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The Center for Medicare and Medicaid Services issued revised guidelines March 9 for infection control and prevention of the novel Coronavirus 2019. These guidelines call on providers to limit – and in some cases restrict – in-person visitor access to prevent the spread of COVID-19 in senior health care communities.

The guidelines call for communities to screen and limit visitor access to senior health care communities. The restrictions for communities in areas where there are active COVID-19 cases are more stringent, but visitation is discouraged at any senior living community unless absolutely necessary.

In a proactive and preventive move, PMMA (Presbyterian Manors of Mid-America) has adopted these guidelines, and is working to educate staff, residents, families, vendors, volunteers and community partners.

All PMMA communities are subject to visitor restrictions.

Limited access is the designation for those locations where there are identified cases of COVID-19 in the county or adjacent counties. In the affected locations, PMMA campuses will observe LIMITED ACCESS as recommended by the CDC and CMS. All visits to the community must be rescheduled except in case of end-of-life situations or if the visitor is essential to resident’s emotional well-being and care. Families should communicate with their loved one via telephone, email or other electronic methods.

Visitation is discouraged means that unless a visit is absolutely necessary, it should be rescheduled. This includes family members, vendors and friends. While visitation is not prohibited, those wishing to visit the community should consider the risks to their family member and those who care for them in determining if a visit is necessary during this time.

Signs have been posted at community entrances indicating which visitation category the campus is under, and those designations are subject to change.

What to do if you are visiting a community

If your visit is not absolutely necessary, please reschedule your visit to the community if:

• You are exhibiting signs or symptoms of a respiratory infection, such as fever, cough, shortness of breath, or sore throat.
• You have had contact with someone with a confirmed case of COVID-19, or under investigation for COVID-19, or are ill with respiratory illness.
• You have been traveling internationally to affected countries within the last 14 days. As of March 11, 2020, countries with travel advisories include more than 25 European countries as well as China, South Korea, Italy, Japan and Iran. A current list of countries is available on the CDC website, www.cdc.gov.
• You reside in a community where community-based spread of COVID-19 is occurring.

Visitors who do come to the community should:

• Wash hands with soap and warm water for 20 seconds, rubbing palms together, cleaning between fingers and the backs of hands.
• Utilize hand sanitation stations prior to entering and upon leaving resident rooms.
• Limit movement within the community to your resident’s room or your contact’s office
• Limit physical contact with the resident – no hugging, kissing or hand-shaking – and remain 6 feet apart
• Report to the community any signs or symptoms of COVID-19 or acute illness within 14 days after visiting the community

Personal protective equipment (PPE), which includes gloves, masks and gowns, are available as necessary.

The guidance also calls for additional signage at visitor entries, increasing availability of hand sanitizer and offering personal protective equipment to people who do enter.

Both the Kansas Department of Health and Environment and the Missouri Department of Health and Senior Services announced the first “presumptive positive” cases in the two states on March 7. Timely updates are available from each state’s health department (www.kdheks.gov or health.mo.gov/) and the CDC (www.cdc.gov).