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Delaware Valley Veterans' Home 

Implementation Plan for Reopening

In Accordance with the Pennsylvania Department of Health’s

Interim Guidance for Skilled Nursing Facilities During COVID-19



FACILITY INFORMATION

This section contains the name and location of the facility along with contact information for an individual designated by the facility. That individual does not have to be the Nursing Home Administrator but should be someone available to respond to questions regarding the Implementation Plan.

1. FACILITY NAME

Delaware Valley Veterans' Home


2. STREET ADDRESS


2701 Southampton Road

3. CITY


Philadelphia 

4. ZIP CODE


19154

5. NAME OF FACILITY CONTACT PERSON


Peter Ojeda, Commandant

6. PHONE NUMBER OF CONTACT PERSON


215-856-2701



DATE AND STEP OF REOPENING

The facility will identify the date upon which all prerequisites will be met for reopening and entering Phase Alpha.  Those facilities that experienced a significant COVID-19 outbreak will identify the date the Department of Health survey was conducted (that is required prior to reopening).

7. DATE THE FACILITY WILL ENTER REOPENING


9/1/2020

8. SELECT THE PHASE AT WHICH THE FACILITY WILL ENTER REOPENING – EITHER PHASE ALPHA OR PHASE BRAVO (CHECK ONLY ONE) (All PVHs WILL BEGIN THE REOPENING IN PHASE ALPHA)


  Phase Alpha  

The facility must meet all the Prerequisites, including the baseline universal test for COVID-19 administered to staff and residents (in accordance with the June 8, 2020, Order of the Secretary of Health)


  Phase Bravo

The facility must meet all the Prerequisites, including the baseline universal test for COVID-19 administered to staff and residents (in accordance with the June 8, 2020, Order of the Secretary of Health)

AND

Have the absence of any new facility onset of COVID-19 cases for 14 consecutive days since baseline COVID-19 testing

9. HAS THE FACILITY EXPERIENCED A SIGNIFICANT COVID-19 OUTBREAK? (IF NO, SKIP TO #11)


yes

10. DATE THE FACILITY WAS SURVEYED BY THE DEPARTMENT OF HEALTH TO ENSURE THE FACILITY IS ADEQUATELY PREVENTING TRANSMISSION OF COVID-19


6/25/2020



STRATEGY FOR TESTING, COHORTING, PERSONAL PROTECTIVE EQUIPMENT, AND STAFFING

To ensure the facility has taken appropriate measures to protect residents and staff, descriptions of those strategies are required in this section (prerequisites to reopening).

11. DATE RANGE FOR THE BASELINE UNIVERSAL TEST ADMINISTERED TO STAFF AND RESIDENTS (BETWEEN MAY 24, 2020 AND JULY 24, 2020) IN ACCORDANCE WITH THE JUNE 8, 2020, ORDER OF THE SECRETARY OF HEALTH 


5/24/2020 to 6/24/2020
12. DESCRIBE THE CAPACITY TO ADMINISTER COVID-19 DIAGNOSTIC TESTS TO ALL RESIDENTS SHOWING SYMPTOMS OF COVID-19 AND TO DO SO WITH 24 HOURS

DVVH has the clinical staff to conduct COVID-19 testing. DVVH obtains supplies for COVID-19 testing supplies through their contract with Quest Diagnostic and Philadelphia County Department Of Health. Additionally, DVVH will work with the Philadelphia VA Medical Center for additional support and testing capacity. Finally, if needed, DVVH would utilize the Pennsylvania Department of Health (DOH) emergency assistance via the DOH testing program by contacting the resource account at: ra-dhcovidtesting@pa.gov 


13. DESCRIBE THE CAPACITY TO ADMINISTER COVID-19 DIAGNOSTIC TESTS TO ALL RESIDENTS AND STAFF IF THE FACILITY EXPERIENCES AN OUTBREAK


