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PA Soldiers’ and Sailors’ 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


PA Soldiers’ and Sailors’ Home


2. STREET ADDRESS


560 East Third Street

3. CITY


Erie

4. ZIP CODE


16507

5. NAME OF FACILITY CONTACT PERSON


Elizabeth Seibert, Commandant 

6. PHONE NUMBER OF CONTACT PERSON


814-871-4531



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


9/24/2020

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)


NO

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


6/24/2020



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 


Yes 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


PSSH has the clinical staff to conduct COVID-19 testing.  PSSH obtains the supplies for COVID-19 testing through a contract with Quest Diagnostic.  In addition, if needed PSSH 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) for emergency assistance.

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


PSSH clinical staff would be adequate to conduct the testing.  Testing supplies would be obtained from Quest Diagnostic PSSH is contracted with. In addition, if needed PSSH 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


PSSH has the clinical staff to conduct COVID-19 testing.  PSSH obtains the supplies for COVID-19 testing through a contract with Quest Diagnostic.  Utilization of retail pharmacy testing sites would occur as needed. (CVS, WalMart, RiteAid).  In addition, if needed PSSH 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) for emergency assistance. 


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


All PSSH 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 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.  The utilization of retail pharmacy testing sites (i.e. CVS, WalMart, RiteAid) or personal physicians can be used if needed.

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 an appropriate cohorting unit (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 Transmisison -based Precautions can be made based upon using the symptom-based strategy outined 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 Return To Work program established in accordance to the Center for Disease Control and Prevention (CDC) and DOH infection control guidelines pertaining to returning 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 Zone model defined as 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 – 20 days dependent on severity of symptoms.  The decision to discontinue Transmisison-Based Precautions can be made based upon using the symptom-based strategy outined in PAHAN517.  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)


PPE equipment is procured for staff in accordance to the Infection Control Precautions program and the type of protective barriers(s) should be appropriate for the procedure being performed and the type of exposure anticipated.  PPE available includes gloves, gowns or aprons, masks and eye protection, face shields, foot covers, and resuscitation devices.  Other items will be made available as needed.  Procurement maintains inventory of all supplies and orders according to par levels established, which fluxtuates according to clinical needs of residents.  Procurement secures PPE shopping orders according to the Bureau of Veterans Homes protocols and requests are made from PEMA if further assistance is necessary.

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


We have been adequately staffed in all departments and positions.  Ongoing monitoring of the staffing situation occurs and the Emergency Staffing plan is available if needed.  Elements of the plan include; approval of additional temporary staff positions for nurse aide trainee positions which was implemented, offering overtime, offer staff to work out of class as long as they meet licensing parameters, (i.e. RNs working as LPNs, LPNS working as CNAs), offering employee to work in position they are eligible for but may not be currently tasked with (i.e. Ward Clerk who is certified nursing assistant can work as CNA), contracts established with outside nursing staffing agencies in case they would be needed, requesting support from our sister facilities and utilization of the National Guard as an available resource from our BVH department in emergency 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


The BVH Phased Reopening Plan states “If a county in which a BVH is located moves into the Red Phase, the home must return to the most tringent Red Phase restrictions based on DOH guidance.



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

 

Resident Screening: Each resident will have their temperature obtained and documented at least daily for the duration of the COVID-19 pandemic, or until directed otherwise per BVH and DOH guidelines. Should a resident present with signs or symptoms of COVID-19, the following protocol will be followed: The RNS will be notified by the charge nurse & report to the unit to ensure all equipment is on hand and proper utilization of PPE protocol is reviewed with the staff. The Medical Provider will be notified and informed of 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. (The Respiratory SBAR is available as a guide.) The Medical Provider will also be made aware of any resident roommates. Provider will order a COVID-19 swab if warranted. Residents and their primary contacts will be informed of results and necessary steps that will need to be taken.  The resident and any roommates will be moved to a Yellow Zone or if private room/bath will be isolated in their room, their room becoming a Yellow Zone.  Resident/s, Responsible Party/s as well as any new roommate/s will be notifed of the room move/s.  Each resident moving to the Yellow Zone will be provided their own room when available. Residents will be cohorted with other residents in the YELLOW ZONES or RED ZONES only if necessary, due to room availability.  Licensed Nurse or other properly trained personnel will obtain a specimen utilizing a Quest Diagnostics/other contracted lab PCR culturette via nasopharyngeal swab in the resident’s room, donning full PPE, including N-95 mask. A nursing staff member will retrieve a PPE cart and biohazard waste & linen bins for outside the resident’s room or anteroom. Proper signage for Contact Isolation and Droplet Precautions, as well as donning and doffing signage will be hung. All residents on YELLOW or RED ZONES will be monitored for s/sx of COVID-19 and have a respiratory observation, temperature, and pulse ox documented each shift. Documentation regarding s/sx, procedures initiated, orders obtained, responsible party notification, will be completed in the Medical Record.  Appropriate notifications will be completed of positive or negative results, including Provider/s, Responsible Party/s and Resident/s.  Unless otherwise necessary for the health, welfare, safety and security of other residents, consistent staffing will be maintained within YELLOW and RED ZONES. Residents will be maintained in RED or YELLOW ZONES until symptom free for at least 14 days from onset of symptoms or positive test.  Residents are observed closely on all 3 shifts and as needed for symptoms that correlate with COVID-19. Residents will be maintained in RED and YELLOW Zones until the recommended symptom-based strategy outined in PAHAN 517 are met related to the discontinuation of transmission based precautions.

