Section 300.3340 Social Isolation

TITLE 77: PUBLIC HEALTH

CHAPTER I: DEPARTMENT OF PUBLIC HEALTH

SUBCHAPTER d: LONG-TERM CARE FACILITIES

PART 300 SKILLED NURSING AND INTERMEDIATE CARE FACILITIES CODE

SECTION 300.3340 SOCIAL ISOLATION

Section 300.3340  Social Isolation

a)         For the purposes of this

Section:

1)

"Assistive

and supportive technology and devices" means computers, video conferencing

equipment, distance-based communication technology, or other technological equipment,

accessories, or electronic licenses as may be necessary to ensure that

residents are able to engage in face-to-face, verbal-based, or auditory-based

contact, communication, religious activity, or recreational activity with other

facility residents and with family members, friends, loved ones, caregivers,

and other external support systems, through electronic means, in accordance

with the provisions of

the Act and subsections (d)(2) and (3).

2)

"Religious

and recreational activities" includes any religious, social, or

recreational activity that is consistent with a resident's preferences and

choosing, regardless of whether the activity is coordinated, offered, provided,

or sponsored by facility staff or by an outside activities provider.

3)

"Resident's

representative" has the same meaning as provided in Section 1-123

of

the Act and Section 300.330.

4)

"Social

isolation" means a state of isolation wherein a resident of a long-term

care facility is unable to engage in social interactions and religious and

recreational activities with other facility residents or with family members,

friends, loved ones, caregivers and external support systems.

5)

"Virtual

visitation" means the use of face-to-face, verbal-based, or auditory-based

contact through electronic means.

(Section 3-102.3(a) of the Act)

b)

Each

facility

shall

adopt and implement written policies

that

provide

for the availability of assistive and supportive technology and devices to

facility residents

ily members,

friends, loved ones, caregivers and external support systems.

5)

"Virtual

visitation" means the use of face-to-face, verbal-based, or auditory-based

contact through electronic means.

(Section 3-102.3(a) of the Act)

b)

Each

facility

shall

adopt and implement written policies

that

provide

for the availability of assistive and supportive technology and devices to

facility residents.

Facilities shall

ensure that appropriate staff are

in place to help prevent the social isolation of facility residents.

(Section 3-102.3(b)(1) of the Act)

c)

The

virtual visitation policies shall not be interpreted as a substitute for

in-person visitation, but shall be wholly in addition to existing in-person

visitation policies.

(Section 3-102.3(b)(2) of the Act)

d)

The

social isolation prevention policies adopted by each long-term care facility

pursuant to

this Section

shall be consistent with rights and privileges

guaranteed to residents and constraints provided under Sections 2-108, 2-109,

and 2-110

of the Act and this Subpart P,

and

shall include the

following:

1)

Authorization

and inclusion of specific protocols and procedures to encourage and enable

residents of the facility to engage in in-person contact, communication,

religious activity, and recreational activity with other facility residents and

with family members, friends, loved ones, caregivers, and other external

support systems, except when prohibited, restricted, or limited by federal or

State statute, rule, regulation, executive order, or guidance;

2)

Authorization

and inclusion of specific protocols and procedures to encourage and enable

residents to engage in face-to-face, verbal-based, or auditory-based contact,

communication, religious activity, and recreational activity with other

facility residents and with family members, friends, loved ones, caregivers,

and other external support systems through the use of electronic or virtual

means and methods, including, but not limited to, computer technology, the

Internet, social med

idents to engage in face-to-face, verbal-based, or auditory-based contact,

communication, religious activity, and recreational activity with other

facility residents and with family members, friends, loved ones, caregivers,

and other external support systems through the use of electronic or virtual

means and methods, including, but not limited to, computer technology, the

Internet, social media, videoconferencing, videophone, and other innovative

technological means or methods, whenever the resident is subject to

restrictions that limit his or her ability to engage in in-person contact,

communication, religious activity, or recreational activity as authorized by

subsection

(d)(1)

and when the technology requested is not being used by other

residents in the event of a limited number of items of technology in a

facility;

3)

A mechanism

for residents of the facility or the residents' representatives to request

access to assistive and supportive technology and devices as may be necessary

to facilitate the residents' engagement in face-to-face, verbal-based, or

auditory-based contact, communication, religious activity, and recreational

activity with other residents, family members, friends, and other external

support systems, through electronic means, as provided by

subsection

(d)(2);

4)

Specific

administrative policies, procedures, and protocols governing

:

A)

The

acquisition, maintenance, and replacement of assistive and supportive

technology and devices;

B)

The

use of environmental barriers and other controls when the assistive and

supportive technology and devices acquired pursuant to

subsection (4)(A)

are

in use, especially in cases where the assistive and supportive technology and

devices are likely to become contaminated with bodily substances, are touched

frequently, or are difficult to clean; and

C)

The

regular cleaning of the assistive and supportive technology and devices

acquired pursuant to

subsection (4)(A)

and any environmental barriers or

other physical controls used in ass

(A)

are

in use, especially in cases where the assistive and supportive technology and

devices are likely to become contaminated with bodily substances, are touched

frequently, or are difficult to clean; and

C)