DVVH has the clinical staff to conduct COVID-19 testing. DVVH obtains supplies for COVID-19 testing supplies through their contract with Quest Diagnostic and Philadelphia County Department Of Health. Additionally, DVVH will work with the Philadelphia VA Medical Center for additional support and testing capacity. Finally, if needed, DVVH would utilize the Pennsylvania Department of Health (DOH) emergency assistance via the DOH testing program by contacting the resource account at: ra-dhcovidtesting@pa.gov

14. DESCRIBE THE CAPACITY TO ADMINISTER COVID-19 DIAGNOSTIC TESTS TO ALL STAFF, INCLUDING ASYMPTOMATIC STAFF


DVVH has the clinical staff to conduct COVID-19 testing. DVVH obtains supplies for COVID-19 testing supplies through their contract with Quest Diagnostic and Philadelphia County Department Of Health. Additionally, DVVH will work with the Philadelphia VA Medical Center for additional support and testing capacity. Finally, if needed, DVVH would utilize the Pennsylvania Department of Health (DOH) emergency assistance via the DOH testing program by contacting the resource account at: ra-dhcovidtesting@pa.govIn  the event of a supply shortage, priority testing will be residents and direct care staff. The baseline testing of staff was completed on 6/22/20 as per DOH requirements.

15. DESCRIBE THE PROCEDURE FOR ADDRESSING NEEDED TESTING OF NON-ESSENTIAL STAFF AND VOLUNTEERS

All DVVH staff are designated essential and were tested during the baseline testing. The capacity to test volunteers and contractors can be met through the contract with Quest Diagnostic, when volunteers are permitted to resume volunteer work on campus as per the Bureau of Veterans Homes (BVH) Reopening Plan. Contractors are screened and assessed on an “as needed” basis for required testing.


16. DESCRIBE THE PROCEDURE FOR ADDRESSING RESIDENTS OR STAFF THAT DECLINE OR ARE UNABLE TO BE TESTED

Residents who decline testing &/or are unable to be tested and have potential exposure and/or are experiencing symptoms will be moved/transferred and remain in a YELLOW Zone for at least 14 days after symptoms subside. Staff who refuse or are unable to be tested will not be permitted to work until the facility has received a negative COVID-19 test result. If the employee failed the DVVH screening tool and/or has been symptomatic, they must be symptom free for at least 14 days and whenever possible have a negative COVID19 test result prior to return to work.


17 DESCRIBE THE PLAN TO COHORT OR ISOLATE RESIDENTS DIAGNOSED WITH COVID-19 IN ACCORDANCE WITH PA-HAN-509 PURSUANT TO SECITON 1 OF THE INTERIM GUIDANCE FOR SKILLED NURSING FACILITIES DURING COVID-19.  


The facility will use the Red-Yellow-Green Unit/Zone model, defined as follows: 

Red Zone: Residents with positive COVID-19 test and still within the parameters for transmission-based precautions

Yellow Zone: Residents with a negative COVID-19 test who remain asymptomatic but are within 14 days of possible exposure.  Residents refusing test and/or unable to test.  Residents with symptoms awaiting test results. 

Green Zone: Units or areas with residents in the facility who tested negative and are thought to be unexposed to COVID-19


18 DESCRIBE THE CURRENT CACHE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) AND THE PLAN TO ENSURE AN ADEQUATE SUPPLY OF PPE FOR STAFF (BASED ON THE TYPE OF CARE EXPECTED TO BE PROVIDED)


The facility’s Procurement Specialist maintains an inventory of required PPE including N95 masks, shields, isolation gowns, caps and booties, latex suits.  DVVH maintains an adequate supply and receives additional supplies through our headquarters as well as through emergency relief efforts.  Our Procurement Department has many resources for obtaining supplies as needed and will reach out to County, State and Federal resources if needed.  A daily procurement report is issued from DVVH to BVH to demonstrate our current supplies and project potential usage.