22. STAFF


The screeing policies and practices are based on Infection Prevention and Control recommendations from the Centers for Disease Control and Prevention (CDC), Pennsylvania Department of Health (DOH) and the World Health Organization (WHO).  Staff entering the facility will be screened prior to entering the facility and leaving the facility.  Staff will participate in the screening process which is as non-touch as possible and includes products to sanitize tools in the screening process.  During the screening of staff any temperatures outside of parameters that are noted and or symptoms listed in the screening tool are circled the CSM or designee will be notified for further investigation and screening and report findings to Commandant.  Staff that experience any temperature and or symptoms listed on the screening tool on their shift must report to the nursing supervisor for further investigation and screening.  These findings then will be reported to CSM or designee.  Staff with a temperature of 99.5<  or above will be reevaluated by the ADON and/or designee prior to reporting to work.  Any Staff who is currently showing symptoms of the coronavirus will be provided with the Initial Return to Work letter as applicable, sent home and will not be permitted to return to work until cleared by the CSM and/or designee.  Staff member who has traveled to or through an area with sustained community spread, has been exposed to someone who has or is being monitored for coronavirus, will be provided with the initial Return to Work letter as applicable and not be permitted to work until cleared by the CSM and/or designee.  Staff and authorized individuals with a susceptive positive screen will be sent home as per the BVH Return to Work Policy as applicable. Identified staff will be provided with the initial Return to Work letter as applicable.  Security will maintain a list of staff who are not permitted to return to work and the duration of their exclusion from the workplace.  Any person with a temperature of 99.5< or greater will be asked to stand aside. A call to Nursing Administration or designee to re-screen the individual prior to granting entrance. 

23. HEALTHCARE PERSONNEL WHO ARE NOT STAFF


Healthcare personnel who are not staff follow the same screening process as the essential staff (see #22)

24. NON-ESSENTIAL PERSONNEL


Non-essential personnel who are not staff follow the same screening process as the essential staff (see #22)

25. VISITORS


Visitation will occur as per the BVH Phased Reopening plan as follows: Compassionate care visits are permitted in all phases.  Compassionate care visits are limited to residents recovered from or unexposed to COVID-19.  Visitation will occur only in the resident’s room.  Vistation in all phases must be coordinated with PSSH Social Workers.  All Univeral Source Control Guidelines must be followed in all phases and visitation situations. Visitors must follow 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 in all phases is limited to residents recovered from or unexposed to COVID-19.   Visiting areas will be cleaned between visits in all phases/situations. Phase Bravo, currently scheduled 8/28/20: Outdoor visitation (weather permitting) is allowed in neutral zones as designated by the facility. Visitation will be limited to 2 family members at a time, in 30 minute increments. Visitors are not permitted in the facility. In Phase Charlie, currently scheduled for 9/11/20: Visitors are permitted in the facility in designated areas. Designated areas will be in neutral zones away from other residents. Visitation will be limited to 3 family members. In Phase Delta, currently 9/25/20: Indoor visitation is allowed in neutral zones to be designated by the facility. Visiting in a resident’s room (within facility’s established protocols) is permitted only if the resident is unable to be transported to the designated area. Visitation will be limited to 3 family members/2 family members if the visit is to take place in the resident’s room. If a resident has a roommate, then only one family member can visit at a time.  Roommate will be offered to enjoy the living room area or other common area while maintaining social distance from others.
 

26. VOLUNTEERS


 Volunteers will not be permitted on campus in Phases Alpha or Bravo.  Phase Charlie, currently 9/11/20: Test for COVID-19 prior to volunteering is required, then further testing or restrictions for symptoms consistent with COVID-19. Established volunteers (volunteers that regularly/daily perform volunteering at PSSH will be screened following staff guidelines.) Screening, social distancing, and additional precautions, including hand hygiene and universal masking are required for all Volunteers. Volunteers are allowed but may only conduct volunteer activities with residents recovered from or unexposed to COVID-19. Volunteers are permitted for the purpose of assisting with visitation protocols, that is to assist staff in setting up resident visits with families.  



COMMUNAL DINING FOR RESIDENTS UNEXPOSED TO COVID-19

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

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.

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


Staff providing assistance to residents with feeding will utilize PPE as appropriate and proper hand washing or use of hand sanitizer. 

30. DESCRIBE ANY OTHER ASPECTS OF COMMUNAL DINING DURING REOPENING


Review of dining services will be ongoing by the Registered Dietician, the Infection Preventionist and with the support of the Quality Assurance Committee necessary improvements will be initiated through the QA process.