The

regular cleaning of the assistive and supportive technology and devices

acquired pursuant to

subsection (4)(A)

and any environmental barriers or

other physical controls used in association therewith;

5)

A

requirement that upon admission and at the request of a resident or the

resident's representative, appropriate staff shall develop and update an

individualized virtual visitation schedule while taking into account the

individual's requests and preferences with respect to the residents'

participation in social interactions and religious and recreational activities;

6)

A

requirement that appropriate staff, upon the request of a resident or the

resident's family members, guardian, or representative, shall develop an

individualized virtual visitation schedule for the resident, which shall:

A)

Address

the need for a virtual visitation schedule and establish a virtual visitation

schedule if deemed to be appropriate;

B)

Identify

the assessed needs and preferences of the resident and any preferences

specified by the resident's representative, unless a preference specified by

the resident conflicts with a preference specified by the resident's

representative, in which case the resident's preference shall take priority;

C)

Document

the facility's defined virtual hours of visitation and inform the resident and

the resident's representative that virtual visitation pursuant to

subsection

ces

specified by the resident's representative, unless a preference specified by

the resident conflicts with a preference specified by the resident's

representative, in which case the resident's preference shall take priority;

C)

Document

the facility's defined virtual hours of visitation and inform the resident and

the resident's representative that virtual visitation pursuant to

subsection

(d)(2)

will adhere to the defined visitation hours;

D)

Describe

the location within the facility and assistive and supportive technology and

devices to be used in virtual visitation; and

E)

Describe

the respective responsibilities of staff, visitors, and the resident when

engaging in virtual visitation pursuant to the individualized visitation plan;

7)

A

requirement that, upon admission and at the request of the resident or the

resident's representative,

the facility

provides notification to the

resident and the resident's representative that they have the right to request

of facility staff the creation and review of a resident's individualized

virtual visitation schedule;

8)

A

requirement that, upon admission and at the request of the resident or

resident's representative, the facility provide, in writing to the resident or

resident's representative, virtual visitation hours, how to schedule a virtual

visitation, and how to request assistive and supportive technology and devices;

9)

Specific

policies, protocols, and procedures governing a resident's requisition, use,

and return of assistive and supportive technology and devices maintained

pursuant to

subsection (4)(A)

and require appropriate staff to

communicate those policies, protocols, and procedures to residents; and

10)

The

designation of at least one member of the therapeutic recreation or activities

department, or, if the facility does not have this department, the designation

of at least one senior staff member, as determined by facility management, to

train other appropriate facility employees, including, but not limited to,

activities pr

te those policies, protocols, and procedures to residents; and

10)

The

designation of at least one member of the therapeutic recreation or activities

department, or, if the facility does not have this department, the designation

of at least one senior staff member, as determined by facility management, to

train other appropriate facility employees, including, but not limited to,

activities professionals and volunteers, social workers, occupational

therapists, and therapy assistants, to provide direct assistance to residents

upon request and on an as-needed basis, as necessary to ensure that each

resident is able to successfully access and use, for the purposes specified in

subsections (d)(2) and (3), t

he assistive and supportive technology and

devices acquired pursuant to

subsection (4)(A).  (Section 3-102.3(c) of the

Act)

e)

A

facility may apply to the Department for competitive civil monetary penalty

fund grants for assistive and supportive technology and devices and may request

other available federal and State funds.

(Section 3-102.3(d) of the Act)

f)

In

addition to any other applicable penalties provided by law, a facility that

fails to comply with the provisions of this Section or properly implement the

written policies, protocols, and procedures adopted pursuant to

subsection

(b)

shall be liable to pay an administrative penalty as a Type "C"

violation, the amount of which shall be determined in accordance with

subsections (f) and (g) of Section 300.282.  (Section 3-102.3(e) of the Act)

g)

Implementation

of an administrative penalty as a Type "C" violation under this

subsection will not be imposed prior to January 1, 2023.

(Section

3-102.3(e) of the Act)

h)

This

Section does not impact, limit, or constrict a resident's right to or usage of

his or her personal property or electronic monitoring under Section 2-115

of the Act

of Section 300.282.  (Section 3-102.3(e) of the Act)

g)

Implementation

of an administrative penalty as a Type "C" violation under this

subsection will not be imposed prior to January 1, 2023.

(Section

3-102.3(e) of the Act)

h)

This

Section does not impact, limit, or constrict a resident's right to or usage of

his or her personal property or electronic monitoring under Section 2-115

of the Act.  (Section 3-102.3(g) of the Act)

i)

Specific

protocols and procedures shall be developed to ensure that the quantity of

assistive and supportive technology and devices maintained on-site at the

facility remains sufficient, at all times, to meet the assessed social and

activity needs and preferences of each facility resident. Residents' family

members or caregivers shall be considered, as appropriate, in the assessment

and reassessment.

(Section 3-102.3(h) of the Act)

j)          No

administrative penalty shall be imposed against a facility for internet

bandwidth limitations or internet access barriers beyond the control of the

facility, such as a natural disaster.

k)

Nothing

in this

Section

shall be interpreted to mean that addressing the issues

of social isolation shall take precedence over providing for the health and

safety of the residents.

(Section 3-102.3(k) of the Act)