19. DESCRIBE THE CURRENT STAFFING STATUS AND THE PLAN TO ENSURE NO STAFFING SHORTAGES 


Staffing levels have been maintained above the State minimum requirement. Should a staffing shortage araise the facility has contracts with 2 staffing agencies (Around the Clock and General healthcare Resources).  The facility also has Nurse Assistant Trainees that will be available to alleviate any additional staffing needs. The facility will utilize voluntary overtime, double time, dual employees, temporary nurse aides and mandatory overtime as needed.

20. DESCRIBE THE PLAN TO HALT ALL REOPENING FACILITIES IF THE COUNTY IN WHICH THE FACILITY IS LOCATED IS REVERTED TO A RED PHASE OF THE GOVERNOR’S REOPENING PLAN


Reopening will be halted immediately, and quarantine will be restablished.  Non-essential staff will be tested prior to being permitted in the building. Shields and masks will continue to be worn as well as isolation gowns, gloves, booties and headcovers as needed depending upon conditions within the facility.
 



SCREENING PROTOCOLS

In each block below, describe the screening protocol to be used including where screening occurs, method of determining symptoms and possible exposure, and action taken if screening reveals possible virus.

21. RESIDENTS

 

Full Vital signs taken each shift for all residents. Resident assessed and monitored throughout each shift. Any changes in status will be discussed with physician, swab as needed and transfer to a private negative pressure room. All staff will wear full PPE when interacting with confirmed or suspected positive Residents. Symptoms will be addressed, family will be notified.  Any Resident that leaves the facility will be screened upon return, utilizing the Resident Screening Tool.   All staff who are working with Residents that return to the facililty will utilize full PPE.  All dialysis Residents will remain in their room for 24 hrs. following dialysis day.  Residents returning from an inpatient hospital stay, will require a negative COVID-19 test and will be will be readmitted to a private room  for a period of 10 days and they will be retested as per facility testing cycle.
 

22. STAFF


All DVVH staff are considered to be essential and are screened at the Screening station upon arrival for their shift. Staff temperature is taken and questionnaire is completed.  When there is an irregularity nursing supervisor is called to make an assessment.  In addition, all staff are tested per DOH recommendations.  Using a Symptom-based strategy for when staff can return to work, those with mild to moderate illness who are not severely immunocompromised must wait at least 10 days from when symptoms first appeared AND at least 24 hours have passed since last fever without the use of fever-reducing medications and AND symptoms (e.g., cough, shortness of breath) have improved. Staff who are not severely immunocompromised and were asymptomatic throughout their infection may return to work when at least 10 days have passed since the date of their first positive viral diagnostic test. Staff with severe to critical illness or who are severely immunocompromised must wait at least 20 days from when symptoms first appeared, wait at least 24 hours have passed since last fever without the use of fever-reducing medications and symptoms (e.g., cough, shortness of breath) have improved. Staff who are severely immunocompromised but who were asymptomatic throughout their infection may return to work when at least 20 days have passed since the date of their first positive viral diagnostic test.

23. HEALTHCARE PERSONNEL WHO ARE NOT STAFF


Health care personnel who are not staff (such as contracted medical providers) are evaluated via a Screening questionaire  at the Screening station, have their temperature taken and must have a negative COVID-19 test prior to gaining entrance. When there is an irregularity nursing supervisor is called to make an assessment.  

24. NON-ESSENTIAL PERSONNEL

 

Non-essential Personnel are required to fill in and sign an Acknowledgement of the Facility Expectations prior to coming to the building. Upon arrival, visitor will stop at the screening station,  get their temperature taken and they must complete and submit a screening questionnaire prior to entering the facility. 

25. VISITORS


Phase Alpha: No visitors will be permitted. 


