LTC Home Visitors Policy
The home is open to residents, their family members, and significant others seven days a week.
Visitors provide important mental, emotional, spiritual, and physical benefits to residents.
Essential visitors continue to have access to the home during an outbreak of a communicable disease, an outbreak of public health significance, an epidemic or pandemic or another emergency subject to applicable laws. An emergency is defined as an urgent or pressing situation or condition presenting an imminent threat to the health or well-being of residents and others attending the home that requires immediate action to ensure the safety of persons in the home.
Generally accepted visiting hours to ensure the rights of all residents will be set by the individual home. For ill or palliative/end of life residents, visiting by caregivers, family members or significant others 24 hours per day will be supported. To ensure safety, no individual other than a resident, employee, Ministry of Long-Term Care (MLTC) Inspector or designated physician/RN (EC) may enter the home between the hours of 12 midnight and 5:30 a.m. unless prior arrangements have been made with the Administrator or designate.
The Administrator or designate reserves the right to alter the visiting practices of the home during an outbreak and at other times under the direction of the local Medical Officer of Health, or Chief Medical Officer of Health appointed under the Health Protection and Promotion Act, in compliance with any applicable laws including any applicable directives, orders, guidance, advice or recommendations.
Homes will maintain the required visitor logs for a minimum of 30 days.
Definitions
Not Considered Visitors
- Long-term care home staff (as defined under the Fixing Long-Term Care Act, 2021), volunteers, and student placements are not considered visitors as their access to the home is determined by the licensee.
- Infants under the age of 1 year are not considered visitors.
Types of Visitors
- Essential Visitors - There are no limits on the total number of essential visitors allowed to come into a home at any given time. Essential visitors may continue to visit the home when there is an outbreak of communicable disease, an outbreak of public health significance, an epidemic or pandemic, or another emergency, subject to applicable laws.
An emergency is defined as an urgent or pressing situation or condition presenting an imminent threat to the health or well-being of residents and others attending the home that requires immediate action to ensure the safety of persons in the home.
As per O. Reg. 246/22 under the Fixing Long-Term Care Act, 2021, there are four types of essential visitors: (a) a caregiver, as defined under section 4 of O. Reg. 246/22, (b) a support worker who visits a home to provide support to the critical operations of the home or to provide essential services to residents, (c) a person visiting a very ill resident for compassionate reasons including, but not limited to, hospice services or end-of-life care, or (d) a government inspector with a statutory right to enter a long-term care home to carry out their duties.
Under O. Reg. 246/22 s. 4, a caregiver is defined as an individual who:
(a) is a family member or friend or a resident or a person of importance to a resident, (b) is able to comply with all applicable laws including any applicable directives, orders, guidance, advice or recommendations issued by the Chief Medical Officer of Health or a medical officer of health appointed under the Health Protection and Promotion Act, (c) provides one or more forms of support or assistance to meet the needs of the resident, including providing direct physical support such as activities of daily living or providing social, spiritual or emotional support, whether on a paid or unpaid basis, (d) is designated by the resident or the resident's substitute decision-maker with authority to give that designation, if any, and (e) in the case of an individual under 16 years of age, has approval from a parent or legal guardian to be designated as a caregiver.
- Designated Caregivers - Homes will not require scheduling or restrict the length or frequency of visits by caregivers. However, in the case where a resident resides in an area of the home in outbreak, is symptomatic or isolating under additional precautions, the local Medical Officer of Health appointed under the Health Protection and Promotion Act may restrict at their discretion the number of caregivers.
Recognizing there are caregivers who may be volunteering to support residents, in the event of an outbreak, they may continue to do so, provided the home obtains consent from all involved residents (or their substitute decision makers). Caregivers may also support residents in non-outbreak situations, with the same expectation regarding resident consent.
- General Visitors - A general visitor is a person who is not an essential visitor and is visiting to provide non-essential services related to either the operations of the home or a particular resident or group of residents. General visitors include those persons visiting for social reasons as well as visitors providing non-essential services such as personal care services, entertainment, or individuals touring the home. This would include hairdressers and or barbers.
There are no limits on the number of visitors permitted for indoor or outdoor visits subject to the individual home's capacity limits.
General visitors may be advised to postpone all non-essential visits if the home has been directed by their local public health unit during an outbreak to restrict general visiting or in the event of another emergency. An emergency is defined as an urgent or pressing situation or condition presenting an imminent threat to the health or well-being of residents and others attending the home that requires immediate action to ensure the safety of persons in the home.