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)


Activities during Phase Alpha, currently scheduled for 8/14/20 includes:  Onsite small scale (5 residents maximum) activities are allowed on the individual units for residents recovered from or unexposed to COVID-19.  Onsite large scale (greater than 5 residents) not permitted.  Offsite activity programs are not permitted.  Resident use of hand sanitizer upon entry to and exit from the activity location will be encouraged.  Staff will maintain social distancing guidelines during activity as able to their job duties and universal masking guidelines are to be 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.  

32. DESCRIBE ACTIVITIES PLANNED FOR Phase Bravo (TEN OR LESS RESIDENT UNEXPOSED TO COVID-19)


Phase Bravo, currently scheduled 8/14/20: Onsite small scale (10 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.  

33. DESCRIBE ACTIVITIES PLANNED FOR Phase Charlie 


Phase Charlie, currently scheduled 8/28/20: 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.  

34. DESCRIBE OUTINGS PLANNED FOR Phase Charlie / Delta


Outings/off-site activities are allowed only for residents recovered from or unexposed to COVID-19 upon entering Phase Delta, currently 9/11/20. Outings limited to no more than the number of people where social distancing between residents can be maintained.  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.  PSSH 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 


Non-essential personnel are determined to be necessary on a case-by-case basis by PSSH Leadership.

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


The non-essential personnel will be educated and sign off on the facility’s expectations on screening, hand hygiene, social distancing, mask adherence and making attempts to minimize or eliminate their presence in resident areas unless absolutely necessary.

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


Non-essential personnel (re: Contractors) must sign in with Security and are escorted and monitored by PSSH staff to assist in minimizing or eliminating contact in resident spaces.



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 VISIT


Visitation will be scheduled with and held to a 30 minute duration.  Special accommodations will be made with end of life situations and at the discretion of the clinical team as needed given resident situation.

39. DESCRIBE HOW SCHEDULING VISITORS WILL OCCUR


The hours of visitation are as follows: 10:00AM to 10:30AM, 1:30PM to 2:00PM, 7:00PM to 7:30PM, daily. The visits will be limited to 30 minutes. Visitation will be coordinated with PSSH staff. Children under the age of 12 and pets will not be permitted until Phase Delta. Family and Responsible Parties will be able to schedule visits via phone with the Social Services Department (814-878-4917).

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


PSSH has established a deep cleaning/terminal clean disinfecting scheduling for cleaning of designated visitation/high-touch areas between visits coordinated between housekeeping and nursing personnel.

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

Phase Bravo, currently scheduled for 8/28/20; the resident will be limited to 2 family members at a time. Phase Charlie, currently scheduled for 9/11/20 the resident will be limited to 3 family members. During Phase Delta, currently scheduled for 9/25/20, visitation will be limited to 3 family members/2 family members if the visit is to take place in the resident’s room.  See number 25 above.  

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


Scheduling of visits will be prioritized by compassionate care needs first, then residents who have had difficulty utilizing electronic or telephonic visits, then all residents having an initial opportunity for visitation scheduled before a second round of visitation is secured and so on in an effort to see all residents and families who desire to participate in a visit have an opportunity to do so.  The resident’s right to pass or refuse a visitation will be honored. 

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)


Any residents who are not experiencing health conditons that require them to be on isolation or otherwise maintained in their rooms will be eligible for off-unit visitation.

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


Visitation is not permitted in the facility; visitation will take place outside on a patio or other area shielded from the elements.  The entrance and pathway will be posted and include walkways that are external to the facility.  The visitation will be scheduled and staff will be available to provide direction and support the the visitor.  In the event of severe weather, visitation will be shortened or cancelled.

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


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


Indoor visitation will not be offered during Step 2 (Phase Bravo) per the BVH Phased Reopening Plan. 

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


Floor signage will be utilized.  

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)

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


In Phase Charlie, outdoor visition will be utilized weather permitting.

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 as #44

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 as #45

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”)


Visitors are permitted in the facility in designated areas in Phase Charlie.  Designated areas in neutral zones away from other residents will be utilized, such as the Activity Room, areas in the Main Dining Room, Unit Lounges. Compassionate care situations will be addressed with the PSSH leadership and ideal locations established, probably in resident room.  The entrance and route used to access the space will be the most direct one to reach the designated location.  

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 as #45

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


Visiting times must be scheduled in advance with the PSSH staff.  Visitation will be limited to 3 family members.  Universal source control measures will need to be followed.  Visitors will follow CDC and DOH social distancing guidelines.  Only residents who are not being cared for or monitored for infectious disease may receive visitors.  Compassionate care situations will be addressed with the PSSH leadership, and visitation will take place in a designated area.  The entrance and route used to access the space will be the most direct one to reach the designated location.  The scheduled visitation will allow the staff to support escorting the visitor to the ideal location to support the infection prevention efforts. 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.

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


During Phase Bravo volunteers will not be permitted.



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


Elizabeth Seibert, Commandant 


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.


                                                                                                                  

                                                                                                                    July 27, 2020

____________________________________________ _____________________________

SIGNATURE OF NURSING HOME ADMINISTRATOR       DATE