10-18-2021 Covid-19 Update

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October 18, 2021

Hi Everyone,

We received great news yesterday afternoon!  All of our staff swabs have come back as negative.  We notified the local health department, who then notified the State Health Department, and we were removed from Outbreak status.  We now go back to previous protocols.  Visitation goes back to our usual protocols prior to the outbreak.  See below. 

Thanks!   Angie

VISITATION POLICY AND PROCEDURE    

Purpose:

To provide a safe and sanitary environment in which all resident’s and families are able to visit and see each other during the current COVID-19 health crisis.

Visitor Testing and Vaccination:

The risks associated with visitation will be explained to visitors and residents prior to the visitation commencing.  They will make an informed decision regarding visitation.

The facility strongly encourages but does not require visitors to comply with testing.  Facility will request visitors to complete COVID-19 testing approximately 72 hours prior to visitation or the Facility will offer testing prior to visit. 

All visitors must don/apply a well-fitting surgical mask upon entrance to the facility.  If visitor does not have a mask, the facility will provide a mask. 

Children of any age may visit.  Any child above the age of 2 will wear a mask.  Any child below the age of 12 will be accompanied by an adult.  One adult per child. 

The facility encourages visitors to become vaccinated when they have an opportunity. 

***Residents requiring Transmission Based Precautions should only receive virtual or window visits or Compassionate visits with adherence to Infection Control Measures.

Procedure for Visitation:

  1. The Facility will permit resident visitation under the following guidance: 
  2. All visitors must screen at the entrance of the building and be asked to complete a release form.
  3. All visitors will be asked to provide documentation of their COVID Vaccine status at each visit.  If visitor is fully vaccinated, In-Room Visitation will be allowed.  If unable to provide vaccination documentation, Facility will accommodate visit in designated visiting area.  Copies of vaccine records will not be maintained by facility.  Visitors must present their vaccination documentation at each visit.
  4. The facility does not require but strenuously encouraged all visitors to be tested for COVID 19 prior to their visit.  The facility will provide testing to all visitors.
  5. All visitors and residents must complete hand hygiene before and after all visits. 
  6. Visitors who fail any screening, or who do not follow guidance or facility protocol during their visit will be asked to leave promptly.  The resident involved will then be placed in Observation for at least 14 days on Droplet  and Contact Precautions. 
  7. Any resident who is currently under Droplet/Contact Isolation Precautions, will not be able to utilize in-person visitation.  They will receive virtual or window visits or Compassionate Visits (approved by Nursing Management only) with adherence to Infection Control Measures.
  8. The facility reserves the right to eliminate or further restrict visitation based on the outbreak status of the facility.
  9. When a new case of COVID is detected in either resident or staff, the facility will begin Outbreak Testing.  If the first round of testing (1POC and 1PCR for staff and 1PCR for resident) reveals no additional cases of COVID 19, then visitation can resume in resident areas not affected by positive cases.  If the first round of testing reveals one or more additional cases of COVID, then no Indoor Visitation will be allowed.  Continuation of Outdoor Visitation will be determined by Local Health Department. 
  10. If a resident is fully vaccinated, and their visitor/visitors are fully vaccinated, the visitor/visitors may go to the resident’s room for a private visit.   See below for further details regarding Vaccinated Res/Vaccinated Visitor guidelines. 
  11. If a resident if fully vaccinated, and their visitor/visitors are not fully vaccinated, they may have a visitor/visitors meet them in the lobby or outdoor patio for private visit.  See below for further details regarding Vaccinated Res/Unvaccinated Visitor. 
  12. If a resident is unvaccinated, they may have a visitor/visitors meet them in the lobby or outdoor patio for a private visit.  See below for further details regarding Unvaccinated Res guidelines.

