COVID -19 Management Policy For Long Term Care Facilities - Department Health and Social Services (DHSS)
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COVID -19
Management Policy
For
Long Term Care
Facilities
Department Health
and Social Services (DHSS)Contents
Introduction ..................................................................................................................................................................... 3
How to use ........................................................................................................................................................................ 4
Alert Table for LTC Facilities..................................................................................................................................... 6
Glossary............................................................................................................................................................................ 11
Screening ......................................................................................................................................................................... 13
Symptoms........................................................................................................................................................................ 15
Testing for COVID-19 ................................................................................................................................................. 17
Reporting......................................................................................................................................................................... 18
Resident Movement .................................................................................................................................................... 19
Staff Movement and Cohorts ................................................................................................................................... 20
Managing Visitors ........................................................................................................................................................ 21
Routine Practices ......................................................................................................................................................... 22
Masking for Source Control ..................................................................................................................................... 22
References....................................................................................................................................................................... 23
Updated: August 27, 2021Introduction
Individuals over 60 years of age and those with certain pre-existing health conditions and living in
congregate settings such as long-term care (LTC) are the most at risk for severe outcomes from
COVID-19. Vaccination is an important prevention tool in keeping COVID-19 out of our LTC facilities
and it is highly recommended that all staff, residents and visitors are fully vaccinated. Vaccination
against COVID-19 does not stand alone and as the pandemic evolves, it is important to maintain
strong protections within LTC settings to minimize the introduction and risk of virus transmission
and spread.
It is challenging to balance diligence in protecting our residents with the recognition that
socialization and activity are an important part of quality of life. With the threat of COVID variants
ever-present, this policy was created to ensure that our LTC residents are protected, even with the
national/territorial easing of restrictions, travel, and opening of boarders. These are to ensure that
seniors and other vulnerable individuals living and working in these congregate settings are kept as
physically safe as possible, mitigating the risks of COVID -19, as well as other infections. This policy
applies to facility managers, staff, visitors, residents and volunteers who all have a part in preventing
the spread of respiratory viruses, including COVID-19, among seniors and vulnerable groups.
This territorial policy will guide the Health and Social Services Authorities (HSSA’s) in the
development of operational policies and procedures for the prevention and management of COVID-
19. Non-GNWT providers must meet, at a minimum, the Northwest Territories Health and Social
Services Authority (NTHSSA) requirements but can be more restrictive if deemed necessary.
Early detection and immediate implementation of control measures are two of the most important
factors in reducing the impact of an outbreak.
Health care professionals (HCPs) must report all suspect outbreaks to OCPHO immediately by
telephone at (867) 920-8646.
3 Updated: August 26, 2021How to use
This policy provides a framework for LTC facilities in the Northwest Territories to use while
addressing individual situations that arise within their facility, and/or community, and/or region.
Risk assessments are to be completed by the facility manager and care staff using the most current
Public Health information on epidemiological risk within the territory or community.
The directions in this policy set the requirements for all LTC facilities for operationalizing and
developing policy around the increasing or easing of restrictions during the COVID-19 pandemic and
when public health emergency measures are in place. These expectations apply to all staff,
volunteers, designated family/support persons and essential visitors, including any person
employed or contracted by the site, any GNWT employee working within or visiting the site (e.g.,
home care, OT/PT) or other service provider.
This policy document includes guidance for NWT LTC facilities using alert levels (green, yellow, red).
The colors represent COVID-19 activity levels that will impact decision making for LTC in the NWT.
These decisions will be made by LTC Managers/Directors and the Territorial Manager Continuing
Care, with support from Seniors and Continuing Care division and OCPHO. The following steps are
recommended:
Step 1 Identify which alert level your LTC facility is in referring to the color guide below and
in discussion with HSSA senior leadership.
Step 2 Consult the Alert Table on pages 6-9, which summarizes COVID-19 measures and
restrictions related to visits and any applicable measures and/or restrictions.
Step 3 Review the description of the type of visit, facility, visitor and/or resident
requirements as outlined in this guidance document
A change in level will be reported to Seniors and Continuing Care Services and OCPHO.
