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 |
6/3/2020 to 6/12/2020
|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|
HVH has the clinical staff to conduct COVID-19 testing. HVH obtains the supplies for COVID-19 testing through a contract with Quest Diagnostic. Additionally ,HVH has partnered with the Veterans Adiministration VanZandt medical center for additional support and testing capacity. Finally , if needed HVH would obtain utilize the Pennsylvania Department of Health (DOH) emergency assistance via the DOH testing program by contacting the resource account at (email@example.com) .
|13. DESCRIBE THE CAPACITY TO ADMINISTER COVID-19 DIAGNOSTIC TESTS TO ALL RESIDENTS AND STAFF IF THE FACILITY EXPERIENCES AN OUTBREAK|
HVH’s complement of clinical staff is more than adequate to conduct the testing. HVH obtains testing supplies through their contract with Quest Diagnostic. Additionally, HVH has partnered with the VA VanZandt medical center for additional support and testing capacity. Finally , if needed HVH would obtain utilize the Pennsylvania Department of Health (DOH) emergency assistance via the DOH testing program by contacting the resource account at (firstname.lastname@example.org) .
|14. DESCRIBE THE CAPACITY TO ADMINISTER COVID-19 DIAGNOSTIC TESTS TO ALL STAFF, INCLUDING ASYMPTOMATIC STAFF|
HVH has the needed clinical staff to conduct the testing. HVH obtains the supplies for testing via a contract with Quest Diagnostic. Additionally, HVH has partnered with the VA VanZandt medical center for additional support and testing capacity. Finally , if needed HVH would obtain utilize the Pennsylvania Department of Health (DOH) emergency assistance via the DOH testing program by contacting the resource account at (email@example.com) .
|15. DESCRIBE THE PROCEDURE FOR ADDRESSING NEEDED TESTING OF NON-ESSENTIAL STAFF AND VOLUNTEERS|
All HVH 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 diagnostics, when volunteers are permitted to resume volunteer work in 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 will be moved/transferred to a YELLOW or RED ZONE per the physician’s guidance for maintaining safety. If a patient suspected of having COVID-19 is never tested, the decision to discontinue Transmission-Based Precautions can be made based upon using the symptom-based strategy outlined in PAHAN 517.
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 from the employee based upon the criteria from the BVH infection control policies and procedures/ return to work guidance.
|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.|
Per the Outbreak of COVID Policy (pg1) The facility will use the Red – Yellow – Green Units/Zones model, defined at follows:
Red Zone: Units or areas for Positive COVID-19 residents. The decision to discontinue Transmission-Based Precautions can be made based upon using the symptom-based strategy outlined in PAHAN 517.
Yellow Zone: Units or areas for residents with a negative test or suspected COVID-19 who are symptomatic or asymptomatic but are within 10 to 20 days dependent on severity of symptoms. The decision to discontinue Transmission-Based Precautions can be made based upon using the symptom-based strategy outlined in PAHAN 517
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)|
HVH maintains a supply of PPE that is more than adequate to provide the required levels of protection for the residents and staff . A daily procurment report is issued from HVH 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 |
The facility will utilize voluntary overtime, double time, dual employees, temporary nurse aides and mandatory overtime as needed. The facility has increased its compliment of some essential employees and will continue hiring efforts.
|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|
The BVH Phased Reopening Plan states "If a county in which a PVH is located moves into the Red Phase, the home must return to the most stringent Red Phase restrictions based on DOH guidance. (pg5)
Screening protocol for residents is as follows: Each resident will have their temperature obtained and documented every shift for the duration of the COVID-19 pandemic or until directed otherwise per BVH and DOH guidelines.Should a staff member present with signs and symptoms of COVID-19 during their shift, they will be tested in a designated testing room and sent home to await results. The unit(s) that they worked on during their shift will begin monitoring and documenting respiratory status, temperature and oxygen saturation levels for every resident residing on the unit each shift until the staff member’s test results are received. The facility will proceed accordingly based on the test results. (Move to appropriate RED and YELLOW ZONES or discontinue respiratory observations and oxygen saturation levels each shift).Should a resident present with signs or symptoms of COVID-19, the following protocol will be followed: The resident will be isolated in their room, along with any roommates and staff will calmly explain to the resident(s) that for their safety and the safety of others, we need to have them remain in their room until the residents physician is notified and they are tested them to ensure that they do not have a contagious infection. Licensed nurse will retrieve a PPE cart and disposal bins/biohazard hampers from the physician’s exam room on your unit (Center 2 unit I Arnold Hall will have a PPE cart and disposal bins/biohazard hampers, stored in the West 2 physician’s exam room since they do not have their own). The PPE cart along with the Contact Isolation and Droplet Precaution signage and proper donning and doffing signage are to be placed outside in the hall, with signage hung on the wall above the PPE cart. The biohazard bins are to be placed inside the resident’s room to ensure infected PPE is disposed of properly before staff exit the residents room. Licensed nurse will call the RNS and inform him/her of the situation. The RNS will report to the unit to ensure all equipment is on hand and staff training is completed regarding proper utilization of PPE protocol. Licensed nurse will call the physician to report the resident’s signs and symptoms to include current temperature, oxygen saturation levels, lung sounds, any known disease processes that may be attributing to their current status, etc. (USE THE Respiratory SBAR as a guide.) Be certain to inform the physician of any resident roommates. Physician orders a COVID-19 swab if warranted. If a COVID-19 test is ordered by the physician, the resident(s) will be transferred to the RED ZONE per the physician’s directive, along with any roommates who may have potentially been exposed. Each resident will be provided their own room while available. Residents will be cohorted with other residents in the YELLOW ZONES or RED ZONES only if necessary due to room availability. The unit from which the resident(s) were moved, now becomes a YELLOW ZONE. All residents on YELLOW and RED ZONES will be monitored for s/sx. of COVID-19 and have a respiratory observation, temperature, and pulse ox documented each shift. Consistent staffing wearing full PPE will be maintained within YELLOW and RED ZONES to avoid exposure to COVID-19. Licensed staff will obtain a specimen utilizing a QUEST culturette via nasopharyngeal swab in the residents room, donning full PPE. Complete thorough documentation regarding s/sx., procedures initiated, orders obtained, family/POA informed, etc. Designate staff the RED and YELLOW ZONES. Inform the physician and RNS immediately upon receipt of results. Residents and their primary contacts must also be informed of results.Residents will be maintained in RED and YELLOW ZONES until the recommended symptom-based strategy outlined in PAHAN 517 are met related to the discontinuation of transmission based precautions.
