59A-36.007(6) FAC; 429.28( ) FS 429.27 Resident Care – Rights & Facility Procedures
59A-36.007
(6) RESIDENT RIGHTS AND FACILITY PROCEDURES.
(a) A copy of the Resident Bill of Rights as described in section 429.28, F.S., or a summary provided by the Long-Term Care Ombudsman Program must be posted in full view in a freely accessible resident area, and included in the admission package provided pursuant to rule 59A-36.006, F.A.C.
(b) In accordance with section 429.28, F.S., the facility must have a written grievance procedure for receiving and responding to resident complaints and a written procedure to allow residents to recommend changes to facility policies and procedures. The facility must be able to demonstrate that such procedure is implemented upon receipt of a complaint.
(c) The telephone number for lodging complaints against a facility or facility staff must be posted in full view in a common area accessible to all residents. The telephone numbers are: the Long-Term Care Ombudsman Program, 1(888)831-0404; ….. Rights Florida, 1(800)342-0823; the Agency Consumer Hotline 1(888)419-3456, and the statewide toll-free telephone number of the Florida Hotline, 1(800)96-. . …. or 1(800)962-2873. The telephone numbers must be posted in close proximity to a telephone accessible by residents and the text must be a minimum of 14-point font.
(d) The facility must have a written statement of its house rules and procedures that must be included in the admission package provided pursuant to rule 59A-36.006, F.A.C. The rules and procedures must at a minimum address the facility’s policies regarding:
1. Resident responsibilities;
2. and tobacco use;
3. Medication storage;
4. Resident elopement;
5. Reporting resident …….., neglect, and
6. Administrative and housekeeping schedules and requirements;
7. ……. control, sanitation, and universal precautions, and,
8. The requirements for coordinating the delivery of services to residents by third party providers.
(e) Residents may not be required to perform any work in the facility without compensation. Residents may be required to clean their own sleeping areas or apartments if the facility rules or the facility contract includes such a requirement. If a resident is employed by the facility, the resident must be compensated in compliance with state and federal wage laws.
(f) The facility must provide residents with convenient access to a telephone to facilitate the resident’s right to unrestricted and private communication, pursuant to section 429.28(1)(d), FS. The facility must allow unidentified telephone calls to residents. For facilities with a licensed capacity of 17 or more residents in which residents do not have private telephones, there must be, at a minimum, a readily accessible telephone on each floor of each building where residents reside.
(g) In addition to the requirements of section 429.41(1)(K), E.S., the use of physical by a facility on a resident must be reviewed by the resident’s physician annually. Any device, Including half-bed rails, which the resident chooses to use and can remove or avoid without assistance, is not considered a physical …..
429.28 Resident bill of rights.
(1) No resident of a facility shall be deprived of any civil or legal rights, benefits, or privileges guaranteed by law, the Constitution of the State of Florida, or the Constitution of the United States as a resident of a facility. Every resident of a facility shall have the right to:
(a) Live in a safe and decent living environment, free from ……. and neglect.
(b) Be treated with consideration and respect and with due recognition of personal dignity, Individuality, and the need for privacy.
(c) Retain and use his or her own clothes and other personal property in his or her immediate living quarters, so as to maintain individuality and personal dignity, except when the facility can demonstrate that such would be unsafe, impractical, or an infringement upon the rights of other residents.
(d) Unrestricted private communication, including receiving and sending unopened correspondence, access to a telephone, and visiting with any person of his or her choice, at any time between the hours of 9 a.m. and 9 p.m. at a minimum. Upon request, the facility shall make provisions to extend visiting hours for caregivers and out-of-town guests, and in other similar situations.
(e) Freedom to participate in and benefit from community services and activities and to pursue the highest possible level of independence. autonomy, and interaction within the community.
(f) Manage his or her financial affairs unless the resident or, if applicable, the resident’s representative, designee, surrogate, guardian, or attorney in fact authorizes the administrator of the facility to provide safekeeping for funds as provided in s. 429.27.
(g) Share a room with his or her spouse if both are residents of the facility.
