Guidelines to Prevent and Control the Spread of COVID-19

The general strategies CDC recommends to prevent the spread of COVID-19 in healthcare facilities are the same strategies to detect and prevent the spread of other respiratory viruses like influenza. If there is a concern that a resident, visitor, or employee may be a COVID-2019 patient under investigation the facility should contact their local or state health department immediately for consultation and guidance. Following the guidelines below will ensure protection of personnel and prevention of the spread of the infection.

Updated: 4/19/20

 

Community Visitation

  1. In light of the rapid developments regarding the highly contagious COVID-19 and the potential risk posed to our fragile resident population and associates; we are taking the precaution of limiting visitation of family members to our community until further notice. On a case by case basis families will be allowed visits for a hospice resident in crisis, expectation of death within 72 hours. This allowance must be approved by the Director of Resident Care or Executive Director in collaboration with Hospice appointed physician or Hospice nurse.
  2. Visitor by written allowance will be required to:
    1. Take temperature – if above 100.0 degrees F. or higher visiting will be prohibited
      1. If temperature is between 99 and 100.0 degrees F, individual must wear a face
        mask.
    2. Wash hands before and after visit
  3. Supply Vendors (including USPS) are to drop supplies outside the community, they are not to enter the community without written permission from VP of AL Operations or Senior VP of Operations.
  4. Visitation will be only open to:
    1. Emergency personnel,
    2. Diagnostic related personnel, example: lab, mobile X-ray,
    3. Physicians – sick visits
    4. Government/State agency personnel
  5. All group activities are cancelled. Resident activities will be provided in resident apartments.
  6. Beautician services have been discontinued.
  7. Community in person tours are discontinued until further notice.
    1. Tours may occur electronically through FaceTime, Video Tour or Web Conference
    2. Video from Alex to prospects sent 3/20/20-3/21/20
    3. Letter sent to prospects 3/21/20-3/22/20 as a follow-up to Alex’s video
  8. Window visitation is not permitted if the window is open at all; a window screen is not an effective barrier.
    1. Window visitation may be confusing to a Memory Care resident.
    2. Nevada Only
      1. In addition to the allowances stated above:
        1. Allow home health agency personnel to provide necessary skilled nursing,
          therapy, hospice and social services for their residents.

 

Family Communication

  1. Daily community/family conference calls began 3/16/20 in order to increase communication.
  2. Video conferencing offered to families and residents.
  3. COVID-19 CDC reference packets were sent to families.
  4. Letters sent to families regarding visitation restrictions and what we are doing to protect the residents.
  5. Video from President/CEO sent to families 3/21/20-3/22/20.
  6. Communities should also continue to use CDC recommended signage reminding people that anyone with symptoms of respiratory illness should not enter the facility, including employees, government officials and contractors. Please ensure all hand washing signage is visible in every restroom and at every hand wash sink with the appropriate soap and paper towels and a covered waste receptacle.

 

