COVID-19 (coronavirus) – Frequently Asked Questions (FAQs)
RETIREMENT HOME RESIDENTS AND THEIR FAMILIES
Current as of June 13, 2020
VISITORS TO RETIREMENT HOMES AND ACTIVE SCREENING – updated June 13
Q: What is the current Public Health Retirement Home Visitors Policy?
A: As of June 18, the Chief Medical Officer of Health (CMOH) has directed that retirement homes can allow visits for retirement home residents. The home must NOT be in outbreak. Homes are required to develop visitor policies that reflect their unique circumstances, comply with directives from Ontario’s Chief Medical Officer of Health and guidance provided by the Ministry for Seniors and Accessibility. Homes are required to communicate this policy with residents and families.
Q: What kind of visiting structure/schedule can we expect?
A: Note that while each home may differ in its visitor policy, the following will/may occur:
- Scheduling of visits is required to allow for appropriate physical distancing and staffing coverage.
- The number of visitors per resident, per day, is to be determined by the home, provided that current CMOH guidance on physical distancing can be accommodated.
- For outdoor visits, the visitor may bring an outdoor/lawn chair, or one may be provided by the retirement home. Staff will clean and disinfect the visiting area after each visit
- Visits can be time limited to allow the home to accommodate all residents. Homes may consider the needs of residents in prioritizing visits.
- If visits will occur in a resident room, scheduling must ensure that overcrowding does not occur especially for shared rooms.
- A sufficient block of time should be made available by homes to allow for at least one meaningful weekly visit per resident at a minimum.
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, and also attest that they are not experiencing any of the typical and atypical symptoms of COVID-19. They should not be allowed to visit if they do not pass the screening
- Attest to home staff that the visitor has tested negative for COVID-19 within the previous 2 weeks and subsequently not tested positive. The home is not responsible for providing the testing.
- The visitor will comply with the home’s infection and prevention control protocols (IPAC), including proper use of masks.
- Visitors should use a mask 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. b)
- 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.
- The visitor must only visit the indoor/outdoor area or suite they are intending to visit, and no other resident.
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:
- The retirement home must NOT be currently in outbreak. In the event that a home has relaxed visitor restrictions and enters into an outbreak, all non-essential visitations must end.
- 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 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.
- Protocols to maintain the highest of IPAC standards prior to, during and after visits.
- Each home should create and maintain a list of visitors.
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.
Q: Who is an essential visitor?
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 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
- Are the only type of visitors allowed when a resident is self-isolating or symptomatic, or a home is in an outbreak.
The essential visitor must visit only the one resident they are intending to visit, and no other resident. They must wear a mask while visiting a resident without COVID-19 and if the resident does have COVID-19, appropriate PPE must be worn. These visitors must continue to be actively screened on entry for symptoms of COVID-19. The essential visitor must also attest to not be experiencing any of the typical and atypical symptoms. Those who fail screening will not be permitted to enter.
Q: Are external care providers considered “visitors”?
A: Paid caregivers/companions are not visitors. They will be screened according to protocols set out for staff in the Chief Medical Officer of Health’s direction.
Q: What can I do if I can’t visit with my family or loved one?
A: Homes in outbreak cannot allow visitors. Family members and loved ones are strongly encouraged to follow the instructions given by the public health unit. It’s important to protect seniors during this time of uncertainty while not leaving them feeling isolated. The RHRA encourages you to use all means available to connect with loved ones, including by telephone or by using technology like Facetime or Skype. Families can speak with the retirement home to see what can be facilitated. Effective and frequent communication between the home, residents and families is imperative for the well-being of residents, and to alleviate concerns during this stressful time.
RESIDENTS LEAVING AND RETURNING TO THE HOME – updated June 13
Q: Am I/is my loved one able to leave building for a medical appointment?
A: As of June 18, retirement home residents may go outside of the home (e.g., short absences with friends/family, shopping, medical appointments, etc.) if the following requirements are met.