(h) Reasonable opportunity for regular exercise several times a week and to be outdoors at regular and frequent intervals except when prevented by inclement weather,
(i) Exercise civil and religious liberties, including the right to independent personal decisions. No religious beliefs or practices, nor any attendance at religious services, shall be imposed upon any resident
(j) Assistance with obtaining access to adequate and appropriate health care. For purposes of this paragraph, the term “adequate and appropriate health care” means the management of medications, assistance in making …… for health care services, the provision of or arrangement of transportation to health care…………, and the performance of health care services in accordance with $. 429.255 which are consistent with established and recognized standards within the community.
(k) At least 45 days’ notice of relocation or termination of residency from the facility unless, for medical reasons, the resident is certified by a physician to require an emergency relocation to a facility providing a more skilled level of care or the resident engages in a pattern of conduct that is harmful or offensive to other residents. In the case of a resident who has been adjudicated mentally , the guardian shall be
given at least 45 days’ notice of a nonemergency relocation or residency termination. Reasons for relocation must be set forth in writing and provided to the resident or the resident’s legal representative. The notice must state that the resident may contact the State Long-Term Care Ombudsman Program for assistance with relocation and must include the statewide toll-free telephone number of the program. In order for a facility to terminate the residency of an individual without notice as provided herein, the facility shall show good cause in a court of competent jurisdiction.
(l) Present grievances and recommend changes in policies, procedures, and services to the staff of the facility, governing officials, or any other person without interference, coercion. discrimination, or reprisal. Each facility shall establish a grievance procedure to facilitate the residents’ exercise of this right. This right Includes access to ombudsman volunteers and advocates and the right to be a member of, to be active in, and to associate with advocacy or special interest groups.
(2) The administrator of a facility shall ensure that a written notice of the rights, .. . .. and prohibitions set forth in this part is posted in a prominent place in each facility and read or explained to residents who cannot read. The notice must include the statewide toll-free telephone number and e-mail address of the State Long-Term Care Ombudsman Program and the telephone number of the local ombudsman council, the Elder ….Hotline operated by the Department of Children and Families, and, if applicable, . ….., Rights Florida, where complaints may be lodged. The notice must state that a complaint made to the Office of State Long-Term Care Ombudsman or a local tong-term care ombudsman council, the names and identities of the residents involved in the complaint, and the identity of complainants are kept confidential pursuant to s. 400.0077 and that retaliatory action cannot be taken against a resident for presenting grievances or for exercising any other resident right. The facility must ensure a resident’s access to a telephone to call the State Long-Term Care Ombudsman Program or local ombudsman council, the Elder Hotline operated by the Department of Children and Families, and ……., Rights Florida.
429.27 Property and personal affairs of residents.
(1)(a) A resident shall be given the option of using his or her own belongings, as space permits; choosing his or her roommate; and, whenever possible, unless the resident is adjudicated
or under state law, managing his or her own affairs.
(b) The admission of a resident to a facility and his or her presence therein shall not confer on the facility or its owner, administrator, employees, or representatives any authority to manage, use, or dispose of any property of the resident; nor shall such admission or presence confer on any of such persons any authority or responsibility for the personal affairs of the resident, except that which may be necessary for the safe management of the facility or for the safety of the
resident
This Statute or Rule is not met as evidenced by: Based on observation and interview, the facility failed to treat one of five sampled residents with dignity and respect (Resident #4). Staff used the resident’s room to store clothing and to get dressed.
Findings included:
Observation on ……. at 6:25 AM revealed Staff C getting dressed in resident
During an interview on …………. at 8:48 AM, Staff C stated her clothes are being stored in resident.
Class III
59A-36.008(5) FAC Medication – Records
(5) MEDICATION RECORDS.
(a) For residents who use a pill organizer managed in subsection (2), the facility must keep either the original labeled medication container; or a medication listing with the prescription number, the name and address of the issuing pharmacy, the health care provider’s name, the resident’s name, the date dispensed, the name and strength of the drug, and the directions for use.
