This facility will allow visitation of all visitors and non-essential health care personnel through different means based on facility structure and residents’ needs, such as resident rooms, dedicated visitation spaces, outdoors, and for circumstances beyond compassionate care situations. The visitation will be person-centered, consider the resident’s physical, mental, and psychosocial well-being, and support their quality of life.  Exceptions will be in accordance with current CMS directives and CDC recommendations, or as directed by state government (whichever is more stringent).

Policy Explanation and Compliance Guidelines:

1. The Infection Preventionist will monitor the status of the COVID-19 situation through the CDC website and local/state health department, and will keep facility leadership informed of current directives/ recommendations and the need for restricting visitation if indicated.
2. The facility will communicate this visitation policy through multiple channels. Examples include signage, calls, letters, social media posts, emails, and recorded messages for receiving calls.
3. Non-essential staff, as designated in emergency preparedness plans, will be notified through routine and emergency communication procedures for staff.
4. The core principles of COVID-19 infection prevention will be adhered to and as follows:

1. Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions about and observations of signs or symptoms), and denial of entry of those with signs or symptoms or those who have had close contact with someone with COVID-19 infection in the prior 14 days (regardless of the visitor’s vaccination status).
2. Hand hygiene will be conducted with the preferred use of alcohol-based hand rub.
3. A face covering or mask, covering the mouth and nose, will be worn at all times. 
4. Social distancing at least six feet between persons will be observed.
5. Instructional signage throughout the facility and proper visitor education on COVID-19 signs and symptoms, infection control precautions, and other applicable facility practices will be conducted.
6. Cleaning and disinfection of highly touched surfaces in the facility and in designated visitation areas after each visit will be performed.
7. Staff will adhere to the appropriate use of personal protective equipment (PPE).
8. The facility will utilize effective strategies of cohorting residents (e.g., separate areas dedicated to COVID-19 care).
9. The facility will conduct resident and staff testing as per current CMS guidance. 
10. Physical barriers (e.g., clear Plexiglass dividers, curtains) will be used to ensure privacy and reduced risk of transmission during in-person visits. 
11. Visitors who are unable to adhere to these principles of COVID-19 infection prevention will not be permitted to visit or will be asked to leave.

5. Outdoor visitation will be conducted in a manner that reduces the risk of COVID-19 transmission as follows and is the preferred method even when the resident and visitor are fully vaccinated* against COVID-19:

1. Visits will be held outdoors whenever practicable and will be facilitated routinely barring weather conditions, a resident’s health status or the facility’s outbreak status.
2. The facility will have an accessible and safe outdoor space (designate space) in which to conduct outdoor visitation.
3. The facility will have no more than two visitors per resident and no more than five simultaneous visits occurring at the same time and will limit visits to thirty minutes.

6. Indoor visitation will be conducted in a manner that reduces the risk of COVID-19 transmission based on the following guidelines:

1. The facility will allow indoor visitation at all times and for all residents (regardless of vaccination status, except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission (note: compassionate care visits will be permitted at all times). These scenarios include limited indoor visitation for:

1. i.Unvaccinated residents, if the facility’s COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated
2. ii. Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue Transmission-Based Precautions; or
3. iii. Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.

2. Residents and families should continue to adhere to the core principles of COVID-19 infection, including physical distancing, but if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting mask and performing hand hygiene before and after. Visitor should still physically distance from other residents and staff in the facility. 
3. The facility will have no more than two visitors per resident and no more than five simultaneous visits occurring at the same time and will limit visits to thirty minutes.
4. The facility will ensure that visitors are to be maintained at the designated visitation area.
5. The facility will utilize their county positivity rate as a determinate in conducting indoor visitation.

1. Low (<5%) = Visitation will occur according to the core principles of COVID-19 infection prevention and facility policies (beyond compassionate care visits).
2. Medium (5%-10%) = Visitation will occur according to the core principles of COVID-19 infection prevention and facility policies (beyond compassionate care visits).
3. High (10%) = Visitation will only occur for compassionate care situations according to the core principles of COVID-19 infection prevention and facility policies. 

7. When a new case of COVID-19 among staff or residents is identified, the facility will immediately begin outbreak testing and suspend all visitation (except that required under federal disability rights law), until at least one round of facility-wide testing is completed. Visitation can resume based on the following criteria:
   1. If the first round of outbreak testing reveals no additional COVID-19 cases in other areas (e.g. units) of the facility, then visitation can resume for residents in areas/units with no COVID-19 cases. However, the facility will suspend visitation on the affected unit until the facility meets the criteria to discontinue outbreak testing.  
   2. If the first round of outbreak testing reveals one or more additional COVID-19 cases in other areas/units of the facility (e.g., new cases in two or more units), then facilities should suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak testing. 
   3. If subsequent rounds of outbreak testing identify one or more additional COVID-19 cases in other areas/units of the facility, then the facility will suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak testing.
8. Visitors will be notified about the potential for COVID-19 exposure in the facility (e.g. appropriate signage regarding current outbreaks), and adhere to the core principles of COVID-19 infection and prevention, including effective hand hygiene and use of face coverings.
9. Compassionate care visits and visits required under the federal disability rights law should be allowed at all times, for any resident (vaccinated or unvaccinated) regardless of the resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak.
10. Visitor testing may be offered, if feasible, in facilities in medium- or high-positivity counties and should prioritize visitors that visit regularly, although any visitor can be tested.  Visitors will not be required to be tested or vaccinated (or show proof of such) as a condition of visitation.
11. Residents who are on transmission-based precautions for COVID-19 should only receive visits that are virtual, through windows, or in-person for compassionate care situations, with adherence to transmission-based precautions. This restriction will be lifted once transmission-based precautions are no longer required as per CDC guidelines.
12. Special considerations:
    1. Health care workers not employed by the facility but provide direct care services: Healthcare workers will be allowed to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or showing signs or symptoms of COVID-19 after being screened. Screening for fever and respiratory symptoms apply in accordance with surveillance procedures.
    2. Surveyors: Surveyors must be permitted entry into the facility unless they exhibit signs or symptoms of COVID-19 and should adhere to the core principles of COVID-19 infection and any COVID-19 infection prevention requirements set by state law.
    3. Ombudsman: In-person access may be limited due to infection control concerns and/or transmission of COVID-19, such as the scenarios stated above for limiting indoor visitation, but may not be limited without reasonable cause. The core principles of infection prevention will be adhered to by the ombudsman and if in-person access is not advisable, the facility will arrange for alternative communication with the ombudsman.
    4. Representatives of protection and advocacy systems, as designated by the state, will be allowed access to the residents both formally and informally, by telephone, mail and in person.
13. Advise any visitors to monitor for signs and symptoms of respiratory illness and report to the facility if symptoms are evident within 14 days after visiting the facility.
14. Resident-to-resident visitation:

