After a year of stringent restrictions imposed because of COVID-19, the California Department of Social Services (DSS) released new guidance on March 19, 2021 significantly relaxing restrictions on visitors to Residential Care Facilities for the Elderly (RCFE). The guidance also relaxes restrictions on communal dining and group activities, and on residents returning from outings. Set forth in PIN 21-17-ASC, the guidance is effective immediately.
Highlights of the new guidance include the following:
- Essential and Compassionate Care Visits
Expansion of the categories of visits deemed “essential” to include compassionate care visits, e.g.: residents struggling with change in environment and lack of in-person family support; residents grieving after the death of a friend or family member; residents experiencing weight loss or dehydration and needing cueing and encouragement with eating and drinking; and residents experiencing withdrawal, emotional distress, seldom speaking or crying more frequently.
- Close Contact and Physical Touch (Indoor and Outdoor Visitation)
Residents and visitors who are both “fully vaccinated” (defined as two weeks after receiving the second dose of Pfizer or Moderna vaccines, or two weeks after receiving a single dose of Johnson & Johnson’s Janssen vaccine) may have close contact, including touching, hugging and assisting with everyday tasks such as eating and getting dressed.
- Indoor and In-Room Visitation
Indoor visitation, including in-room visits, should be allowed at all times except if a resident was exposed to COVID-19 and is under quarantine, or has a confirmed COVID-19 infection and is under isolation. Residents under isolation or quarantine may only have “essential” visitors inside their rooms.
- Outdoor Visitation
Outdoor visits must be allowed, weather permitting.
- Virtual Visitation (Phone Calls, Video Calls, Online Communications)
At all times, RCFEs must allow and provide assistance in arranging for alternative communications for visitors.
- Communal Dining and Group Activities
Residents not under isolation or quarantine may eat in the same room (including the same table) and participate in group activities with other residents.
- Residents Returning from Outings
Residents returning from outings who are asymptomatic and did not have close contact with a person who tested positive for COVID-19 should not be required to quarantine.
Regardless of vaccination status, the guidance provides that all visitors, including “essential” visitors, must be screened for fever and COVID-19 symptoms, and wear an appropriate face covering. The guidance further provides that visitors must maintain at least six feet of physical distancing from individuals, including the resident that they are visiting, unless both resident and visitor are fully vaccinated. Additionally, if there are differing requirements between federal, state and local agencies, the guidance continues to provide that RCFEs must follow the strictest requirements.
While CANHR hopes that all RCFEs will adopt the new guidance, it has been the policy of DSS not to disturb local visitation rules that are more strict than state standards. This means that it is still possible that RCFEs in counties following more stringent local guidelines will not yet be adapting their rules to comply with the state standard. For residents and families encountering visitation roadblocks, CANHR recommends asking the RCFE what rule it is following regarding visitation, and asking to see the rule. If there is no stricter county public health rule but the facility still refuses to adopt the new state guidelines, residents and their families may be able to challenge the facility’s policies and should contact CANHR for assistance.