(b) The facility must maintain a daily medication observation record for each resident who receives assistance with self-administration of medications or medication administration. A medication observation record must be immediately updated each time the medication is offered or administered and include:
1. The name of the resident and any known the resident may have;
2. The name of the resident’s health care provider and the health care provider’s telephone number;
3. The name, strength, and directions for use of each medication, and ……………
4. A chart for recording each time the medication is taken, any missed dosages, refusals to take medication as prescribed, or medication errors.
(c) For medications that serve as chemical …, the facility must, pursuant to section 429.41, F.S., maintain a record of the prescribing physician’s annual evaluation of the use of the medication
This Statute or Rule is not met as evidenced by: Based on interview and record review, the facility failed to maintain an accurate Medication Observation Records (MOR) that included the specific time the medications were administered for one out of five sampled residents (Resident
#3).
Findings included:
A review of Resident #3’s Medication Observation Record (MOR) showed that in the hour section had handwritten only AM or PM, without a specific time that the resident should take the medication.
Further review of the resident MOR showed that Resident #3’s morning medications and Instructions were:
………………. C 500 mg caplet. Take one tablet via oral twice a day.
…………….. 50 mg tablet. Take one tablet via oral once a day (morning).
…….. SOD DR 20 mg tablet. Take one tablet via oral once a day. Take one tablet via oral once a day.
………….Tart 25 mg tablet. Take one tablet via oral twice a day.
……………. 40 mg tablet. Take one tablet via oral once a day.
……………. 25 mg tablet. Take one tablet via oral once a day.
,………….. 5 mg tablet. Take one tablet via oral once a day in the morning.
…………. 5 mg tablet. Take one tablet via oral once a day in the morning.
,……….. 10 mg tablet. Take one tablet via oral once a day.
……………. 70 mg tablet. Take one tablet via oral once a week (the same day every week) in the morning on an empty with some water at least 30 minutes before the first meal, drink or medication.
Additionally, the resident MOR showed that Resident #3’s bedtime medications and Instructions were: ..
…… 20 mg tablet. Take one tablet via oral at bedtime.
…. …….. 100 mg tablet. Take one tablet via oral daily at bedtime.
…….. 10 mg tablet. Take one tablet via oral once a day,
.. . .. 50 mg capsule. Take one capsule via oral daily at bedtime.
… C500 mg caplet. Take one tablet via oral twice a day.
…….. 15 mg. Take one tablet via oral daily at bedtime.
…….. Tart 25 mg tablet. Take one tablet via oral twice a day.
On …………. at 8:46 AM, the Owner stated, “the time is there, but the employee wrote over it. She further stated that Resident #3 takes her medication at around. AM.”
Class II
429.52(1 & 7)FS; 59A-36.011( – Staff In-Service ) FAC Training
429.52(1)
(1) Each new assisted living facility employee who has not previously completed core training must attend a preservice orientation provided by the facility before interacting with residents. The preservice orientation must be at least 2 hours in duration and cover topics that help the employee provide responsible care and respond to the needs of facility residents. Upon completion, the employee and the administrator of the facility must sign a statement that the employee completed the required preservice orientation. The facility must keep the signed statement in the employee’s personnel record.
(7) Facility staff shall participate in inservice training relevant to their job duties as specified by agency rule. Topics covered during the preservice orientation are not required to be repeated during Inservice training. A single certificate of completion that covers all required inservice training topics may be issued to a participating staff member if the training is provided in a single training course.
59A-36.011
(2) STAFF PRESERVICE ORIENTATION.
(a) Facilities must provide a preservice orientation of at least 2 hours to all new assisted living facility employees who have not previously completed core training as detailed in subsection (1)
(b) New staff must complete the preservice orientation prior to interacting with residents.
(c) Once complete, the employee and the facility administrator must sign a statement that the employee completed the preservice orientation which must be kept in the employee’s personnel record.