Procedure
Upon admission to the home, the resident, family members and significant others will be provided with a copy of the home's LTC Home Visitors Policy.
A copy of the LTC Home Visitors Policy will be provided to both the Resident and Family Councils, posted in a public location within the home for ease of reference and posted on the home�s website.
All visitors must familiarize themselves with education and training on Infection Prevention and Control (IPAC) measures including respiratory hygiene, IPAC practices and proper use of Personal Protective Equipment. See Education Resources at the end of this policy.
All visitors to the home will be required to sign in and sign out of the Home on the Visitor Log sheet and provide their name, contact information, time and date of the visit, purpose of the visit and the name of the resident visited. Visitor logs will be maintained by the home for a minimum of 30 days.
Support Workers, General Visitors, and Designated Caregivers:
Masks are recommended but not required for all indoor visits in all home areas with all visitors (regardless of type). The home is a mask friendly setting.
The process for designating an essential caregiver by a resident or SDM must be made in writing and is entirely the decision of the resident/SDM. The home will maintain a current documented list of designated essential caregivers to the home. The home reserves the right to investigate the designation of an essential caregiver if it does not meet the definition of caregiver as identified in this policy.
Caregivers and general visitors may join in sharing a meal with their loved one(s) in communal dining areas if the home is not in outbreak.
All visitors may join in activities where space permits.
Restriction of Visitors
Staff will respect the resident's right to have privacy during visits.
Staff who have concerns regarding a visitor to the home are to immediately inform their Supervisor/Manager.
The Supervisor/Manager is to immediately inform the home's Administrator or designate of the expressed concern.
Following investigation of a concern should the home's Administrator or designate determine that there are safety risks associated with a person visiting the home, visitation to the home can be either restricted or terminated. Visiting will only be restricted or terminated where there is risk or safety concerns for residents, other visitors or staff and is a last resort if no other options to safe visiting can be determined or negotiated.
Restrictions that may be imposed include but are not limited to:
- Visitation during the hours that the Administrator is in the home;
- Supervised visitation with another family member being present;
- Set hours for visitation; or
- Other visitation restrictions as decided by the Administrator or designate in consultation with the Regional Manager.
When restricting visitation, the Administrator or designate will consult with the Regional Manager and inform the MLTC. A copy of the letter restricting visiting will be forwarded to the MLTC District Office.
The Administrator will meet with persons who are having visitation restricted to outline the reason for the restriction and the home's expectation regarding their visitation.
The Administrator or designate will inform all Supervisors and Managers of people who have visitation restrictions.
Visitation restrictions will be reassessed by the Administrator or designate on a weekly basis.
In the event a restricted visitor violates the conditions of visitation, the Administrator or designate will contact police for assistance.
The home will comply with all current applicable laws including any applicable directives, orders, guidance, advice or recommendations issued by the Chief Medical Officer of Health or a Medical Officer of Health appointed under the Health Protection and Promotion Act relating to access to the home by visitors at all times.
****If the home is in a declared outbreak of a reportable communicable disease or another emergency, please refer to the table below for the differences in policy****
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Non-Outbreak Guidelines |
Outbreak Guidelines |
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General Visitors (INDOOR VISITS) |
All general visitors, including children under the age of 5, can enter the long-term care home. |
General visitors are not permitted:
No restrictions if the resident is ill/palliative or receiving end of life care. |
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General Visitors (OUTDOOR VISITS) |
There are no limits on the number of visitors permitted at outdoor visits. |
General visitors are not permitted:
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Designated Caregivers |
Caregivers must be at least 16 years of age unless written permission from a parent or legal guardian is provided. Homes will have a procedure for documenting caregiver designations. The decision to designate an individual as a caregiver is entirely the decision of the resident and/or their substitute decision-maker and not the home. |
There are no limits on the number of designated caregivers that may visit at a time if the resident resides in an area of the home in outbreak, is symptomatic or is isolating under additional precautions or in the event of another emergency, subject to applicable laws. PPE may be required to be worn. No restrictions if the resident is ill/palliative or receiving end of life care. |
Education Resources
Public Health Ontario Resources
Education for PPE Donning and Doffing
CMOH Memo - Continuation of Masking in Certain Settings - 2022-04-22 AODA EN
CMOH Memo - Continuation of Masking in Certain Settings - 2022-04-22 AODA FR