Phase Bravo:  Visitors are not permitted in the facility.  Only outdoor visitation (weather permitting) is allowed in neutral zones to be designated by the facility and only with residents who have not been exposed to COVID-19. All visitors will need to pre-arrange a date and time (maximum visitation time not to exceed 45 minutes to allow for disinfecting in between visitations) with Social Services prior to the visit. Visitation will be permitted between 9:00am and 7:00pm every day including weekends. In keeping with CDC and DOH guidelines, all visitors over 2 years old will be required to wear a mask.  Visitors will be screened  at the screening station and have their temperature taken before visitation. Visitation will be limited to 2 family members at a time or they can be separate individuals on subsequent visits. Visitor(s) and resident must follow universal source control guidelines during entire visit. Masks must be worn by visitor(s) and resident and visitors will follow CDC and DOH social distancing guidelines. No Cross-over visitation (visiting with more than one resident during a designated time period) is permitted.  

  • Exception: Compassionate care (hospice) situations are coordinated with PVH leadership, and visitation will take place in a designated area.  



Phase Charlie:  Visitors are permitted in the facility in designated areas that are neutral zones away from other residents and only with residents who have not been exposed to COVID-19. All visitors will need to pre-arrange a date and time (maximum visitation time not to exceed 45 minutes to allow for disinfecting in between visitations) with Social Services prior to the visit. Visitation will be permitted between 9:00am and 7:00pm every day including weekends. In keeping with CDC and DOH guidelines, all visitors over 2 years old will be required to wear a mask. Visitors will be screened  at the screening station and have their temperature taken before visitation. Visitation will be limited to 3 family members at a time or they can be separate individuals on subsequent visits. Visitor(s) and resident must follow universal source control guidelines during entire visit. Masks must be worn by visitor(s) and resident and visitors will follow CDC and DOH social distancing guidelines. No Cross-over visitation (visiting with more than one resident during a designated time period) is permitted.  


  • Exception: Compassionate care (hospice) situations are coordinated with PVH leadership, and visitation will take place in a designated area.  



Phase Delta: Indoor visitation is allowed in neutral zones to be designated by the facility and is  limited to residents unexposed to COVID-19. Visitation will be permitted between 9:00am and 7:00pm every day including weekends. In keeping with CDC and DOH guidelines, all visitors over 2 years old will be required to wear a mask. Visiting in a resident's room (within facility's established protocols) is permitted only if the resident is unable to be transported to designated area. Cross-over visitation is only permitted if there is no new facility onset of COIVD-19.  Visitation will be limited to 3 family members  in a neutral zone. It can be separate individuals on subsequent visits. 


  • Visitors will be screened and must follow Universal source control guidelines.


26. Volunteers


Phase Alpha: Volunteers are not permitted in the building during this phase. 


Phase Bravo:  A minimally select group will be permitted in the facility to staff the canteen only but must be screened and have their temperature taken at the screening station upon arrival. When there is an irregularity nursing supervisor is called to make an assessment.  Volunteers must be tested Negative for COVID-19, follow universal control guidelines and will only be permitted to work with residents that have not been exposed to COVID-19. Volunteers are required to conduct regular hand hygiene and wear a mask and a face shield at all times. 



Phase Charlie:  A minimally select group will be permitted in the facility to staff the canteen only but must be screened and have their temperature taken at the screening station upon arrival. When there is an irregularity nursing supervisor is called to make an assessment.  Volunteers must be tested Negative for COVID-19, follow universal control guidelines and will only be permitted to work with residents that have not been exposed to COVID-19. Volunteers are required to conduct regular hand hygiene and wear a mask and a face shield at all times. 


Phase Delta: A minimally select group of volunteers are permitted in the facility but must be screened and have their temperature taken at the screening station upon arrival. When there is an irregularity nursing supervisor is called to make an assessment.  Volunteers must be tested Negative for COVID-19, follow universal control guidelines and will only be permitted to work in the canteen and at designated events with prior approval from leadership. Volunteers are required to conduct regular hand hygiene and wear a mask and face shield at all times.



COMMUNAL DINING FOR RESIDENTS UNEXPOSED TO COVID-19

Communal dining is the same for all steps of reopening so there is no need to differentiate among the three steps.