(d) In addition to topics that may be chosen by the facility administrator, the preservice orientation must cover:
1. Resident’s rights; and …………….
2. The facility’s license type and services offered by the facility.
(3) STAFF IN-SERVICE TRAINING. Facility administrators or managers shall provide or arrange for the following in-service training to facility staff:
(a) Staff who provide direct care to residents, other than nurses, certified nursing assistants, or home health aides trained in accordance with rule 59A-8.0095, F.A.C., must receive a minimum of 1 hour in-service training in ……. control, including universal precautions and facility sanitation procedures, before providing personal care to residents. The facility must use its
….. control policies and procedures when offering this training. Documentation of compliance with the staff training requirements of 29 CFR 1910.1030, relating to bome
….., may be used to meet this requirement
(b) Staff who provide direct care to residents must receive a minimum of 1 hour in-service
training within 30 days of employment that covers the following subjects:
1. Reporting adverse incidents.
2. Facility emergency procedures including chain-of-command and staff roles relating to emergency evacuation.
(c) Staff who provide direct care to residents, who have not taken the core training program, shall receive a minimum of 1 hour in-service training within 30 days of employment that covers the following subjects:
1. Resident rights in an assisted living facility.
2. Recognizing and reporting resident ……., neglect, and ……….. The facility must use its
prevention policies and procedures when offering this training.
(d) Staff who provide direct care to residents, other than nurses, CNAs, or home health aides trained in accordance with rule 59A-8.0095, F.A.C., must receive 3 hours of in-service training within 30 days of employment that covers the
following subjects: 1. Resident behavior and needs. 2. Providing assistance with the activities of daily living.
(e) Staff who prepare or serve food, who have not taken the assisted living facility core training must receive a minimum of 1-hour-in-service training within 30 days of employment in safe food handling practices.
(f) All facility staff shall receive in-service training regarding the facility’s resident elopement response policies and procedures within thirty (30) days of employment.
1. All facility staff shall be provided with a copy of the facility’s resident elopement response policies and procedures.
2. All facility staff shall demonstrate an understanding and competency in the Implementation of the elopement response policies and procedures.
This Statute or Rule is not met as evidenced by: Based on record review and interview, one out of four sampled staff (Staff D) failed to undergo control training prior to providing direct care to residents.
Findings included:
Review of Staff D’s personnel record revealed she was hired on……..
On ………. at 8:55AM, The owner stated Staff D has not worked at the facility since .. . as she has been in Cuba since….
Record review of Staff D’s personnel record revealed an … control training completed on ………
Class III
59A-36.012(2) FAC Food Service – Dietary Standards
(2) DIETARY STANDARDS.
(a) The meals provided by the assisted living facility must be planned based on the current USDA Dietary Guidelines for Americans, 2010, which are incorporated by reference and available for review at: http://www.firules.org/Gateway/reference.asp?NO
Ref-04003, and the current summary of Dietary Reference Intakes established by the Food and Nutrition Board of the Institute of Medicine of the National Academies, 2010, which are incorporated by reference and available for review at: http://iom.edu/Activities/Nutrition/SummaryDRIS/ /media/Files/Activity%20Files/Nutrition/DRIs/New
%20Material/5DRI%20Values%20Summary Table s%2014.pdf. Therapeutic diets must meet these nutritional standards to the extent possible,
(b) The residents’ nutritional needs must be met by offering a variety of meals adapted to the food habits, preferences, and physical abilities of the residents, and must be prepared through the use of standardized recipes. For facilities with a licensed capacity of 16 or fewer residents, standardized recipes are not required. Unless a resident chooses to eat less, the facility must serve the standard minimum portions of food according to the Dietary Reference Intakes.
(c) All regular and therapeutic menus to be used by the facility must be reviewed annually by a licensed or registered dietitian, a licensed nutritionist, or a registered dietetic technician supervised by a licensed or registered dietitian, or a licensed nutritionist to ensure the meals meet the nutritional standards established in this rule. The annual review must be documented in the facility files and include the original signature of the reviewer, registration or license number, and date reviewed. Portion sizes must be indicated on the menus or on a separate sheet.
1. Daily food servings may be divided among three or more meals per day, including snacks, as necessary to accommodate resident needs and preferences.
2. Menu items may be substituted with items of comparable nutritional value based on the seasonal availability of fresh produce or the preferences of the residents.
