and Contact Precautions can be discontinued.
- For more information, please see our Scenario Matrix.
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: In Stage 3, hospitals may discharge patients to retirement homes.
For fully immunized residents, testing and self isolation is not required. For partially immunized or unimmunized residents, a lab-based PCR test is required at time of admission/transfer, and the resident must be placed in isolation on Droplet and Contact Precautions for a minimum of 10 days. A second negative lab-based PCR test result collected on day 8 is required to discontinue isolation on Droplet and Contact Precautions on day 10. If this second test is not obtained, isolation on Droplet and Contact Precautions must be maintained until day 14.
ACTIVITIES IN THE HOME
Q: What about social activities and communal dinning?
A: Retirement homes are required take all reasonable steps to follow the recommendations and directives from the Chief Medical Officer of Health. Retirement homes are to maintain physical distancing of two meters wherever possible. In smaller homes, where this is not possible, all residents and staff are to be managed as if they are potentially infected and wear appropriate PPE when around residents in such environments. Retirement homes are required to follow their infection prevention and control policies which may require further changes to communal activities in the event of an outbreak of an infectious disease. In the event of a confirmed COVID-19 case, homes are required to contact public health for additional instructions.
- Social Activities, Organized Events and Other Recreational Services are permitted in alignment with Step 3 of the Roadmap to Reopen. Must not exceed provincial limits (50% of the total capacity of the room) for meeting and event spaces and/or religious services, as applicable when indoors, ensuring that: Activities are consistent with CMOH Directives, provincial orders, including group size*, and any additional advice from the local PHU.
- Organized in such a way to maximize resident and staff safety. Home must ensure Participants and activity facilitators:
- Physical distancing of at least 2 metres is recommended;
- Adhere to IPAC measures;
- Conduct activities in designated areas;
- Ensure enhanced environmental cleaning of designated areas prior to and following activities; and
- Wear face coverings/masks (if tolerated).
NEW RESIDENT ADMISSIONS
Q: Are homes allowed to admit new residents?
A: Yes, new residents can be admitted in Stage 3. For fully immunized residents, testing and self isolation is not required. For partially immunized or unimmunized residents, a lab-based PCR test is required at time of admission/transfer, and the resident must be placed in isolation on Droplet and Contact Precautions for a minimum of 10 days. A second negative lab-based PCR test result collected on day 8 is required to discontinue isolation on Droplet and Contact Precautions on day 10. If this second test is not obtained, isolation on Droplet and Contact Precautions must be maintained until day 14.
Please see our Scenario Matrix for more information.
Admissions and readmissions may take place during an outbreak only if approved by the local public health unit, and there is concurrence between the home local public health unit, and hospital. An individual who has tested positive for COVID-19 may be admitted or readmitted to the home provided that the admission is approved by the local public health unit.
Q: Will my loved one need to self isolate upon being admitted to their new retirement home?
A: Partially immunized or unimmunized residents require a lab-based PCR test at the time of admission/readmission and the resident must be placed in isolation on Droplet and Contact Precautions for a minimum of 10 days. A second negative lab-based PCR test result collected on day 8 is required to discontinue isolation on day 10. Otherwise isolation and Droplet and Contact Precautions must be maintained until day 14.
Recently recovered residents who are within 90 days from a prior lab confirmed COVID-19 infection are not required to be tested or placed in isolation on Droplet and Contact on arrival.
RHRA’s OPERATIONS DURING COVID-19 PANDEMIC
Q: What is the RHRA’s role in the event of an outbreak at a retirement home?
A: Homes are required by the Retirement Homes Act to have an Infection Prevention and Control (“IPAC”) program and are required to conduct active screening for signs and symptoms of illness. Retirement homes must contact their local Public Health Unit (“PHU”) if there are residents (and staff) with symptoms. Homes must report any COVID-19 outbreak to RHRA (in addition to reporting to Public Health). The report to RHRA must include the name of the home, licence number, number of positive resident cases, number of positive staff cases and public health contact. Licensees must send to firstname.lastname@example.org. Homes must consider one laboratory confirmed case of COVID-19 in either a resident or staff member as an outbreak.
RHRA is proactively reaching out to homes and requires them to actively screen essential visitors, staff, residents, and anyone else entering the home (with the exception of first responders in emergencies) and take other precautions in response to the COVID-19 outbreaks.
The RHRA will take swift action if there is evidence that homes do not report or manage outbreaks in accordance with public health direction.
RHRA has regular communication to ensure retirement home sector issues are identified and raised with Ministry of Health through multiple levels/channels. RHRA also has a web page available here that is updated regularly with information and resources on COVID-19.
Q: Are RHRA inspectors still doing inspections? If so, what precautions do they take not to spread the virus?
A: Yes. Consistent with our regulatory modernization initiative to place greater emphasis on assessing the implementation of important policies and strategies in retirement homes, all routine inspections are unannounced. We are also taking significant precautions with our inspections staff recognizing that they may visit multiple locations. RHRA Inspectors have completed Public Health Ontario’s Infection Prevention and Control Core Competencies training course and carry appropriate personal protective equipment (PPE).