Per the BVH Phased Reopening Plan, HVH will: Actively screen all staff for fever and COVID-19 symptoms at the start and end of their shift; test staff who screen positive. Staff who have fever or symptoms of COVID-19 should be excluded from work pending results of the test as per BVH screening tool.
Staff who test positive for COVID-19, or who have suspected COVID-19 ( e.g., developed symptoms of COVID-19 but did not get tested for COVID -19 Staff who test positive for COVID-19, or who have suspected COVID-19 ( e.g., developed symptoms of COVID-19 but did not get tested for COVID -19 should be excluded from work until they meet return to work criteria. Conduct baseline testing of all residents and staff. HVH will follow their facility testing plan with regard to results from the baseline testing and responding to results for post-test interventions. Actively screen all residents for fever and COVID-19 symptoms at least daily and test any resident who exhibits fever or symptoms consistent with COVID-19. HV H utilizes the Staff Screening questionnaire (pg. 21) in the BVH Phased Reopening plan).
|22. HEALTHCARE PERSONNEL WHO ARE NOT STAFF|
HVH utilizes a Screening questionnaire (pg. 21) in the BVH Phased Reopening plan.
|23. NON-ESSENTIAL PERSONNEL|
Non-Essential personnel are screened using the same procedure as essential employees and also sign and acknowledgement of the facilities expectations they need to meet when conducting business on campus.
Per the BVH Phased Reopening plan , Phase Bravo: Outdoor visitation (weather permitting) is allowed in neutral zones to be designated by the facility. defined in their Implementation Plan. Visitation is limited to residents unexposed to COVID-19. Visitation will be limited to 2 family members at a time, they can be separate individuals on subsequent visits. Must follow universal source control guidelines. All visitors will be screened before visitation. HVH will be responsible for informing the visitor of the screening requirements before visitation. Visitors will follow CDC and DOH social distancing guidelines posted throughout the PVH and distributed to visitors. Visitors are not permitted in the facility.Visitations will need to be scheduled through the PVH to maintain universal source control and social distancing guidelines. No Cross-over visitation. Compassionate care situations are coordinated with PVH leadership, and visitation will take place in a designated area. In Phase Charlie : Visitors are permitted in the facility in designated areas. Designated areas must be in neutral zones away from other residents. Visiting times must be scheduled in advance with the PVH staff.Visitation will be limited to 3 family members Must follow universal source control measures. Visitors will follow the CDC and DOH social distancing guidelines.Visitation is limited to residents unexposed to COVID-19.Visiting areas will be cleaned between visits. No Cross-over visitation. Compassionate care situations will be addressed with the PVH leadership, and visitation will take place in a designated area. In Phase Delta: Indoor visitation is allowed in neutral zones to be designated by the facility . Visitation is limited to residents unexposed to COVID-19. 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 in the facility in which the cross-over visitor resides. Visitation will be limited to 3 family members / 2 family members if the visit is to take place in the resident room. It can be separate individuals on subsequent visits. o If a resident has a roommate, then only one family member to visit at a time. Visitors will be screened and must follow Universal source control guidelines. Compassionate care situations will be addressed with the PVH leadership, and visitation will take place in a designated area.
Volunteers will not be permitted on campus in Step 1(Phase Alpha) or Step 2 (Phase Bravo ) of the BVH Phased Reopening Plan. In Step 3 (Phase Charlie) : Volunteers are allowed but may only conduct volunteer activities with residents unexposed to COVID-19. Volunteers must be screened and follow universal source control guidelines. Test for COVID-19 prior to volunteering, then test for symptoms consistent with COVID-19. Established volunteers (volunteers that regularly / daily perform volunteering at the PVH will be screened following staff guidelines) Screening, social distancing, and additional precautions including hand hygiene and universal masking are required.