(d) Menus must be dated and planned at least 1 week in advance for both regular and therapeutic diets. Residents must be encouraged to participate in menu planning. Planned menus must be conspicuously posted or easily available to residents. Regular and therapeutic menus as served, with substitutions noted before or when the meal is served, must be kept on file in the facility for 6 months.
(e) Therapeutic diets must be prepared and served as ordered by the health care provider,
1. Facilities that offer residents a variety of food choices through a select menu, buffet style dining, or family style dining are not required to document what is eaten unless a health care provider’s order indicates that such monitoring is necessary. However, the food items that enable residents to comply with the therapeutic diet must be identified on the menus developed for use in the facility.
2. The facility must document a resident’s refusal to comply with a therapeutic diet and provide notification to the resident’s health care provider of such refusal.
(f) For facilities serving three or more meals a day, no more than 14 hours must elapse between the end of an evening meal containing a protein food and the beginning of a morning meal. Intervals between meals must be evenly distributed throughout the day with not less than 2 hours nor more than 6 hours between the end of one meal and the beginning of the next. For residents without access to kitchen facilities, snacks must be offered at least once per day. Snacks are not considered to be meals for the purposes of the time between meals.
(g) Food must be served attractively at safe and palatable temperatures. All residents must be encouraged to eat at tables in the dining areas. A supply of eating ware sufficient for all residents, including adaptive equipment if needed by any resident, must be on ………..
(h) A 3-day supply of nonperishable food, based on the number of weekly meals the facility has
…….. with residents to serve, must be on at all times. The quantity must be based on the resident census and not on licensed capacity, The supply must consist of foods that can be stored safely without refrigeration. Water sufficient for drinking and food preparation must also be stored, or the facility must have a plan for obtaining water in an emergency, with the plan coordinated with and reviewed by the local disaster preparedness authority.
This Statute or Rule is not met as evidenced by: Based on observation, interview and record review, the facility failed to write the substitutions on the menu prior to serving the meal or when the meal was served.
Findings included:
Observation on …….. at 7:21 AM showed Resident #1 had a grilled cheese sandwich and Resident #2 had an omelet.
A review of the menu showed that the residents will have for breakfast 4 cup of dry cereal or 12 cup cooked cereal, 1 slice of bread, 1 tablespoon of margarine, 4 ounces of juice and 8 ounces of milk,
On ………… at 8:56 AM, the Owner stated,” make substitutions because if they do not want what is on the menu, I offer them something that they like.”
Class III
59A-36.014(3) FAC Physical Plant – Safe Living Environ/Other
(3) OTHER REQUIREMENTS.
(a) All facilities must:
1. Provide a safe living environment pursuant to section 429.28(1)(a), F.S.;
2. Be maintained free of hazards; and,
3. Ensure that all existing architectural, mechanical, electrical and structural systems, and appurtenances are maintained in good working order.
(b) Pursuant to section 429.27, F.S., residents must be given the option of using their own belongings as space permits. When the facility supplies the furnishings, each resident bedroom or sleeping area must have at least the following furnishings:
1. A clean, comfortable bed with a mattress no less than 36 inches wide and 72 inches long, with the top surface of the mattress at a comfortable ….. to ensure easy access by the resident,
2. A closet or wardrobe space for hanging clothes,
3. A dresser, ….. or other furniture designed for storage of clothing or personal effects,
4. A table or nightstand, bedside lamp or floor tamp, and waste basket; and,
5. A comfortable chair, if requested.
(c) The facility must maintain master or duplicate keys to resident bedrooms to be used in the event of an emergency.
(d) Residents who use portable bedside commodes must be provided with privacy during use.
(e) Facilities must make available linens and personal laundry services for residents who require such services, Linens provided by a facility must be free of tears, stains and must not be ……..
This Statute or Rule is not met as evidenced by: Based on observation and interview, the facility failed to ensure that all existing architectural, mechanical, electrical, and structural systems and appurtenances were maintained in good working order. The facility also failed to ensure that four of four sampled residents had the minimum required furnishings (Residents #1,2,3,4).
