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Reopening Implementation Plan for the Pennsylvania Department of Human Services’s Interim Guidance for Personal Care Homes, Assisted Living Residences and Private Intermediate Care 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 Administrator but should be someone available to respond to questions regarding the Implementation Plan. 
  1. FACILITY NAME 
 
Hollidaysburg Veterans’ Home 
  1. STREET ADDRESS 
 
PO Box 319 
  1. CITY 
 
Hollidaysburg 
  1. ZIP CODE 
 
16648 
  1. NAME OF FACILITY CONTACT PERSON 
 
Anissa Rosemas 
  1. PHONE NUMBER OF CONTACT PERSON 
 
814 696 5290 
 
DATE AND STEP OF REOPENING 
The facility will identify the date upon which all prerequisites will be met to begin the reopening process and the Step at which the facility will enter reopening. 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). 
  1. DATE THE FACILITY WILL ENTER THE REOPENING PROCESS 
 
11/4/2020 
  1. SELECT THE STEP AT WHICH THE FACILITY WILL ENTER THE REOPENING PROCESS – EITHER STEP 1 OR STEP 2 (CHECK ONLY ONE) 
 
  Step 1  
The facility must meet all the Prerequisites included in the Interim Guidance for Personal Care Homes, Assisted Living Residences and private Intermediate Care Facilities During COVID-19 
 
  Step 2 
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 26, 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 
  1. HAS THE FACILITY EXPERIENCED A SIGNIFICANT COVID-19 OUTBREAK? (IF NO, SKIP TO #11) 
 
No 
 
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 enter the reopening process). 
  1. DATE RANGE FOR THE BASELINE UNIVERSAL TEST ADMINISTERED TO STAFF AND RESIDENTS (BETWEEN JUNE 14, 2020 AND AUGUST 31, 2020) IN ACCORDANCE WITH THE JUNE 26, 2020, ORDER OF THE SECRETARY OF HEALTH  
 
8/12/2020to 8/12/2020 
  1. DESCRIBE THE ABILITY TO HAVE  COVID-19 DIAGNOSTIC TESTS ADMINISTERED TO ALL RESIDENTS SHOWING SYMPTOMS OF COVID-19 AND TO DO SO WITHIN 24 HOURS 
 
HVH has the  clinical staff to conduct COVID-19  testing.  HVH obtains the supplies for COVID-19 testing through a contract with Department of Health contracted lab.  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 (ra-dhcovidtesting@pa.gov) 
  1. DESCRIBE THE ABILITY TO HAVE COVID-19 DIAGNOSTIC TESTS ADMINSTERED TO ALL RESIDENTS AND STAFF IF THE FACILITY EXPERIENCES AN OUTBREAK, INCLUDING ASYMPTOMATIC STAFF 
 
HVH’s complement of clinical staff is more than adequate to conduct the testing.  HVH obtains testing  supplies through their contract with Department of Health contracted lab.  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 (ra-dhcovidtesting@pa.gov) . 
 
  1. DESCRIBE THE PROCEDURE FOR 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 Department of Health contracted lab, 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. 
  1. 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.  
 
  1. 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 Personal Care Homes, Assisted Living Residences and Intermediate Care 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   
  1. 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 
  1. 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. 
  1. DESCRIBE THE PLAN TO HALT ALL REOPENING FACILITIES AND RETURN TO STEP 1 IF THE FACILITY HAS ANY NEW ONSET OF POSITIVE COVID-19 CASES 
 
If at any time a PVH identifies a new onset COVID-19 case in the facility during any time, that facility returns to the highest level of mitigation, and starts over. 
 
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. Include how the data will be submitted to the Department.  
  1. RESIDENTS 
  
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.  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 lab  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.   
  1. STAFF 
 
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. HVH utilizes the Staff Screening questionnaire  in the BVH Reopening plan. 
  1. HEALTHCARE PERSONNEL WHO ARE NOT STAFF 
 
HVH utilizes the BVH Screening questionnaire. 
  1. 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.   
  1. VISITORS 
 
Per the BVH Reopening plan , Step 1 and Step 2: Outdoor visitation (weather permitting) and indoor visitation is allowed in neutral zones to be designated by the facility. Visitations will need to be scheduled through the PVH to maintain universal source control and social distancing guidelines. 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. Visitors 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. No Cross-over visitation between the skilled nursing levels of care and PC level of care. Compassionate care situations are coordinated with PVH leadership, and visitation will take place in a designated area.  Visitors are permitted in the facility in designated areas. Visitation is limited to residents unexposed to COVID-19.Visiting areas will be cleaned between visits.  Step 3, scheduling of visitation is no longer required and will take place in a designated area. Visitor restrictions will be lifted in this step. 
  1. VOLUNTEERS 
 
Volunteers will not be permitted on campus in Step 1.   In step 2  Volunteers are allowed only for the purpose of assisting with visitation protocols. In Step 3,volunteers are allowed. 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. 
 
