IDH Update to Essential Family Caregivers (EFCs)

Applicable to NFs, LRCFs, Unlicensed AL The decision to designate an EFC should be individualized and integrated with person-centered care planning. Realizing both the potential benefits and risks of allowing additional “essential” caregivers into the building, LTCFs should carefully consider the current status of COVID-19 in their facility and local communities prior to designating EFCs. If LTCF residents have been cohorted by COVID-19 status, EFCs are allowed in COVID-19 negative (green) areas only; an exception to this requirement is if the essential family caregiver has had COVID-19. is no longer transmissible and is within 90 days of their previous symptom onset date. Essential Family Caregiver (EFC)

  • Designation is at the sole discretion of the LTCF executive director (or designee) and only upon agreement by the resident (and/or their representative). This designation and agreement should outline what support will be provided by the EFC.

  • A family member or other outside caregiver (e.g., friend, volunteer, private personal caregiver) age 18 or older who can provide regular (at least twice weekly) care and support to the resident.

  • Schedule and amount of time in facility agreed upon in advance and no more than 2 hours per day (e.g., daily for 1 hour from Noon-1 p.m.).

  • Provides care and support similar in nature as provided to residents by family members and other outside caregivers before the pandemic (e.g., help with meal set up, grooming, and companionship).

  • A mask must be worn at all times while in the building, and frequent hand hygiene performed (other PPE may be required depending on care provided). If the support to be provided requires additional PPE, the EFC should meet with the facility’s infection control lead to be instructed on proper use prior to providing support.

  • Physical distancing must be maintained with staff and other residents while in building.

  • Sign-in upon arrival with screening as required of facility staff; agree to monitor their own symptoms and limit contacts outside the facility.

  • A negative COVID-19 test is required before the EFC may be scheduled for support, and the EFC is subject to any regular testing required of facility staff.

Restriction or revocation of EFC status is at the sole discretion of the LTCF executive director (or designee), for example, of an individual who fails to follow physical distancing, PPE or other COVID-19 related rules.


As part of your pre-planning and communication with EFCs HOPE encourages providers to:

  • Provide basic infection control training and PPE usage and training

  • Education on facility parameters and guidelines for EFCs

Complete details of the update of Essential Family Caregivers in Long-term Care Facilities


IDH Updates to Visitation Guidelines for Long Term Care Facilities (11/22/20) Applicable to NFs, LRCFs, Unlicensed AL and these important updates are found here: Visitation Guidelines for Long-term Care Facilities IDH Updated COVID-19 LTC Facility Infection Control Guidance SOP (11/22/20) Find the updated SOP here: COVID-19 LTC Facility Infection Control Guidance SOP

  • Adds gown conservation for yellow zone

Clinical Nurse Observers Most, by now, are aware that the Indiana Department of Health has hired registered nurses to perform observations in nursing facilities across the state. HOPE along with the other trade association asked for more information about this program and understands the visits should take about 2 hours. This is a copy of the observation tool used by the nurses while in your facility. IDH Issues Infection Prevention FAQ The Indiana Department of Health (IDH) issued Infection Prevention FAQs for all long-term care facilities. This is an important document and recommend all long-term care facilities to review this FAQ document carefully. Find the complete details here. Questions regarding the FAQ document may be emailed to Jennifer Spivey at jspivey1@isdh.in.gov.

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Hoosier Owners & Providers for the Elderly

HOPE is an association representing providers of services for older adults. Our members consist of for profit and non-profit owners and providers of health care and housing services throughout Indiana. Our members include: Post Acute Care Providers, Hospital Owners, Continuing Care Retirement Communities, Assisted Living Providers and Senior Housing Apartments.

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