27. DESCRIBE COMMUNAL DINING MEAL SCHEDULE, INCLUDING STAGGERED HOURS (IF ANY) 


The BVH Phased Reopening Plan guidance on communal dining will be followed. Modified Communal dining is permitted on the units for residents recovered from or unexposed to COVID-19. Continue with disposable dishware as appropriate for yellow & red zones. Maintain social distancing by limiting the number of residents at each table, stagger arrival times, and maintain two service times  as possible per meal to allow for fewer residents in common areas at a time.

 

28. DESCRIBE ARRANGEMENT OF TABLES AND CHAIRS TO ALLOW FOR SOCIAL DISTANCING


Residents who need assistance with feeding and eat in a common areas must be spaced apart as much as possible, ideally six feet or more, with no more than one or two (depending on table size to support social distancing) residents who need assistance with feeding at a table. Mealtimes will be staggered as possible for the residents that require assistance with feeding to lessen the amount of residents present in the dining room at a time.


29. DESCRIBE INFECTION CONTROL MEASURES, INCLUDING USE OF PPE BY STAFF


All staff wear masks and shields while assisting with meals.  Staff feeding residents that are at high risk for choking/aspiration will wear a gown and goggles/faceshield. When assisting more than one resident to eat, staff must perform hand hygiene with hand sanitizer each time when switching between residents.

Between each seating, all areas will be cleaned and sanitized.

30. DESCRIBE ANY OTHER ASPECTS OF COMMUNAL DINING DURING REOPENING


Residents may eat outside in good weather while maintaining social distancing.  All staff will wear masks and shields while assisting with meals.  



ACTIVITIES AND OUTINGS

In each block below, describe the types of activities that will be planned at each Phase and the outings that will be planned at Phase Charlie (an all-inclusive list is not necessary). Include where they will be held and approximately how many residents will be involved. Describe how social distancing, hand hygiene, and universal masking will be ensured. Also include precautions that will be taken to prevent multiple touching of items such as game pieces.

31. DESCRIBE ACTIVITIES PLANNED FOR Phase Alpha (FIVE OR LESS RESIDENTS UNEXPOSED TO COVID-19)


 Phase Alpha: Onsite small scale (5 residents maximum) activities are allowed on the unit for residents recovered from or unexposed to COVID-19. Residents will be encouraged to wear masks, if able to tolerate and to use hand sanitizer upon entry to and exit from the activity location. Staff will adhere to proper hand hygiene before, during and after the activity, maintain social distancing as able to their job duties and universal masking guidelines are maintained during activity.  Whenever possible disposable products will be used for activities.  When reusable items must be utilized, Activities staff will clean with disinfectant after each resident use.  

    • All surfaces will be disinfected between activities. No offsite activites are permitted. 


32. DESCRIBE ACTIVITIES PLANNED FOR Phase Bravo (TEN OR LESS RESIDENTS UNEXPOSED TO COVID-19)
    • Phase Bravo: Ten or less residents can engage in a unit acitivity or ten or less residents from the same unit can use the Community Room for larger group activities such as lunch and movie, movies on the large screen, discussion groups and Wii games. Staff will assure appropriate social distancing is maintained and that masks are worn by residents. Hand hygiene will be maintained upon entry to and exit from the room. Staff will maintain hand hygiene during the activity as well and will encourage residents to do the same. Cleaning will be performed on all surfaces in between activities. No offsite activites are permitted.


33. DESCRIBE ACTIVITIES PLANNED FOR Phase Charlie:   Activities will remain the same in Phase Charlie as in Phase Bravo                                                                                                                     Phase Charlie: Onsite Activities may be conducted with residents recovered from or unexposed to COVID-19. However, events/activities for groups larger than 10 residents must be held in a large room (e.g. multipurpose room) to allow for social distancing. Residents will be encouraged to wear masks, if able to tolerate and to use hand sanitizer upon entry to and exit from the activity location. Staff will adhere to proper hand hygiene before, during and after the activity, maintain social distancing as able to their job duties and universal masking guidelines are maintained during activity. Whenever possible disposable products will be used for activities.  When reusable items must be utilized, Activities staff will clean with disinfectant after each resident use. Activity’s vendors are permitted in the facility after screening and with adherence to universal source control guidelines.  