- The retirement home must NOT be currently in outbreak.
- The resident must pass active screening every time they re-enter the home and also attest that they are not experiencing any of the typical and atypical symptoms of COVID-19. If a resident cannot meet these conditions, the home will follow existing outbreak or isolation policies.
- The short absence is limited to a maximum of 12 hours and cannot be overnight.
- The resident wears a cloth mask while outside the home. The resident is responsible for supplying a cloth mask while they are on short absences. The home may, at its discretion, opt to supply masks for short absences but should avoid accessing the provincial pandemic stockpile for this purpose.
Q: I/my loved one has gone to the hospital. Can the Retirement Home refuse take me back to manage the risk of COVID-19 transmission in the home?
A: The Ministry of Health announced that hospitals may resume discharging patients to retirement homes.
Hospitals may discharge patients to retirement homes where:
- It is a readmission to the retirement home (the resident is returning to their home)
- 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 with 24 hours of receiving the result
- The receiving home has a plan to ensure that the resident being readmitted can complete 14-days of self-isolation
There are no restrictions on residents returning to the home from outpatient visits. 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.
COMMUNAL DINING – updated March 31
Q: Why hasn’t my/my loved one’s home stopped communal dining or group activities?
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.
NEW RESIDENT ADMISSIONS – updated June 13
Q: I/my loved one is scheduled to move into a Retirement Home shortly. Are homes allowed to admit new residents?
A: For homes not in an outbreak, all new admissions from the community or from a hospital to a retirement home must be tested for COVID-19 and have a negative result and is transferred to the home within 24 hours of receiving the result or is confirmed infected and cleared of COVID-19. Residents being admitted who have been confirmed infected and then cleared of COVID-19 before move-in do not need to undergo 14-days of self-isolation.
Homes in outbreak are NOT allowed to admit new residents.
Q: Can family members help with move-in of new residents?
A: As of June 18, 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. However, the number of visitors and duration of the visit is dependent upon your home’s policy, which must be taken into consideration before allowing a family member or visitor to assist with move-in of new residents.
ISOLATION OF RESIDENTS AND INFECTION PREVENTION AND CONTROL (IPAC) PROGRAM PROTOCOLS – updated June 13
Q: In what situations would residents be isolated/quarantined in the home/rooms?
A: If a home is instructed by the local public health unit to isolate a resident, the retirement home must adhere to the Public Health Unit’s instructions. All new admissions must be placed in self-isolation for 14 days. Any resident exhibiting symptoms of COVID-19 must be placed in isolation and tested. Maintaining the health of all residents is paramount.
Q: What is a retirement home required to do if they suspect a resident may have COVID-19 or has come into contact with someone with COVID-19?
A: A retirement home must immediately contact their local public health unit if they suspect a resident has COVID-19 or has come into contact with COVID-19. Any resident exhibiting symptoms of COVID-19 (including mild respiratory symptoms) must be placed in isolation and tested.
COVID-19 INFORMATION SOURCES – updated April 16
Q: I’m overwhelmed by all of the information about COVID-19. Where do I get the best information?
A: The Ministry of Health website and your local public health unit website will have the most up-to-date information.
RHRA’s OPERATIONS DURING COVID-19 PANDEMIC – updated May 31
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: RHRA will be deferring our routine inspections on a temporary basis however continue to focus on complaint, mandatory report and compliance inspections. We will make every effort to limit the need to enter retirement homes for those inspections we do conduct and when it can’t be avoided, we will of course take every precaution in line with the recommendations of Public Health. 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).
Q: Is RHRA changing the approach to the implementation of the legislation and regulation during the COVID-19 situation? Are inspectors able to show more flexibility during this time?
A: We will take a pragmatic and flexible approach to how we regulate and take the evolving situation into account. Please refer to this March 15 RHRA special advisory for list of the ways RHRA is altering our approach during this time.