Findings included:
Observation on …….. at 8:51 AM showed a chair in the dining room had a ripped plastic cover.
On ….. at 8:52 AM, the Owner stated, “that happened yesterday when he got stuck with his pants (Referring to Resident #1).”
Observation on …….. at 9:02 AM showed that … # had no closet and nightstands.
# had no dressers. # had no closet.
On ………… at 9:05 AM, the Owner stated, “so they all have to have a closet?”
Class III
Dem Emerg Order 20-011 Visitation
1. Every facility must continue to prohibit the entry of any individual to the facility, except in the following circumstances:
A. Family members, friends, and individuals visiting residents in end-of-life situations including any resident enrolled in hospice;
B. Hospice or, care workers caring for residents in end-of-life situations including any resident enrolled in hospice;
C. Any individuals or providers giving necessary health care to a resident, provided that such individuals or providers:
(1) comply with the most recent Centers for . Control and Prevention (CDC) requirements for personal protective equipment (PPE),
(2) are screened for signs and symptoms of COVID-19 prior to entry, and
(3) comply with the most recent control requirements of the CDC and the facility;
D. Facility staff;
E. Facility residents;
F. Attorneys of Record for residents in Adult Mental Health and Treatment Facilities or forensic facilities for court-related matters if virtual or telephonic means are unavailable,
G. Public Guardians as set forth in chapter 744, Florida Statutes, Professional Guardians as defined by subsection 744.102(17), and their professional staff pursuant to subsection 744.361(14), Florida Statutes;
H. Attorneys and their legal staff who are acting in their capacity as the legal representatives of residents where (a) the residents and lawyers are engaged in an active attorney-client relationships, (b) the visit is related to representation in legal proceedings or in consultation on legal matters, and (c) virtual or telephonic means are unavailable:
I. Representatives of the federal or state government seeking entry as part of their official duties, including but not limited to Long-Term Care Ombudsman program, representatives of the Department of Children and Families, the Department of Health, the Department of Elderly Affairs, the Agency for Health Care Administration, the Agency for Persons with . , a protection and advocacy organization under 42 U.S.C. $15041, the Office of the Attorney General, any law enforcement officer, and any emergency medical personnel;
J. Compassionate care visitors who meet the following definitions and satisfy the following criteria:
i. Compassionate care visitors provide support, including emotional support, to help residents deal with difficult transition or loss, upsetting events, end-of-life situations, significant changes (such as recent admission to the facility), the need for assistance, cueing or encouraging with eating or drinking, or emotional distress or decline.
ii. Regarding compassionate care visitors, the facility shall:
1. Establish policies and procedures for designation and utilizations of compassionate care visitors:
2. Set a limit on the total number of visitors allowed in the facility based on the ability of staff to safely screen and monitor visitation:
3. Develop an agreeable schedule in concert with the residents and visitors, including evening and weekends, to accommodate work or childcare barriers;
4. Provide instructional signage throughout the facility and …… prevention and control education, including education on proper use of PPE, hygiene, and social distancing;
5. Designate key staff to support prevention and control training,
6. Screen compassionate care visitors to prevent possible introduction ofCOVID-19;
7. Maintain a visitor log for signing in and out;
8. Monitor visitor adherence to appropriate use of masks, PPE, and social distancing, especially for those who may have difficulty with compliance such as children, and
9. After attempts to mitigate concerns, restrict or revoke visitation if the compassionate care visitor fails to follow …. prevention and control requirements or other COVID-19-related rules of the facility.
lil. Compassionate care visitors shall:
1. Wear a surgical mask and other PPE as appropriate. PPE for compassionate care visitors must be consistent with the most recent CDC guidance for health care workers;
2. Participate in facility-provided training on …… prevention and control, use of PPE, use of masks, sanitation, and social distancing, and sign acknowledgement of completion of training and adherence to the facility’s ….. prevention and control policies,
3. Comply with facility-provided COVID-19 testing, if offered;
4. Visit in the resident’s room or in facility-designated visitation areas within the building, and
5. Maintain social distance of at least six with staff and other residents and limit movement in the facility except compassionate care visitors are not required to maintain social distance from the resident being visited.