Procedure for Vaccinated Res/Vaccinated Visitor:

  1. Vaccinated Res/Vaccinated Visitor visitation will be daily, from 9am to 8pm, Monday through Friday and 9am to 6pm, Saturday and Sunday.  Visitors do NOT need to schedule their visits.  They may come at will.
  2. We ask for no more than 4 visitors at one time.  Visitors may ‘tag in/tag out’ to allow for several visitors at one time.
  3. The vaccinated visitor will don a well-fitting surgical mask as they utilize the most direct access to the resident room.  Surgical masks will be provided by the facility.
  4. If the resident resides in a semi-private room, Nursing staff will remove the roommate prior to visitation.  The visit should last no more than 2 hours as a courtesy to the roommate and their needs.  The honor system will be used for time keeping of visits.   If the roommate is unable to leave their room due to health concerns, the visitation cannot occur in the resident room.  Another private area will be provided by the facility. 
  5. If the resident being visited is in a private room, there is no limit to length of visit except for 8pm close of visiting hours. 
  6. Visitors and Resident will don and maintain a well-fitting mask during the entire visit.
  7. The vaccinated resident and their vaccinated visitor are able to leave the resident room to visit on facility grounds (outside) ONLY, however, all parties must don well-fitting surgical masks provided by the facility.  They must also, utilize the most direct exit, while not loitering or visiting other parts of the building or other residents.  Visitors are not allowed access to any other areas of the building.  IE:  lobbies, activity areas, rehab, hallways
  8. Upon exiting the resident room at the end of the visit, the visitor will don a well-fitting surgical mask to exit the building and exit the building utilizing the most direct egress. 

Procedure for Vaccinated Res/Unvaccinated Visitor:

  1. Vaccinated Res/Unvaccinated Visitor visitation will be Monday thru Saturday from 9am to 12 noon and on Tuesday evenings from 6pm to 8pm. 
  2. Visitors will be required to schedule their visit with the Receptionist at 301-733-6284. 
  3. The preference for visitation site for unvaccinated residents is outside.  However, if the resident is unable to tolerate an outdoor visit, the visit may occur in the lobby.
  4. If an Outdoor Visitation is not optimal due to weather or resident condition, Residents may have an Indoor Visit except for a few circumstances when visitation will be limited due to a high risk of COVID-19 transmission.  Those circumstances include:  unvaccinated residents if the County Positivity rate is >10% (CMS and/or Washington County Health Department) and <70% of the residents in the facility are fully vaccinated, or residents with confirmed COVID-19 infection regardless of vaccination status and continue in Transmission Based Precautions (Droplet/Contact), or Residents in Quarantine regardless of vaccination status, until they have met criteria for release from quarantine or Facility is in Outbreak Status.
  5. Only 1 outdoor visit will be allowed at one time in each area to allow Facility staff to focus on maintaining correct protocols during visits. 
  6. Areas of Visitation: 

For SNF/Assisted Living: Back patio and front veranda 

For Memory Care:  Memory Care Patio

  1. Only 2 visitors permitted per visit.
  2. Each visit is limited to 45 minutes.
  3. Social Distancing will be required unless vaccinated resident able to give consent for physical contact.
  4. All unvaccinated resident visits will be supervised by Facility personnel to monitor the visit for appropriate use of PPE, Social Distancing.  Residents and their visitor will be afforded as much privacy as possible. 
  5. Visitors and Resident will don and maintain a well-fitting mask during the entire visit.
  6. Before and after each visit, Facility personnel will utilize the appropriate disinfecting products to sanitize the visiting area.   IE: bleach wipes, Quaternary ammonium, Effersan
  7. When all visits are completed for the day, EVS will again sanitize the area with the appropriate disinfecting solution.  IE: Quaternary ammonium or Effersan

Procedure for Unvaccinated Res:

  1. Unvaccinated Res visitation will be Monday thru Saturday from 9am to 12 noon and on Tuesday evenings from 6pm to 8pm. 
  2. Visitors will be required to schedule their visit with the Receptionist at 301-733-6284. 
  3. The preference for visitation site for unvaccinated residents is outside.  However, if the resident is unable to tolerate an outdoor visit, the visit may occur in the lobby.
  4. If an Outdoor Visitation is not optimal due to weather or resident condition, Residents may have an Indoor Visit except for a few circumstances when visitation will be limited due to a high risk of COVID-19 transmission.  Those circumstances include:  unvaccinated residents if the County Positivity rate is >10% (CMS and/or Washington County Health Department) and <70% of the residents in the facility are fully vaccinated, or residents with confirmed COVID-19 infection regardless of vaccination status and continue in Transmission Based Precautions (Droplet/Contact), or Residents in Quarantine regardless of vaccination status, until they have met criteria for release from quarantine or Facility is in Outbreak Status.
  5. Only 1 outdoor visit will be allowed at one time in each area to allow Facility staff to focus on maintaining correct protocols during visits. 
  6. Areas of Visitation: 