Residents are permitted in the canteen while maintaining CDC and DOH social distancing guidelines with use of floor markings as visual cues. Self-service is not permitted. Unpackaged products and dispensing units are permitted. Enhanced cleaning protocols will be maintained. 


34. DESCRIBE OUTINGS PLANNED FOR Phase Delta


Onsite activities may be conducted with residents unexposed to COVID-19.  Events/activities for groups larger than 10 residents must be held in a large room (e.g. multipurpose room) to allow for social distancing, and all participants must adhere to Universal source control guidelines. Activities vendors are permitted outside (weather permitting) with adherence to Universal source control guidelines.


Offsite Outings/activities are allowed only for residents unexposed to COVID-19 and will be  limited to areas we determine to be safe and where social distancing between residents can be maintained. Appropriate hand hygiene, and universal masking are required.PVH leadership is required to utilize discretion in determining off -site activities. 










NON-ESSENTIAL PERSONNEL

In Phase Bravo, non-essential personnel deemed necessary by the facility are allowed (in addition to those already permitted in Section 4 of Interim Guidance for Skilled Nursing Facilities During COVID-19). In Phase Charlie, all non-essential personnel are allowed. Screening and additional precautions including social distancing, hand hygiene, and universal masking are required for non-essential personnel.

35. DESCRIBE THE LIMITED NUMBER AND TYPES OF NON-ESSENTIAL PERSONNEL THAT HAVE BEEN DETERMINED NECESSARY AT Phase Bravo 

Ancillary services are permitted such as therapy, hospice and other medical services provided by contracted vendors / credentialed providers. Vendors will be screened upon entering building per BVH policy. 

  • Vendors may not be co-operating in any county that is in the red or yellow phase
  • Vendors must follow universal source control guidelines.


Phase Charlie: Barber/Beauty services may resume while following universal source control measures. Services will only be available to residents who have not been exposed to COVID-19 and technicians will follow CDC and DOH social distancing guidelines. Vendor may not co-operate in any county that is in the red or yellow phase. 


36. DESCRIBE HOW SOCIAL DISTANCING, HAND HYGIENE, AND UNIVERSAL MASKING WILL BE ENSURED FOR NON-ESSENTIAL PERSONNEL AT Phases Bravo and Charlie 

All non-essential personnel will receive frequent inservicing. Signage will be located throughout the building and supplies of hand sanitizer and soap are available for adequate hand washing. PPE is available and replaced as needed.


37. DESCRIBE MEASURES PLANNED TO ENSURE NON-ESSENTIAL PERSONNEL DO NOT COME INTO CONTACT WITH RESIDENTS EXPOSED TO COVID-19

Residents who are positive are kept isolated from the general population and are cohorted. Plastic barriers exist to prevent entry into the Red Zones. 



VISITATION PLAN

For visitation to be permitted in Phases Bravo and Charlie of reopening (as described in Section 6 of Interim Guidance for Skilled Nursing Facilities During COVID-19), the following requirements are established. Screening and additional precautions including social distancing, hand hygiene, and universal masking are required for visitors.

38. DESCRIBE THE SCHEDULE OF VISITATION HOURS AND THE LENGTH OF EACH VISIts

Visitation will be arranged in advance through Social Services to allow for a maximum  visit time of 45 minutes. Fifteen minutes will be permitted for sanitizing in between visits which will allow visits to safely occur on the hour between 9:00am and 7:00pm 7 days a week. Please see #25 for restrictions in place at each phase (Alpha, Bravo, Charlie, Delta). During all phases, social distancing must be maintained and masks worn. Any child 2 years or older must wear a mask.