Associates

  1. Daily update calls are conducted with the corporate team, Executive Director’s and Directors of Resident Care.
  2. All associates must wash their hands and practice universal precautions as per CDC guidelines and policy & procedures.
  3. Check for any signs of illness before reporting to work each day and notify your supervisor immediately of your symptoms.
  4. Every associate must complete screening and acknowledgement of information regarding Covid-19 at once.
  5. An associate log tracks associates who work in additional communities.
  6. Every associate must be screened daily upon entry to the community utilizing a COVID-19 associate daily screening form, including their recorded temperature.
    1. Associate temperatures will be taken and recorded on the associate temperature log every four hours while at work.
    2. Any associate that present with a cough or other respiratory symptoms will have their temperature taken by the nurse using infrared thermometer, forehead thermometer or disposable Tempa*Dots.
  7. A COVID-19 Associate/Visitor binder is maintained in each community.
  8. An associate incident report is completed for any associate who displays symptoms or notifies the community representative of potential COVID-19 exposure. Please ensure number of ideas of self-isolation; 72 hours, 7 days or 14 days. Please provide the 14 day COVID-19 fever & symptom monitoring log to the associate.
  9. If an associate develop symptoms while at work, the employee should stop working, put on a mask immediately and notify their manager or the nurse.
  10. All direct care associates are to wear a mask while in the community.
  11. Associate break times should be scheduled to allow for social distancing.
  12. Dietary Associates are not to leave the kitchen area. Upon reporting to work they are to be screened and report directly to the dietary department. The DDS office can be utilized for dietary associate breaks. Breaks should be spaced so only one dietary associate is on break at a time to allow for social distancing. A community restroom will be designated for Dietary associates only.
    1. Flyer to be posted on designated dietary restroom.
    2. Servers can serve to resident apartments, they should not enter the kitchen or utilize the designated dietary restroom. Servers should wear a mask when delivering resident meals.
  13. Any associate that has worked in another location with confirmed or suspected cases must report this to the Director of Nursing or their immediate supervisor.
  14. Follow HR sick leave policies that allows associates to stay home if they have symptoms of respiratory infection.
  15. Any associate that has visited out of state or another country must report to the Director of Resident Care or Executive immediately. They will also self-isolate for 7-14 days.
  16. Associates are offered free meals during their shift to minimize external exposure.
  17. 17. A blackout period has been implemented for associate vacation requests. Any scheduled vacations are to be cancelled.
  18. Community supply totals are uploaded to a corporate portal daily.
  19. Recruiting efforts have been ramped up, front line associate postings have been sponsored on Indeed.
  20. Community Orientation was abbreviated, while meeting state requirements, to allow for prompt onboarding of new associates.
  21. Essential associate letters pertaining to COVID-19 were sent to all associates through PC Payroll and emailed to community Executive Director’s.

 

Residents

  1. Resident temperatures are taken/documented daily as well as a progress note indicating if the resident shows any signs or symptoms of fever, cough or shortness of breath.
  2. Communities ordered 7 additional days of emergency food supplies to increase community emergency food supplies to 10-11 depending on state regulations.
  3. Assisted living dining rooms are closed.
    1. Assisted living residents should be served in their apartment utilizing regular dining plates, glasses, etc. when possible to maintain disposable supply.
    2. Room service times will need to be established per hall or floor.
  4. Paper napkins, disposable flatware and disposable cups should be utilized in all communities.
  5. Memory care residents should be served in their apartments if it is safe to do so.
    1. Room service times will need to be established per hall
    2. For applicable memory care residents, if it is unsafe for them to eat in their room, additional dining times need scheduled.
      1. Tables at least 6 feet apart
      2. 1 person per table.
      3. Flatware, napkins, etc. should not be placed on a table until the resident is seated.
      4. Dining tables should be cleared of table tents, centerpieces and condiments.
      5. Poet’s Walk communities can take condiment requests when delivering plates (if the resident is eating in the dining room for safety reasons).
      6. Sanitizing of the dining room is to be ongoing. Following each meal service dining room tables, chairs, counter tops, etc. must be sanitized.
  6. Common area snacks/refreshments should be removed from common areas & are available upon request.
    1. A schedule is to be developed by 3/22/20 for delivering snacks and fluids to residents during specific time ranges.
  7. Group activities and outings are cancelled (Note: this does NOT apply to residents who need to leave the building for medical care such as dialysis, medical visits, etc.).
  8. Offer alternative means of communication for people who would otherwise visit their loved one. Example: FaceTime, phone, etc.
  9. COVID-19 tests have been ordered (20 per community) and will be available Tuesday, March 24, 2020. Clarification on utilization will be provided, do not use prior to ensuring clarification.
  10. If a resident is displaying symptoms of COVID-19 please call ahead to report prior to transfer.

 

Admissions

Prior to Move-in:

  1. Resident must complete the following form:
    1. 24hours prior to move-in – New Resident Screening & Acknowledgement of Information regarding COVID-19 (coronavirus)
    2. Day of move-in must complete New Resident Screening Checklist COVID-19
    3. Review the referral to assess, screen and evaluate residents with potential signs and symptoms of respiratory infections to enable the facility to prevent and control COVID-19.

