A Letter from the State Health Commissioner
Thank you for all you are doing as part of Indiana’s COVID-19 response. As you know, people older than 60 years old and those with underlying health conditions are the most vulnerable to this new disease, and the most likely to suffer severe outcomes.
As a result, ISDH is updating its recommended visitation guidelines for the following types of facilities:
• Nursing homes
• Residential care facilities
• Assisted-living facilities
• Residential care & assistance program providers
• Housing with services establishments
• Intermediate care facilities for IDD, including group homes
• Rehabilitation hospitals
• State psychiatric hospitals
• Free standing psychiatric hospitals
All facilities should restrict visitation of ALL visitors and non-essential healthcare personnel. The only exception for visitors is for compassionate care situations, as in end of life. Decisions about visitation during an end of life situation should be made on a case-by case-basis, which should include careful screening of the visitor (including clergy, bereavement counselors, etc.) for fever or respiratory symptoms.
Those with symptoms of a respiratory infection (fever, cough, shortness of breath, or sore throat) should not be permitted to enter the facility at any time (even in end-of-life situations).
Those visitors who are permitted will be:
• Instructed before entry to the facility of the need to be screened for temperature and symptoms;
• Limited to a specific location (the resident’s room or other designated location); and
• Required to perform hand hygiene and wear personal protective equipment (PPE) including gloves and a standard surgical facemask, if available.
In addition, facilities are asked to advise visitors and any individuals who enter the facility to monitor for signs and symptoms of respiratory infection for at least 14 days after leaving the facility. If symptoms occur, the visitor should self-isolate at home, contact a healthcare provider and immediately notify the facility of the date and person visited.
The only exceptions to the restrictions are healthcare workers (facility staff) and government surveyors.
Other CMS guidance:
• Cancel group dining and activities (both in and out of the facility)
• Implement Active Screening of residents and staff for fever and respiratory symptoms
• Remind residents to practice social distancing and perform frequent hand hygiene
In lieu of in-person visits, please do your best to facilitate increased video calls and phone calls for your clients in order to help minimize the negative psychological impact of restricted visitation. Please also see the attached poster to help you communicate these new requirements.
Thank you in advance for your compliance with this CMS guidance.
Kristina M. Box, M.D., FACOG
State Health Commissioner