39. DESCRIBE HOW SCHEDULING VISITORS WILL OCCUR

Visitation will be arranged in advance through Social Services at 215-856-2786. 

40. DESCRIBE HOW VISITATION AREA(S) WILL BE SANITIZED BETWEEN EACH VISIT

Housekeeping staff wearing PPE will follow the disinfecting routine as directed by the Infection Preventionist 


41. WHAT IS THE ALLOWABLE NUMBER OF VISITORS PER RESIDENT BASED ON THE CAPABILITY TO MAINTAIN SOCIAL DISTANCING AND INFECTION CONTROL?

Please see #25 for restrictions in place at each phase (Alpha, Bravo, Charlie, Delta). During all phases, social distancing must be maintained and masks worn. 


42. DESCRIBE THE ORDER IN WHICH SCHEDULED VISITS WILL BE PRIORITIZED 

Visits will be scheduled in the order in which they are received by the Social Services Clerk. Hospice/comfort care residents and residents who do not have the opportunity to utilize telecommunications wil be given priority to receive visits.  The first responsible party listed in the medical record or their designee will be given priority for visitation.


STEP 2 (Phase Bravo) 

43. DESCRIBE HOW THE FACILITY WILL DETERMINE THOSE RESIDENTS WHO CAN SAFELY ACCEPT VISITORS AT PHASE BRAVO (CONSIDERING SUCH SAFETY FACTORS AS EXPOSURE TO OUTDOOR WEATHER AND TRANSPORTING RESIDENT TO VISITOR LOCATION)

Residents will be assessed on day of their visit and every effort will be made to complete the visit. If a resident is sick,  the visit will be rescheduled.


44. DESCRIBE THE OUTDOOR VISITATION SPACE FOR PHASE BRAVO TO INCLUDE THE COVERAGE FOR SEVERE WEATHER, THE ENTRANCE, AND THE ROUTE TO ACCESS THE SPACE

There is an outdoor area available to each unit, where visits can be accommodated. Residents will not visit outside in inclement weather. The 2nd floor unit will exit through the front door for visitation under the front entrance patio.


45. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING OUTDOOR VISITS  This will be measured and marked on the brick or cement walkway and directed by staff.  Plexiglass visitation dividers will be utilized. Decals will also be applied to the floor of the visitation areas to indicate six-foot spacing for social distancing.


46. DESCRIBE THE INDOOR VISITATION SPACE THAT WILL BE USED IN THE EVENT OF EXCESSIVELY SEVERE WEATHER TO INCLUDE THE ENTRANCE AND THE ROUTE TO ACCESS THE SPACE


Visitors will be escorted via Main Street to a room on B Wing designated as the visitation room. Floor markings will indicate 6 foot distances

47. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING INDOOR VISITS


Markings on the floor in designated areas and monitored by staff  


STEP 3 (Phase Charlie)

48. DESCRIBE HOW THE FACILITY WILL DETERMINE THOSE RESIDENTS WHO CAN SAFELY ACCEPT VISITORS AT PHASE CHARLIE (CONSIDERING SUCH SAFETY FACTORS AS TRANSPORTING RESIDENT TO VISITOR LOCATION)


Residents will be assessed by nursing and any residents who are not experiencing health conditions that require them to be on isolation or otherwise maintained in their rooms will be eligible for off-unit visitation.


49. WILL OUTDOOR VISITATION BE UTILIZED AT PHASE CHARLIE? IF NO, SKIP TO QUESTION #52

Yes outdoor visitations will be used to the extent possible

50. DESCRIBE THE OUTDOOR VISITATION SPACE FOR PHASE CHARLIE TO INCLUDE THE COVERAGE FOR SEVERE WEATHER, THE ENTRANCE, AND THE ROUTE TO ACCESS THE SPACE (IF THE SAME AS PHASE BRAVO, ENTER “SAME”)

Same

51. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING OUTDOOR VISITS (IF THE SAME AS PHASE BRAVO, ENTER “SAME”)