Step 4
DHSS contacts are identified as:
o Manager, Senior’s Affairs: Karin Bucher
(Karin_Bucher@gov.nt.ca/867-767-9030 ext. 49208)
o Senior Nursing Consultant, LTC: Soura Rosen
(Soura_Rosen@gov.nt.ca/867-767-9030 ext. 49316)
Updated: August 27, 2021Green (Caution): Low level of COVID-19 activity to no activity in the community or
region
(Restricted/Caution): Moderate level of COVID-19 activity in the community,
Yellow
region or as directed by OCPHO.
Red (Critical): High level of COVID–19 activity in the community, region or as
directed by OCPHO.
Note: This scale can be subjective based on environmental factors such as immunization rates (staff,
residents, community members), and geographic location. The alert level of the facility is determined
in collaboration between the HSSAs, OCPHO and DHSS.
Note: in the case of a LTC facility outbreak, LTC facilities will follow the Interim Outbreak
Management of Coronavirus Disease (COVID-19) in Long Term Care Facilities
5 Updated: August 26, 2021Alert Table for LTC Facilities
The Alert Table provides a quick reference of applicable measures within LTC facilities for each alert
level. This table is intended as a framework only. Based on the risk assessment, OCPHO may reinstate
any restrictions in the absence of a Territorial Alert Level change.
COVID-19 Measures for the Northwest Territories
WHO PUBLIC HEALTH ALERT LEVEL
MEASURE GREEN YELLOW RED
SCREENING Active Active Active
VACCINATION It is highly recommended that all staff, residents, and visitors are fully
STATUS vaccinated against COVID-19. HSSAs have policies and protocols to
address vaccination status of staff
TESTING HSSA’s have policies and protocols in place outlining a robust testing
strategy of all staff regardless of alert level or vaccination status
PPE Medical Grade Medical Grade Mask – Medical Grade Mask –
STAFF
Mask – continuous use continuous use
continuous use
Eye Protection – based Eye Protection –
on PCRA (continuous use continuous use
an option)
TRAVEL As per Mandatory Public Health Order
MOBILITY Recommend Restricted to one facility Restricted to one facility
only working in if unvaccinated or
one facility partially vaccinated
PHYSICAL
2 meters apart at all times (except when providing direct resident care)
DISTANCING
SCREENING Once daily Twice daily Twice daily
&
Upon leaving
and returning
from pass
VACCINATION It is highly recommended that all staff, residents, and visitors are fully
RESIDENTS
STATUS vaccinated against COVID-19
TESTING Test if any resident has symptoms of COVID-19, or if there is a clinical
suspicion of COVID-19 or related to screening questions (e.g., travel,
exposure, etc.)
MASKING Recommended Recommended Recommended
Where use of PPE is
unsettling to the resident
due to medical or cognitive
reasons, it is acceptable to
Updated: August 27, 2021WHO PUBLIC HEALTH ALERT LEVEL
MEASURE GREEN YELLOW RED
remove PPE if physical
distancing can be
maintained
PHYSICAL Residents who are not on isolation should 2 meters apart at all
DISTANCING not be restricted from visiting each other in times
natural, self-directed ways in the building
ADMISSIONS & No testing Negative COVID-19 test Negative COVID-19 test
TRANSFERS required; no
droplet/contact Vaccinated: Decision to admit or
precautions social distancing, hand transfer is made in
required hygiene consultation with
Territorial Continuing
Partially or unvaccinated Care Manager
or coming from an area
of COVID-19 activity:
Droplet/contact isolation
precautions
If a resident is transferring from (or visited) a health care facility/unit
that had an outbreak, the resident must be tested and placed on 14
days droplet/contact precautions
OFFSITE Offsite Passes Limited Offsite Prohibited except for
PASSES are Permitted for essential medical essential medical only
only
Active
Screening: • No visitation offsite
RESIDENTS
• Of visitor • No overnight or
accompanyin extended passes
g resident on
pass
Active Screening:
• Of resident
prior to • Of resident prior
leaving to leaving facility
facility and and upon return to
upon return facility
• Daily self-
checks for Perform PCRA upon
duration of resident’s return to
pass if it is an
assess the risk and
extended or
determine appropriate
overnight
pass control measures
Perform PCRA Ensure all mobility aids
upon resident’s cleaned upon resident’s
return to assess return to facility
the risk and
determine
appropriate
control
measures
7 Updated: August 26, 2021WHO PUBLIC HEALTH ALERT LEVEL
MEASURE GREEN YELLOW RED
Ensure all
mobility aids
cleaned upon
resident’s
return to facility
*Residents are
permitted to
have overnight
and weekend
visitation
PETS Permitted Permitted
(Resident or
Facility-Owned) Facility-owned pets should be confined to one area
of the LTC facility.