The facility may require compassionate care visitors to submit to facility-provided COVID-19 testing so long as use of testing is based on the most recent CDC and U.S. Food and Drug Administration (FDA) guidance.
K. General visitors, i.e. individuals other than compassionate care visitors, under the criteria detailed below:
1. To accept general visitors, the facility must meet the following criteria:
1. Other than in a dedicated wing or unit that accepts COVID-19 cases from the community, the facility must have no new facility-onset of resident COVID-19 cases in the previous fourteen (14) days;
2. The facility must have fourteen (14) days with no new facility-onset of staff COVID-19 cases where a positive staff person was in the facility in the ten (10) days prior to the positive
test;
3. Sufficient staff to support management of visitors;
4. Adequate PPE for staff, at a minimum;
5. Adequate cleaning and .. … supplies; and
6. Adequate capacity at referral hospitals for the facility
ii. General visitors must:
1. Wear a mask and perform proper hygiene;
2. Sign an acknowledgement form noting receipt and understanding of the facility’s visitation and
prevention and control policies.
3. Comply with facility-provided COVID-19 testing, if offered;
4. Visit in a resident’s room or other facility-designated area; and
5. Maintain social distance of at least six … with staff and residents, and limit movement in the facility.
iii. Before allowing general visitors, the facility shall:
1. Set a policy to prohibit visitation if the resident receiving general visitors is, positive for COVID-19 and not recovered (as defined by most recent CDC guidance), or P….. for COVID-19;
2. Screen general visitors to prevent possible introduction of COVID-19;
3. Establish limits on the total number of visitors allowed in the facility, or with a resident at one time based on the ability of staff to safely screen and monitor visitation;
4. Establish limits on the length of visits, days, hours, and number of visits allowed per week,
5. Schedule visitors by. .. only:
6. Maintain a visitor log for signing in and out;
7. Immediately cease general visitation if a resident other than in a dedicated wing or unit that accepts COVID-19 cases from the community–tests positive for COVID- 19, or is exhibiting symptoms indicating that he or she is presumptively positive for COVID-19, or a staff person who was in the facility in the prior ten (10) days tests positive for COVID-19;
8. Monitor visitor adherence to appropriate use of masks, PPE, and social distancing;
9. Notify and inform residents and their representatives of any changes in the facility’s Visitation policy,
10. Clean and .. . visiting areas between visitors and maintain handwashing or sanitation stations; and
11. Designate staff to support …….. prevention and control education of visitors on use of PPE, use of masks, sanitation, and social distancing.
Facilities allowing general visitation shall enable general visitation as described in either or both paragraphs 1 and 2 below:
1. Provide outdoor visitation spaces that are protected from weather elements, such as porches, courtyards, patios, or other covered areas that are protected from heat and sun, with cooling devices if needed. The provisions of K.(i) (1) and (2) are not applicable to outdoor visitation.
2. Create indoor visitation spaces for residents in a room that is not accessible by other residents, or in the resident’s private room if the resident is bedbound and for health reasons cannot leave his or her room.
v. Limit the number of visitors per resident at one time,
vi. Each facility may require general visitors to submit to facility- provided COVID-19 testing
so long as use of testing is based on the most recent CDC and FDA guidance.
L. Barbers and beauty salons may resume services to residents with the following precautions:
i. Services are permissible only if:
1. Other than in a dedicated wing or unit that accepts COVID-19 cases, the facility has had no new facility-onset of resident COVID-19 cases in the previous fourteen (14) days; and
2. Fourteen (14) days have passed with no new staff COVID-19 cases where a positive staff person was in the facility in the ten (10) days prior to the positive test.
Barbers and salon staff must wear surgical masks, gloves, practice proper hygiene, and follow the same requirements as compassionate caregivers;
iii. Waiting customers must follow social distancing guidelines;
. Residents receiving services must wear masks;
v. Services are only provided to facility residents, not outside clients or guests;
vi. Services may not be provided to a resident who tests positive for COVID-19 or is exhibiting symptoms indicating that he or she is presumptively positive for COVID-19, and
vii. Service and salon areas must be properly cleaned and , and equipment must be sanitized between residents.