Same

52. DESCRIBE THE INDOOR VISITATION SPACE THAT WILL BE USED TO INCLUDE THE ENTRANCE AND THE ROUTE TO ACCESS THE SPACE (IF THE SAME AS PHASE BRAVO, ENTER “SAME”)

Same

53. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING INDOOR VISITS (IF THE SAME AS PHASE BRAVO, ENTER “SAME”)

Same

54. FOR THOSE RESIDENTS UNABLE TO BE TRANSPORTED TO THE DESIGNATED VISITATION AREA, DESCRIBE THE INFECTION CONTROL PRECAUTIONS THAT WILL BE PUT IN PLACE TO ALLOW VISITATION IN THE RESIDENT’S ROOM


Visits will have time limits (45 minutes) established by DVVH. Visitors will follow CDC and DOH universal source control guidelines; screening must occur, social distancing of at least 6 feet must be maintained, hand hygiene must be performed and masks must be worn. Visitation for residents without a roommate will be limited to 3 family members/2 family members if the visit is to take place in the resident’s room. It can be different individuals on subsequent visits. If a resident has a roommate, then only one family member may visit at a time.  If roommate present, inquire of resident if he/she would like to enjoy the lounge or other common area away from visitors & socially distant from other residents.




VOLUNTEERS

In PHASE BRAVO, volunteers are allowed only for the purpose of assisting with outdoor visitation protocols and may only conduct volunteer duties with residents unexposed to COVID-19. In PHASE CHARLIE, all volunteer duties may be conducted, but only with residents unexposed to COVID-19. Screening, social distancing, and additional precautions including hand hygiene and universal masking are required for volunteers.

55. DESCRIBE INFECTION CONTROL PRECAUTIONS ESTABLISHED FOR VOLUNTEERS, INCLUDING MEASURES PLANNED TO ENSURE VOLUNTEERS DO NOT COME INTO CONTACT WITH RESIDENTS EXPOSED TO COVID-19


 Screening, social distancing, and additional precautions, including hand hygiene and universal masking, will be required for volunteers. Residents are isolated in the red zone separated by plastic barriers, visitors do not have access to the unit.

56. DESCRIBE THE DUTIES TO BE PERFORMED BY VOLUNTEERS DURING PHASE BRAVO


Phase Bravo:  A minimally select group will be permitted in the facility to staff the canteen only but must be screened and have their temperature taken at the screening station upon arrival. When there is an irregularity nursing supervisor is called to make an assessment.  Volunteers must be tested Negative for COVID-19, follow universal control guidelines and will only be permitted to work with residents that have not been exposed to COVID-19. Volunteers are required to conduct regular hand hygiene and wear a mask and a face shield at all times. 



ATTESTATION

The Nursing Home Administrator (NHA) is responsible for the accuracy of the Implementation Plan and the facility’s adherence to it. Upon completion of blocks 1-57, the Implementation Plan should be printed and the signature and date affixed by the NHA in block 58.

57. NAME OF NURSING HOME ADMINISTRATOR


Peter Ojeda

58. ATTESTATION


I attest that the information provided in this Implementation Plan is an accurate representation of the facts and that this facility will adhere to the Implementation Plan as written. I further attest that the county in which this facility is located is in a Yellow or Green phase per the Governor’s Reopening Plan. This Implementation Plan will be posted on our website (if one exists) or made available to all residents, families, advocates such as the Ombudsman and the Department upon request. This facility will progress to the next step of reopening only when the criteria is met as described in the Interim Guidance for Skilled Nursing Facilities During COVID-19. If at any point during reopening the facility fails to meet the criteria for reopening, I will ensure the facility ceases reopening immediately. Further, if at any point during reopening this facility is operating under a contingency staffing plan, I will ensure the facility ceases reopening immediately.


                                                            Peter Ojeda                                                                                           

____________________________________________ _____07/23/2020_______________

SIGNATURE OF NURSING HOME ADMINISTRATOR DATE