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. 
  1. DESCRIBE COMMUNAL DINING MEAL SCHEDULE, INCLUDING STAGGERED HOURS (IF ANY)  
 
Beginning in Step 1: Residents may eat in the same room with social distancing (limited number of people at tables and spaced by at least six feet). If residents cannot be spaced six feet or more apart, roommate residents may be seated together. 
  1. DESCRIBE ARRANGEMENT OF TABLES AND CHAIRS TO ALLOW FOR SOCIAL DISTANCING 
 
Resident eat in a common dining room area must be spaced apart as much as possible, ideally six feet or more with no more than one or two at a table.   
  1. DESCRIBE INFECTION CONTROL MEASURES, INCLUDING USE OF PPE BY STAFF 
 
See Infection Control Manual 
  1. DESCRIBE ANY OTHER ASPECTS OF COMMUNAL DINING DURING REOPENING 
 
N/A 
 
ACTIVITIES AND OUTINGS 
In each block below, describe the types of activities that will be planned at each step and the outings that will be planned at Step 3 (an all-inclusive list is not necessary). Include where they will be held and approximately how many residents will be involvedDescribe 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. 
  1. DESCRIBE ACTIVITIES PLANNED FOR STEP 1 (FIVE OR LESS RESIDENTS UNEXPOSED TO COVID-19) 
 
In Step 1 Limited activities may be conducted with five or fewer residents. Social distancing, hand hygiene, and universal masking are required.    Residents will be encouraged to use hand sanitizer upon entry to and exit from the activity location.  Staff will adhere to hand hygiene protocol upon entering, during and exiting the activity.  Staff will ensure that social distancing, hand hygiene, and universal masking guidelines are maintained during activity. 
  1. DESCRIBE ACTIVITIES PLANNED FOR STEP 2 (TEN OR LESS RESIDENTS UNEXPOSED TO COVID-19) 
 
For Step 2 Limited activities may be conducted with ten or fewer residents. Social distancing, hand hygiene, and universal masking are required. HVH will encourage resident use of hand sanitizer upon entry to and exit from the activity location. Staff will adhere to hand hygiene protocol upon entering, during and exiting the activity. Staff will ensure that social distancing, hand hygiene, and universal masking guidelines are maintained during activity. 
  1. DESCRIBE ACTIVITIES PLANNED FOR STEP 3 
 
Step 3 Activities may be conducted with residents. Social distancing, hand hygiene, and universal masking are required. 
  1. DESCRIBE OUTINGS PLANNED FOR STEP 3 
 
Outings are prohibited in Steps 1 and 2.  In Step 3, outings limited to no more than the number of people where social distancing between residents can be maintained are allowed. Appropriate hand hygiene, and universal masking are required. PVH leadership is required to utilize discretion in determining off -site activities.  
 
NON-ESSENTIAL PERSONNEL 
In Step 1 only non-essential personnel deemed necessary by the facility are allowed. In Step 2, Non-essential personnel (e.g., barbers) are allowed as determined necessary by the facility, with screening and additional precautions including social distancing, hand hygiene, and universal masking. In Step 3, Non-essential personnel are allowed, with screening and additional precautions including social distancing, hand hygiene, and universal masking. 
  1. DESCRIBE THE LIMITED NUMBER AND TYPES OF NON-ESSENTIAL PERSONNEL THAT HAVE BEEN DETERMINED NECESSARY AT STEP 2 
 
Non-essential personnel are determined to be necessary on a case by case basis by the administration 
  1. DESCRIBE HOW SOCIAL DISTANCING, HAND HYGIENE, AND UNIVERSAL MASKING WILL BE ENSURED FOR NON-ESSENTIAL PERSONNEL AT STEPS 2 AND 3 
 
The non-essential personnel sign a written acknowledgment of the facilities expectations on hand hygiene, social distancing and making attempts to minimize or eliminate their presence in resident areas unless absolutely necessary.   
  1. DESCRIBE MEASURES PLANNED TO ENSURE NON-ESSENTIAL PERSONNEL DO NOT COME INTO CONTACT WITH RESIDENTS EXPOSED TO COVID-19 
 
Non-essential personel (Re: Contractors ) are escorted and monitored by HVH staff to assist in minimizing or eliminating contact in resident spaces.                                                                                                           Screening and additional precautions including social distancing, hand hygiene, and universal masking.  
 
VISITATION PLAN 
For visitation to be permitted in Steps 1 and 2 of reopening, the following requirements are established. Screening and additional precautions including social distancing, hand hygiene, and universal masking are required for visitors. 
  1. DESCRIBE THE SCHEDULE OF VISITATION HOURS AND THE LENGTH OF EACH VISIT 
 
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 chaperoned by HVH staff and/or volunteers. Children under the age of 12 and pets will not be permitted until Step 3. 
  1. DESCRIBE HOW SCHEDULING VISITORS WILL OCCUR 
 
Family and Responsible parties will be able to schedule visits via phone with the Social Services Department.  (814 696 5223) 
  1. DESCRIBE HOW VISITATION AREA(S) WILL BE SANITIZED BETWEEN EACH VISIT 
 
HVH will establish a deep cleaning / terminal clean disinfecting schedule for cleaning of designated visitation / high touch areas between visits. 
  1. WHAT IS THE ALLOWABLE NUMBER OF VISITORS PER RESIDENT BASED ON THE CAPABILITY TO MAINTAIN SOCIAL DISTANCING AND INFECTION CONTROL? 
 