For SNF/Assisted Living: Back patio and front veranda 

For Memory Care:  Memory Care Patio

  1. Only 2 visitors permitted per visit.
  2. Each visit is limited to 45 minutes.
  3. Visitors and Resident will don and maintain a well-fitting mask during the entire visit.
  4. All unvaccinated resident visits will be supervised by Facility personnel to monitor the visit for appropriate use of PPE, Social Distancing.  Residents and their visitor will be afforded as much privacy as possible. 
  5. Before and after each visit, Facility personnel will utilize the appropriate disinfecting products to sanitize the visiting area.   IE: bleach wipes, Quaternary ammonium, Effersan
  6. When all visits are completed for the day, EVS will again sanitize the area with the appropriate disinfecting solution.  IE: Quaternary ammonium or Effersan

Procedure for Compassionate Visits:

  1. The facility will allow Compassionate Visits as follows:
  • End of Life situations/Compassionate Care Situations.

***While end-of-life situations have been used as examples of compassionate care situations, the term “compassionate care situations” does not exclusively refer to end-of-life situations. Examples of other types of compassionate care situations include, but are not limited to:

  • A resident, who was living with their family before recently being admitted to a nursing home, is struggling with the change in environment and lack of physical family support.
  • A resident who is grieving after a friend or family member recently passed away.
  • A resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), is experiencing weight loss or dehydration.
  • A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).

***These visits will be determined by Infection Control Department with the assistance of Nursing Administration. 

  1. If an in-room visitation cannot be avoided for Compassionate Care Situations for a resident in a semi-room, all Infection Control Measures will be followed as possible. IE: roommate to be out of room during visit, room will be sanitized after visit then roommate can return to room; if roommate cannot be moved during visit, curtains will be pulled; Visitors will be educated to remain on their loved one’s side of room only, do not utilize BR while in room, etc.)
  2. End of Life visits may have 3 visitors permitted per visit.  Visitors may alternate if more than 3 visitors wish to visit.
  3. Other Compassionate Visits are permitted 2 visitors per visit.
  4. All visitors must be screened and meet the criteria to be allowed to visit.  Visitors will also be asked to complete a facility release form.
  5. All visitors and residents must complete hand hygiene before and after all visits.  Facility staff monitoring In Door visit will witness completion of the hand hygiene. 
  6. Length of Compassionate Visits will be determined on each individual occurrence by Director of Nursing/Assistant Director of Nursing or Nurse Management. 

COMMUNAL ACTIVITIES AND DINING         

  1. The facility will provide communal dining and/or activities programs  when appropriate.
  2. If a resident is unable to abide by core principles of Infection Prevention, they will be asked to dine in their rooms or abstain from communal Activities program.
  3. Residents will be required to perform hand hygiene prior to and after dining and activities.
  4. Residents will receive hand-hygiene before and after activities or dining.
  5. Residents will wear masks to, during and from all dining or activities programs.
  6. Residents who are in Transmission Based Precautions will abstain from communal dining and communal activities until Transmission Based Precautions are discontinued.
  7. Any equipment used for communal activities will be disinfected before and after use.
  8. Dietary staff will sanitize tables before and after meals.
  9. Activities personnel will sanitize tables before and after activities. 
  10. Residents who are fully vaccinated may dine and participate in activities without a face covering and are not required to social distance with any other participating residents during the dining or activity.  However, if any unvaccinated residents or unvaccinated staff are present during communal dining or activity, then all residents must social-distance and wear face coverings when not eating. 
  11. Fully vaccinated volunteers will be permitted to volunteer their services.  They must provide documentation of their vaccination status.
  12. Outside Group Activities may be held.  No singing or woodwind/brass presentations will be allowed.

Angie Keebaugh LPN/QCP/IP/RAC-CT

Director of Quality Assurance/Performance Improvement

Infection Preventionist

Fahrney-Keedy Home and Village

8507 Mapleville Road

Boonsboro, MD

(301) 671-5026

[email protected]