RESIDENTS
Ensure pets do not have access to residents with
COVID-19. Resident owned pets should remain with
owner if possible.
If a pet was exposed to COVID-19, remove the pet
temporarily from the facility. Precautions should be
taken for 14 days after the animal’s last exposure.
SCREENING Daily
VACCINATION It is highly recommended that all staff, residents, and visitors are fully
STATUS vaccinated against COVID-19. Visitors will be asked of their current
vaccination status and dependent on the alert level, may not be allowed
VISITORS
entrance into the facility (unless prior approval from HSSA).
TESTING HSSA’s have policies and protocols in place outlining a robust testing
strategy of visitors regardless of alert level or vaccinations status
MASKING Continuous Masking
PHYSICAL Maintained to 2 meters apart at all times (except when providing
DISTANCING the greatest direct resident care)
extent possible
VISITORS
FACILITY ACCESS Single entry point per facility which allows for logging and screening
PALLIATIVE Permitted, as Permitted on a case-by-case basis by HSSA
per HSSA
Guidelines
Updated: August 27, 2021WHO PUBLIC HEALTH ALERT LEVEL
MEASURE GREEN YELLOW RED
DESIGNATED/ Permitted Permitted
ESSENTIAL *Limited to 2 designated visitors, from the same
VISITORS household, fully vaccinated
GENERAL Permitted Prohibited Prohibited
VISITORS
VOLUNTEERS Permitted Prohibited Prohibited
PROGRAMMING Permitted, Prohibited
*see definition in following IPAC
Glossary protocols &
HSSA Visitor
Guidelines
VISITING PETS All visiting pets Prohibited
(family pets,
therapy pets) (Only pets that reside in the facility are permitted)
must be
designated to
one facility only.
Pet Screening:
ensure pets are
healthy and
have not been
exposed to
anyone who is
required to
isolate due to
COVID-19 in the
last 14 days.
9 Updated: August 26, 2021WHO PUBLIC HEALTH ALERT LEVEL
MEASURE GREEN YELLOW RED
All measures
apply to the
individual
accompanying
the pet
(including but
not limited to:
screening,
masking, hand
hygiene,
physical
distancing).
Only
asymptomatic
residents and
residents not on
isolation are
permitted to
have pet
visitation.
FACILITY Single entry point per facility which allows for screening and logging of all staff, residents,
ACCESS volunteers and visitors
CLEANING & High touch surfaces cleaned and disinfected 4x daily and when soiled
DISINFECTION Low touch surfaces cleaned and disinfected once daily and when soiled
OUTBREAK Single lab-confirmed case in resident or staff
DEFINITION
Updated: August 27, 2021Glossary
Active Screening Temperature screening and recording and use of formal COVID-19
screening tool completed by staff.
COVID-19 Activity COVID-19 activity considers the multiple variables that would indicate
the presence of COVID in the community (e.g., positive cases, exposures
notices and wastewater signals).
Droplet/Contact Used in addition to Routine Practices for clients/patients/residents
Precautions known or suspected of having an infection that can be transmitted by
large infectious droplets, and via contact with an infectious person or
through contaminated items in the environment (indirect contact).
Designated/Essential Person identified by the resident or substitute decision maker as an
Visitor important support. May be a family member, friend, companion, support
worker, power of attorney/trustee, agent, legal guardian, or any other
person identified by the resident or substitute decision maker. As
designated partners in care, these individuals actively and regularly
participate in providing care and may support feeding, mobility, personal
hygiene, cognitive stimulation, communication, meaningful connection,
relational continuity, and assistance in decision-making.
Facility Outbreak One resident with confirmed COVID-19 (or staff member who tested
positive for COVID-19 and is known to have worked in the facility during
infectious period).
General Visitors Family or friends who visit for social reasons. This also includes service
providers who are not deemed essential and can be shut down during a
pandemic (e.g., hairdresser, contractors, clothing providers, etc.).
HSSA Health and Social Services Authority
High-touch surfaces Surfaces touched often. Examples include doorknobs, light switches, call
bells, handrails, phones, elevator buttons, tv remote, etc.
Indoor Anywhere inside the facility’s physical building; areas should be
identified within the facility to accommodate visits. Visits can occur in a
resident’s room if it is a private room and the space allows for physical
distancing parameters.