Day of Move-In

  1. Upon Move-in the resident will be self-quarantine for a period of 72 hours; this will
    include the following provisions:
  1. All meals will be delivered and consumed in the residents apartment
  2. Individual based activities
  3. Vitals taken daily to include; Temperature, O2 saturation
  4. Acuity documentation for 72 hours each shift.
  5. Progress Note Documentation to include resident respiratory status at each entry.
    Example: Resident is observed without cough, shortness of breath or other respiratory symtoms….
  6. Individualized Service Plan will reflect the 72 hour monitoring for selfquarantine.
  7. Assess resident’s symptoms of respiratory infection upon admission including the symptoms of COVID-19 (fever, cough and shortness of breath) to the facility and implement appropriate infection prevention practices for incoming symptomatic residents.

Prevent the introduction of respiratory germs INTO the community

  • Post signs / visual alerts at the entrance providing information on hand hygiene, respirator hygiene, cough etiquette and instructing essentials visitors not to visit if they have symptoms of respiratory infections.
  • Post signs related to COVID-19 including information to speak to the receptionist or nursing supervisor if they have any questions or concerns.
  • Encourage staff and residents in getting flu vaccine, taking everyday preventive actions to help stop the spread of germs, and taking flu antivirals if prescribed.
  • Ensure supplies (tissues, waste receptacles, and alcohol based hand sanitizers) are available.
  • All essential visitors need to sign in and out of the facility and the compliance of this should be monitored by the Executive Director of the community.
  • Follow HR sick leave policies that allows employees to stay home if they have symptoms of respiratory infection.

 

Prevent the spread of respiratory germs WITHIN the community

  • Keep residents and employees informed.
    • The Director of Resident Care/Designee will be answering questions and explaining what they can do to protect themselves and their fellow residents.
  • Monitor residents and employees for fever or respiratory symptoms.
    • Restrict residents with fever or acute respiratory symptoms to their room. If they must leave the room for medically necessary procedures, they must wear a facemask (if tolerated). The Director of Resident Care will follow the CDC criteria to guide evaluation of Persons under Investigation, (PUI) for COVID -19.
    • In general, for care of residents with undiagnosed respiratory infection use Standard, Contact, and Droplet Precautions with eye protection unless suspected diagnosis requires Airborne Precautions (e.g., tuberculosis).
    • Director of Resident Care should monitor their local and state public health sources to understand COVID-19 activity in their community.
    • If there is transmission of COVID-19 in the community, in addition to implementing the precautions above, the Director of Resident Care or the Executive Director will consult with local public health officials.
  • Support hand and respiratory hygiene, as well as cough etiquette by residents, visitors, and employees.
    •  Ensure employees clean their hands according to CDC guidelines.
    • Alcohol-based hand rub is available in the community.
    • Make sure tissues are available and sink is well-stocked with soap and paper towels.
  • Identify dedicated employees to care for resident under investigation of COVID -19 and or who have confirmed COVID-19 residents and provide infection control training.
  • Provide the right supplies to ensure easy and correct use of PPE.
    • Post signs on the door or wall outside of the resident room that clearly describe the type of precautions needed and required PPE.
    • Make PPE, including facemasks, eye protection, gowns, and gloves, available immediately outside of the resident room.
    • Position a trash can near the exit inside any resident room to discard PPE.
  • Water fountains cleaned, disinfected, turn off water and power supplies and label the unit out of order.

 

Prevent the spread of respiratory germs BETWEEN facilities

  • Notify facilities prior to transferring a resident with an acute respiratory illness, including suspected or confirmed COVID-19, to a higher level of care.
  • Report any possible COVID-19 illness in residents and employees to the local health department.
  • A log was created to track associates who work in additional communities.

Policy: Prevention and Control of the Corona Virus – COVID-19

Spring Hills Senior Communities, LLC 2020