2. Individuals seeking entry to the facility, under the above section 1, will not be allowed to enter if they meet any of the screening criteria listed below:
A. Any person …….. with COVID-19 who does not meet the most recent criteria from the CDC to end isolation.
B. Any person showing, presenting signs or symptoms of, or disclosing the presence of a . …, including …Mr ., chills, . …., repeated shaking with chills, new loss of taste or smell, or any other COVID-19 symptoms identified by the CDC.
C. Any person who has been in close contact with any person(s) known to be ……. with COVID-19, who does not meet the most recent criteria from the CDC to end ……..
3. All facilities must require any individual who is entering the facility and who will have physical contact with any resident to wear PPE pursuant to the most recent CDC guidelines. Persons without physical contact with any resident must wear a mask. All facilities are encouraged to provide regular COVID-19 testing for staff and visitors.
4. Any resident leaving the facility temporarily for medical….. … or other activities, and any resident receiving visits from health care providers, must wear a … mask, if tolerated by that resident’s condition. All residents must be screened upon return to the facility. ., protection should also be encouraged.
…… should be scheduled through the facility or group home to ensure proper screening and adherence to … control measures.
5. All visitors must immediately inform the facility if they develop a or symptoms consistent with COVID-19 or test positive for COVID-19 within fourteen (14) days of a visit to the facility.
6. Documentation showing compliance with the following requirements must be kept for all visitation within a facility:
A. Individuals entering a facility must be screened. To achieve this purpose, a facility may use a standardized questionnaire or other form of documentation.
B. The facility is required to maintain documentation of all non-resident individuals entering the facility. The documentation must contain:
i. Name of the individual entering the facility;
ii. Date and time of entry, and
iii. The screening mechanism used by the facility to conclude that the individual did not meet any of the enumerated COVID-19 screening criteria. This documentation must include the screening employee’s printed name and signature.
This Statute or Rule is not met as evidenced by: Based on observation and interview, the facility failed to ensure that state representatives and other individuals arriving at the facility were screened for COVID-19.
The COVID-19 … is a transmissible . . that presents severe risk to persons who are aged, infirm, or suffer from co- …, including, but not limited to, System deficiency, .. ….. …………………, and ….. See generally, Publications of the Centers for ……… Control.
On .. …….., the Governor of the State of Florida issued Executive Order 20-51 designating a Public Health Emergency as a result of COVID-19 and its impact. Pursuant to that authority, emergency orders have been issued by the Florida Division of Emergency Management to implement the protections necessary to assure the health, safety, and well-being of Florida’s citizenry, including those most….. to the effects of
Among those emergency orders was DEM Order 20-006, dated : ………… , delineating minimum screening standards for persons entering identified residential facilities.
The Centers for Control referred to Assisted Living Facility’s high risk of COVID-19 spread to residents and stated: “Given their congregate nature and population served, assisted living facilities (ALF) are at high risk of COVID-19 spreading and affecting their residents. If with SARS-CoV-2, the that causes COVID-19, assisted living residents-often older adults with underlying … medical conditions-are at increased risk of serious illness.”
Observation on …… at 6:00 AM revealed Staff C working at the facility. Staff C opened the door and allowed state representatives entrance into the facility without conducting any COVID-19 screening such as checking temperature, documenting names or temperatures, or asking screening questions related to COVID-19.
On . ……. at 6:43 AM, observation showed that the owner arrived at the facility wearing a … mask. The owner was not screened prior to entering the facility.
On …….. at 7:03 AM, the owner stated she did not undergo any screening because she was nervous.
During an interview on ……. at 7:03 AM, the owner stated the procedure for anyone who enters the facility is to have their temperature taken, wash and sanitize their and sign in on the visitor log.
On ……… at 7:05 AM, Staff C stated she did not screen the state representatives because they looked like they were ready to enter the facility because they had on all of the personal protective equipment (PPE).
Class III