IPAC Infection Prevention and Control
11 Updated: August 26, 2021Isolation Separating and restricting the movement of an individual with symptoms
of COVID-19, potentially exposed to COVID-19 or who is confirmed to
have COVID-19 in order to decrease the risk of transmission to other
individuals.
Low-touch surfaces Examples include shelves, benches, windowsills, message or white
boards, etc.
OCPHO Office of the Chief Public Health Officer
Offsite Outings Offsite outings (either day or overnight). Extended passes are provided
for residents to leave facility for day or overnight visits.
Outdoor Visits occurring in designated areas on the facility’s outdoor premises,
such as garden or yard.
Passive Screening An individual doing a daily self-check to determine if they have any
symptoms of COVID-19.
Pets Pets are defined as but not limited to companion animals such as a cat,
dog or ferret. No farmed or wild (captive) animals are permitted to live
or visit in the LTC facility. For more information about pets and COVID-
19, please refer to the website noted under the reference section of this
policy document.
Point of Care Risk A strategy used by staff of the LTC facility in advance of any interactions
Assessment (PCRA) with the resident or resident environment or upon resident return to the
facility, to determine appropriate PPE and control measures. An
evaluation of the interaction of the health care provider, the resident’s
and the resident’s environment to assess and analyze the potential for
exposure to infectious disease.
Programming For the purpose of this policy document, programming refers to any
programs or services offered through the LTC facility to individuals not
considered residents. This includes the Elder Day Program, meal
programming (e.g. Meals-On-Wheels) and use of the facility by Homecare
for bathing homecare clients.
The individuals (including homecare nursing staff) using the LTC facility
in this capacity are considered visitors to the facility and obligated to
undergo the same active screening and follow all public health measures.
Volunteers Volunteers are individuals not employed by the facility/Health Authority
who provide some type of unpaid service (e.g. run gift shop, deliver meals
on wheels, etc.).
Updated: August 27, 2021Screening
Active screening is completed for staff, residents, volunteers and visitors. Screening by inquiring
about symptoms or exposures to COVID-19, enables early detection and rapid implementation of
additional outbreak control measures. Any symptoms noted during the screening process will
prompt immediate assessment for testing for COVID-19 and isolation of residents or mandatory self-
isolation of staff and visitors. Note that other HSSA policy/guidance (i.e. OHS, IPAC) are in effect and
complement this policy.
Everyone entering the site must be screened. The following measure should be put in place:
• LTC facilities must place signs at all entrances to prompt staff and visitors to self-identify if
they have symptoms of COVID-19 (e.g. “passive screening”). Signage must advise that the LTC
staff will actively screen everyone as they enter.
• Screeners must be present at the entrance of the LTC facility to actively screen all individuals
(staff and visitors) before entering. If this is not feasible, there must be a method in place to
ensure control and monitoring of entry/exiting of the LTC facility and direct access to
screening (e.g. passive or self-screening).
• Screeners should be behind a physical barrier (e.g. plexiglass). If this is not possible, they
must wear personal protective equipment (PPE) as per HSSA policy/guidance and IPAC
policy/guidance.
• Emergency and first responders, who are wearing appropriate PPE, do not require screening
in emergency situations only. At all other times they must be screened upon entry to the
LTC.
• Screening must be documented in a log upon entry and leaving of the LTC facility (e.g., at
the beginningand end of the work shift or upon entering and leaving the LTC).
• LTC managers or delegates must maintain the log of all screening and provide it to the
OCPHO upon request if an outbreak is suspected.
• The screen should include symptom inquiry, temperature check, travel and exposure
history upon entry to the LTC, and a symptom inquiry upon exit or at the end of shift.
13 Updated: August 26, 2021Type of Person Active Screening Passive Screening
Emergency Response Must NOT be stopped to screen
Teams (Fire, Ambulance, Police)
Staff Screened prior to the start Self-checks for COVID-19
Service Providers of each worksite shift and symptoms daily plus
Temperature check ½ way immediately prior to any shift
through the shift or end of
the shift
Essential Visitors, Screened upon entering Staff to educate visitors on
General Visitors and importance of passive
Volunteers, screening prior to entering and
upon leaving the facility
Residents Screened 1x/day in green A resident screening tool
alert level should be provided to the
resident for their reference.