1. Communal activities and dining may occur while adhering to the core principles of COVID-19 infection prevention (e.g., limited number of people at a table, at least six feet of distance between residents).
2. Remind residents to practice social distancing, perform frequent hand hygiene, and wear a mask or face covering.
3. Restrict non-affected residents from entering rooms of residents suspected/confirmed to have COVID-19.

*Fully vaccinated refers to a person who is ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine, per the CDC’s guidance.

15. Communal activities (including group activities and communal dining):

4. Vaccinated and unvaccinated residents with SARS-CoV-2 infection, or in isolation because of suspected COVID-19, may not participate in communal activities until they have met criteria to discontinue Transmission-Based Precautions.
5. Vaccinated and unvaccinated residents in quarantine may not participate in communal activities until they have met criteria for release from quarantine.
6. If all residents participating in a group activity are fully vaccinated, then they may choose to have close contact and not to wear source control during the activity.
7. If unvaccinated residents are present, then all participants in the group activity should wear source control and unvaccinated resident should physically distance from others. 
8. Fully vaccinated residents can participate in communal dining without use of source control or physical distancing. 
9. If unvaccinated residents are dining in a communal area (e.g., dining room), all resident should use source control when not eating and unvaccinated residents should continue to remain at least 6 feet from others. 
10. Residents taking social excursions outside the facility should be educated about potential risks of public settings, particularly if they have not been fully vaccinated, and reminded to avoid crowds and poorly ventilated spaces. They should be encouraged and assisted with adherence to infection prevention and control measures such as physical distancing, source control, and hand hygiene.
11. If the vaccination status cannot be determined, the facility will follow all recommended infection prevention and control practices including maintaining physical distancing and wearing source control.

Reference:

Centers for Medicare & Medicaid Services. (March 10, 2021) QSO-20-39-NH: Nursing Home Visitation – COVID-19.

You may wish to bring some items from home to make your stay more comfortable. The following items are recommended but not required:

• Glasses, hearing aids, dentures
• Comfortable sets of daytime clothes: sweat pants, t-shirts, shorts or any items that do not snap or button are recommended
• Toiletries: electric shaver, makeup etc.
• Comfortable shoes
• Non-slip slippers for nighttime use
• Sleepwear if you prefer not to wear the gowns provided
• Personal items such as photos, pillows or blankets etc.
• Advanced Directive

Clothing is labeled with the resident’s name by the facility with a quick heat press labeling system.

In house cable TV is available for a small monthly viewing charge if you bring your personal TV. We also have public televisions throughout the building. In room telephone services can be arranged for an additional monthly fee.

Does the facility have wifi?
Yes, wifi is offered at no additional charge to all residents and visitors.

We encourage residents to bring their cell phones to communicate with their friends and family. If a resident does not have a personal cell phone, Carbondale Nursing has portable phones for residents to use.

If you are in the hospital because of an illness or surgery and subsequently need assistance with daily activities or walking, you could benefit from in-patient skilled nursing rehabilitation as a short-term rehab patient. We provide a variety of therapy services and specialized rehabilitation programs that help individuals return home with an optimal level of functioning.

We also have provisions for long-term care intended for individuals who can no longer live safely on their own at home.

In a skilled nursing facility Medicare Part A will pay for your room, meals, medication, rehabilitation services, medical supplies and activities. You must have a three-day hospital qualifying stay prior to admission to a skilled nursing facility. For each benefit period you will be responsible for:

• Days 1-20: There is no cost for the patient. Medicare pays the entire cost.
• Days 21-100: There is a $176 co-pay per day. (Rate changes annually.) If there is a Medicare supplement, we will verify the coverage and advise you what the supplement will pay.
• You will be responsible for all costs incurred past the 100th day.

The benefit period for Medicare Part A is a maximum of 100 days. You must meet Medicare criteria throughout your stay for Medicare to continue to pay. Most patients do not require a 100-day stay.

If you have any questions about Medicare coverage please contact the Business Office to clarify any questions you might have.

We offer physical, occupational and speech therapy services. Although the type and amount of therapy provided depends on the resident’s diagnosis and tolerance level, most residents receive approximately 2 to 2½ hours of therapy per day, five days per week.

We believe that interacting with friends and family are essential for your recovery, therefore there are no restrictions to visiting hours.

The facility also offers dental services, optometry, psychology, psychiatry, podiatry, X-ray, laboratory, swallowing diagnostics, pharmacy and social services.

Our dietitian and food service director will carefully supervise your special dietary needs. The menu encompasses a wide variety of choices, and substitutions are readily available.