According to the BVH Reopening Plan, during Steps 1 and 2 the resident will be limited to 2 family members at a time. During  Step 3, scheduling of visitation is no longer required and will take place in a designated area. Visitor restrictions will be lifted at this time. 
  1. DESCRIBE THE ORDER IN WHICH SCHEDULED VISITS WILL BE PRIORITIZED  
 
Visitation opportunities are limited due to space and time constraints.                                                     
Residents: Hospice/comfort care residents and residents who do not have the opportunity to utilize telecommunications will be given priority to receive visits.                                                                            
Visitors: The first next of kin listed in the medical record or their designee will be given priority for visitation. 
 
 
 
 
 
 
 
 
STEPS 1 & 2  
  1. DESCRIBE HOW THE FACILITY WILL DETERMINE THOSE RESIDENTS WHO CAN SAFELY ACCEPT VISITORS AT STEPS 1 AND 2 (CONSIDERING SUCH SAFETY FACTORS AS EXPOSURE TO OUTDOOR WEATHER AND TRANSPORTING RESIDENT TO VISITOR LOCATION) 
 
Any residents who are not experiencing health conditions( with the exception of those qualifying for compassionate care) that require them to be on isolation or otherwise maintained in their rooms will be eligible for off-unit visitation. Cross-over visitation is only permitted if there is no new outbreak in the facility in which the cross-over visitor resides, unless the cross-over visitor resides in a green zone (per PA-HAN 530).   
  1. DESCRIBE THE OUTDOOR VISITATION SPACE FOR STEPS 1 AND 2 TO INCLUDE THE COVERAGE FOR SEVERE WEATHER, THE ENTRANCE, AND THE ROUTE TO ACCESS THE SPACE 
 
HVH has covered outdoor spaces attached or adjacent to each building on campus. The covered spaces are all accessible from designated parking spaces that do not require the visitor to enter a building. In the event of severe weather, visitation will be shortened or cancelled or moved to indoor visitation if time permits. 
  1. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING OUTDOOR VISITS 
 
Plexi-glass 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. 
  1. 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 be offered during Steps1 and 2 per the BVH Reopening Plan. 
  1. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING INDOOR VISITS 
 
Plexi-glass 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 
  STEP 3 
  1. DESCRIBE HOW THE FACILITY WILL DETERMINE THOSE RESIDENTS WHO CAN SAFELY ACCEPT VISITORS AT STEP 3 (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. 
  1. WILL OUTDOOR VISITATION BE UTILIZED AT STEP 3? IF NO, SKIP TO QUESTION #52 
 
Yes, weather permitting 
  1. DESCRIBE THE OUTDOOR VISITATION SPACE FOR STEP 3 TO INCLUDE THE COVERAGE FOR SEVERE WEATHER, THE ENTRANCE, AND THE ROUTE TO ACCESS THE SPACE (IF THE SAME AS STEP 2, ENTER “SAME”) 
 
SAME (See #44) 
  1. 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 STEP 2, ENTER “SAME”) 
 
SAME (See #45) 
  1. DESCRIBE THE INDOOR VISITATION SPACE THAT WILL BE USED TO INCLUDE THE ENTRANCE AND THE ROUTE TO ACCESS THE SPACE (IF THE SAME AS STEP 2, ENTER “SAME”) 
 
In MacArthur Hall the Multi-Purpose Room will be utilized for indoor visitation. There are designated access points to each indoor visitation space that allow for minimal contact with staff and resident areas. 
  1. 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 STEP 2, ENTER “SAME”) 
 
SAME (See #45)   
  1. 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 (SUCH AS END OF LIFE VISITS) IN THE RESIDENT’S ROOM 
 
Visits will have time limits (30 minutes)  established by HVH. Visitors will follow CDC and DOH universal source control guidelines. Visitors will sign an acknowledgement, or consent form of understanding.  
 
Visitation for residents without a roommate will be limited to 2 family members if the visit is to take place in the resident 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.                    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 outbreak in the facility in which the cross-over visitor resides unless the cross-over visitor resides in a green zone (per PA-HAN 530).   
 
 
VOLUNTEERS 
In Step 2 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 Step 3, 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. 
  1. 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. 
  1. DESCRIBE THE DUTIES TO BE PERFORMED BY VOLUNTEERS DURING STEP 2 
 
Volunteers will assist in scheduling and monitoring visitations.