Screened 2x/day during
yellow alert level and
2x/day during red.
Screening is documented in
the screening log.
Possible Exposure to COVID-19 in the last 14 days include:
• A contact of a confirmed or probable case; OR
• Returned to Canada from outside the country; OR
• Returned to the NWT from within Canada
(pertains to partial or unvaccinated staff and essential visitors); OR
• Travelled to an affected area (i.e. community spread within the NWT)
• Is a close contact of a person who had an acute respiratory illness who returned from travel
outside the NWT in the previous 14 days before they became sick; OR
• Participated in a mass gathering identified as a source of exposure (i.e. a conference); OR
• Lived, worked, trained or volunteered in a closed facility experiencing a COVID-19
outbreak; OR
• Had laboratory exposure to biological material (e.g. primarily clinical specimens, virus
culture isolates) known to contain COVID-19
As a precautionary measure, if LTC staff or visitors are a household member of any person with a
possible exposure to COVID-19, as listed above, they are considered as having exposure as well.
Updated: August 27, 2021Symptoms
Symptoms of COVID-19
Symptoms of COVID-19 in elderly residents may be subtle or atypical. Staff performing daily screening
should be sensitive to detection of changes in the resident from baseline and have a low tolerance for
assessment and testing for COVID-19.
Fever (37.80C or higher)
The Public Health Agency of Canada states that for LTC populations, some resources suggest that repeated
temperatures >37.2°C or an increase in temperature of 1.1°C over baseline may represent fever in older
adults; fever may also be absent.
Any new or worsening respiratory symptoms:
• Cough
• Shortness of Breath/Difficulty Breathing
• Runny Nose
• Sneezing
• Nasal Congestion/Stuffy Nose
• Hoarse Voice
• Sore Throat/Painful Swallowing
• Difficulty Swallowing
Any new symptoms including but not limited to:
• Chills
• Muscle/Joint Ache
• Nausea/Vomiting/Diarrhea/Unexplained Loss of Appetite
• Feeling Unwell/Fatigue/Severe Exhaustion
• Headache
• Loss of Sense of Smell or Taste
• Conjunctivitis
• Altered Mental Status
• Delirium
• Increase Falls
• Loss of Orientation to Surroundings
• Onset Incontinence
• Sleepiness/Sleep Disturbances
• Increased Agitation
• Chest Pain
• Abdominal Pain
• Hemoptysis
• General Change in Behavior or Level of Consciousness
15 Updated: August 26, 2021Any staff or visitor showing symptoms of COVID- If a resident exhibits any symptoms of COVID-19 or
19 must: there is a concern for COVID-19 exposure:
• Be excluded from the LTC and advised to go • ISOLATE RESIDENT IMMEDIATELY until test
home and immediately self-isolate. result is known.
• Contact their local public health unit or • Immediately initiate contact and droplet
community health center for investigation and precautions.
follow-up of symptoms.
• Complete testing for COVID-19 as per testing
• Staff must follow guidance from their employer section below.
and WSCC before returning to work.
• Notify Public Health and OCPHO at (867) 920-
• Once an individual has passed the screening 8646 and complete the appropriate forms.
and is able to enter the LTC home, they should
• Notify the Manager/COO and initiate contact
use hand sanitizer and the appropriate PPE, as
tracing with Public Health.
required/recommended by the
organization/HSSA.
• Anyone who has clearance to enter the LTC
should be advised to self-monitor and report
any symptoms immediately.
Updated: August 27, 2021Testing for COVID-19
Testing is in accordance with the most recent guidance for testing and reporting as per OCPHO.
OCPHO advises that health care professionals (HCPs) in LTC facilities must test for COVID-19 if any
residents have symptoms of COVID-19 which are not definitively attributable to another cause. HCPs
in LTC should strongly consider testing if atypical symptoms are present, or they have any other
clinical suspicion for COVID-19.
Not everyone who has COVID-19 will show symptoms. Studies suggest that people without
symptoms may cause up to 50% of COVID-19 transmission (Health Canada, 2021). You can help
reduce the risk of outbreaks by regularly testing and screening.
Although the Northwest Territories continues to vaccinate its residents against the COVID-19 virus,
it is still unknown how well vaccines prevent asymptomatic shedding of the infectious virus.
Individuals who are fully vaccinated can still contract and spread COVID-19, even when
asymptomatic. With increasing transmissibility and virulence of the Variants of Concern (VOC),
testing provides an extra layer of defense.
Due to the Variants of Concern, the HSSAs must ensure policies and protocols are in place
outlining a robust testing strategy, regardless of alert level and vaccination status.
https://www.hss.gov.nt.ca/professionals/sites/professionals/files/resources/covid-19-exposure-
algorithm.pdf
• Symptomatic individuals must be tested for COVID-19 and respiratory pathogen panel
(RPP) as soon as possible.
• If a decision to test a resident is made, the resident should be placed on contact/droplet
precautions.
• By completing a COVID-19 and RPP, identification of other causes of the respiratory
outbreak including influenza can be identified.
• Follow NTHSSA policy/guidance for swab collection based on recommendations by OCPHO.
• If symptoms began (previously asymptomatic), continued or worsened after receiving
negative test results, contact the most responsible practitioner (MRP) and Public Health
(PH) who may recommend repeat testing. The resident should be placed on
contact/droplet precautions. If the test is negative and the resident is still symptomatic, the
resident should remain on contact/droplet precautions until consultation with the MRP
and IPAC (resident may have another infectious virus e.g. influenza, parainfluenza).
• Once an outbreak is declared, HCPs should have a low threshold to test if any additional
residents, staff or visitors have any symptoms associated with COVID-19.
• Anyone with symptoms should be managed as a confirmed, probable or suspected case
(symptoms and close contact with a confirmed case) while waiting for their test results.
• Continue screening and monitoring of all residents and staff in the LTC for new symptoms.
17 Updated: August 26, 2021Reporting
Health Care Providers must:
• Notify OCPHO immediately by telephone at (867) 920-8646 for all confirmed or
symptomatic (suspect) staff, residents or visitors that testing is being completed on.
• Complete the required forms and submit to OCPHO within 24 hours by fax (867) 873-0442
or secure file transfer (SFT)
• Submit the required forms to OCPHO on all confirmed cases any time the disposition of the
case changes, and/or at a minimum of weekly by fax (867) 873- 0442 or SFT. This would
be done by the healthcare provider at the hospital if a resident was transferred or by public
health or community health if the positive case is a staff or essential visitor and is
recovering at home.
• Report to COO/CEO and Territorial Manager, Continuing Care immediately after notifying
OCPHO.
• Link to OCPHO Interim Outbreak Management of COVID-19 in Long Term Care Facilities
Updated: August 27, 2021Resident Movement
• For residents that leave the LTC for an essential out-patient medical visit, staff must follow
HSSA policy/guidance for providing an appropriate mask to the resident and PPE to staff.
o If tolerated, the mask must be worn by the resident while out of the LTC facility.
• Residents leaving LTC for non-essential visits will require Offsite Passes. In Yellow Alert,
Offsite passes are only permitted for essential medical purposes and prohibited in red alert.
Please refer to the Alert Table.
• Consultation with NTHSSA Territorial Manager of Continuing Care regarding the following:
o Transfers within and between facilities (this should be avoided unless medically
indicated).
o If an admission or re-admission is required.
o In situations when the resident is removed from LTC by the family to determine
re- admission.
• Contact/Droplet isolation will not be required for new admissions, re-admissions and
transfers to LTC based on alert levels - refer to table.
• When there is COVID-19 activity (alert levels yellow and red) or if an individual is coming
from a facility or region that is experiencing an outbreak of COVID-19, the facility must
notify OCPHO, and follow alert levels and HSSA policy/guidance.
• If a resident is coming/returning from out-of-territory, follow HSSA policy/guidance.
• After consultation, the NTHSSA Territorial Manager of Continuing Care may consider
testing residents for COVID-19 prior to their admission to the LTC.
19 Updated: August 26, 2021Staff Movement and Cohorts
• HSSA’s will have policies and procedures that addresses the following:
o Staff movement between facilities and/or other employment sites;
o The use of locum staff in LTCs, which considers their shared
housing/accommodations.
• Once a case of COVID-19 is confirmed in a region or community, only staff working in
facilities that use continuous masking will be permitted to work in LTC.
• Cohort staff as strictly as possible, e.g., staff working with symptomatic residents
or LTC residents who are on additional precautions must avoid working with
residents who are well.
• Perform a PCRA, follow the IPAC guidelines and use routine and additional precautions
when caring for residents when entering and cleaning resident rooms.
• Practice strict hand hygiene, healthy respiratory practices and physical distancing
Updated: August 27, 2021Managing Visitors
During the pandemic, allowing visitors into LTC puts residents and staff at risk. Policies and
procedures allowing visitors must be developed in order to protect residents and staff from
COVID-19 exposures. Limiting visitors may be one method to decrease this risk. Signage
directing whether visitors are permitted into the facility must be placed at all entrances to the
LTC and visible. The Department also recognizes the value of visitors and the role they play in
providing support to residents and their wellbeing and will consider allowing essential visitors
to enter LTC under certain circumstances.
HSSA should consider the following to prevent outbreaks in LTC for visitors:
• It is recommended that all routine visitations in LTC cease and policies and procedures
be draftedby HSSA’s to identify who is considered a general visitor, designated visitor,
volunteers and possible exceptions.
• Visitors should be limited to those outlined in the Alert Table starting on page 6. At every
visit, visitors are required to screen for symptoms and exposures (following the
guidance in the screening section of this policy document) and must sign in and out when
entering and leaving the LTC facility.
• Visitors will be asked of their current vaccination status and, dependent on the alert
level, may not be allowed entrance into the facility (unless prior approval from OCPHO
and HSSA).
• HSSA’s have policies and procedures in place to address vaccination status of staff,
visitors, residents and other individuals accessing LTC facilities.
• Staff are to provide support, education and monitor visitors for compliance in hand
hygiene, healthy respiratory practices, physical distancing and appropriate use of PPE
for the duration of their visit.
• Symptomatic persons or persons that meet the travel or exposure criteria in the last 14
days must not enter the LTC facility.
o The symptomatic or previously exposed visitor should be advised to wash their
hands, be given a mask, instructed to return home and to contact their public
health unit or community health center for further investigation and assessment.
21 Updated: August 26, 2021Routine Practices
IPAC best practices used by staff and essential visitors can reduce the risk of transmitting
COVID-19 and other infections to and from residents, staff and essential visitors in the LTC
setting. HSSA’s will have policies and procedures that address IPAC practices. Additional
recommendations include but are not limited to:
• Signage is visible and placed in strategic locations throughout the LTC facility:
o Reminders for hand hygiene, healthy respiratory practices, physical distancing,
and proper mask use,
o Steps to be taken if COVID-19 is suspected or confirmed,
o Locations of alcohol-based hand sanitizers, no touch waste receptacles and
cleaning/disinfection supplies and,
o Visitation procedures.
• Staff must be trained in HSSA’s IPAC measures including performing PCRA in advance of
any interactions with residents, proper hand hygiene, use of PPE and the importanceof
maintaining a 2-meter distance between themselves and residents when not performing
direct care.
• It is recommended that HSSA’s ensure staff are monitored for compliance with
appropriate IPAC measures on a regular basis
• Visitors should be instructed on proper hand hygiene and the use of PPE and provided
teaching on the importance of physical distancing and healthy respiratory practices.
• Access to alcohol-based hand sanitizer, no touch waste receptacles and PPE must be
provided inresident care areas and other strategic locations within the LTC.
Masking for Source Control
Continuous masking aims to prevent asymptomatic/pre-symptomatic transmission between
staff, residents and visitors within the LTC facility. Continuous masking applies whether the LTC
is in an outbreak or not, and the practice of masking for source control must be in accordance
with HSSA’s policies and procedures.
To facilitate judicious and effective use of masks the following are recommended as best
practices. LTC staff should:
• Follow policies and procedures regarding mask usage and allocation,
• Don the mask when entering the LTC and remove or exchange it during breaks,
when it becomes damp or soiled or when leaving the LTC at the end of the shift,
• Perform hand hygiene before putting on and after removing the mask and
• Remain two meters away from others during breaks.
If tolerated, masks are recommended for use by residents when travelling outside of the LTC
to attend appointments and when in the same room as a visitor or staff.
Updated: August 27, 2021References
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https://open.alberta.ca/publications/cmoh-order-16-2021
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19-Presentations-in-Frail- Older-Adults-U-of-C-and-U-fo-T.pdf
25 Updated: August 26, 2021September 1, 2021
Karin Bucher Date
Acting Director, Seniors and Continuing
Care Services
September 1, 2021
Jo-Anne Cecchetto Date
Assistant Deputy Minister, Health &
Social Services
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