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PA Soldiers’ and Sailors’ Home 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 
 
PA Soldiers’ and Sailors’ Home 
  1. STREET ADDRESS 
 
560 East Third Street 
  1. CITY 
 
Erie 
  1. ZIP CODE 
 
16507 
  1. NAME OF FACILITY CONTACT PERSON 
 
Kimberly Horvath, Personal Care Administrator 
814-871-4531 
 
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 
 
11/6/2020 
  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) 
 
YES 
 
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 
 
PSSH has the clinical staff to conduct COVID-19 testing.  PSSH has obtained the supplies for COVID-19 testing through a contract with Quest Diagnostic for all but one week of the testing thus far.  The week of 10/19/2020 testing supplies and lab services were provided by Eurofin, DOH lab.  Iadditional support is needed PSSH would need to 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. 
 
  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 
 
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). 
  1. DESCRIBE THE PROCEDURE FOR TESTING OF NON-ESSENTIAL STAFF AND VOLUNTEERS  
 
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, WalMartRiteAid) or personal physicians can be used if needed. 
  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 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. 
 
  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 Facilitiess 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. 
  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) 
 
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. 
  1. 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. HR will continue their 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 PSSH identifies a new case of Covid-19 the facility returns to the most stringent level and starts over. 
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. Include how the data will be submitted to the Department.  
  1. 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. 
  1. 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. 
  1. HEALTHCARE PERSONNEL WHO ARE NOT STAFF 
 
Healthcare personnel who are not staff follow the same screening process as the essential staff (see #19) 
  1. NON-ESSENTIAL PERSONNEL 
 
Non-essential personnel who are not staff follow the same screening process as the essential staff (see #19) 
  1. 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. 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. 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. 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.   
  1. VOLUNTEERS 
 
Volunteers will not be permitted on campus in Step 1.  Volunteers will be allowed in Step 2 for assistance with visitation only.  In Step 3, volunteers will be allowed on campus.  Testing 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.    
 
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)  
 
Step 1-residents may eat in the same room with social distancing, and limitd amount of people per table. 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. 
  1. DESCRIBE ARRANGEMENT OF TABLES AND CHAIRS TO ALLOW FOR SOCIAL DISTANCING 
 
Residents who eat in a common area 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 at a table. 
  1. DESCRIBE INFECTION CONTROL MEASURES, INCLUDING USE OF PPE BY STAFF 
 
Staff providing assistance serving residents in the dining areas will utilize PPE as appropriate and proper hand washing or use of hand sanitizer. 
  1. 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 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) 
 
Step 1-limited activities with 5 or fewer residents. 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.   
  1. DESCRIBE ACTIVITIES PLANNED FOR STEP 2 (TEN OR LESS RESIDENTS UNEXPOSED TO COVID-19) 
 
Step 2limited activities with 10 or fewer residents.  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.   
  1. DESCRIBE ACTIVITIES PLANNED FOR STEP 3 
 
Step 3-outings are allowed: outings limited to the # of people where social distancing 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. Activity’s vendors are permitted in the facility after screening and with adherence to universal source control guidelines.   
  1. DESCRIBE OUTINGS PLANNED FOR STEP 3 
 
Outings/off-site activities are allowed only for residents recovered from or unexposed to COVID-19 upon entering Step 3. 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 Step 2, non-essential personnel deemed necessary by the facility are allowed (in addition to those already permitted in Section 4 of Interim Guidance for Personal Care Homes, Assisted Living Residences and Intermediate Care Faciilties During COVID-19). In Step 3, all non-essential personnel are allowed. Screening and additional precautions including social distancing, hand hygiene, and universal masking are required for non-essential personnel. 
  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 PSSH Leadership. 
  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 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. 
  1. 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 Steps 2 and 3 of reopening (as described in Section 6 of Interim Guidance for Personal Care Homes, Assisted Living Facilities and Intermediate Care Facilites During COVID-19), 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 
 
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 
  1. DESCRIBE HOW SCHEDULING VISITORS WILL OCCUR 
Visitation will be limited due to space and time constraints.  Hospice and comfort care residents will be given priority. 
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 3. Family and Responsible Parties will be able to schedule visits via phone with the Social Services Department (814-878-4917). 
  1. 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. 
  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.  See number 25 above.   
  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. 
STEP 2  
  1. DESCRIBE HOW THE FACILITY WILL DETERMINE THOSE RESIDENTS WHO CAN SAFELY ACCEPT VISITORS AT STEP 2 (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. 
  1. DESCRIBE THE OUTDOOR VISITATION SPACE FOR STEP 2 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. 
  1. 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. 
  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 not be offered during Step 2 (Phase Bravo) per the BVH Phased Reopening Plan. 
  1. 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  
  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 
 
Yesweather 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 as #41 
  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 as #42 
  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”) 
 
Visitors are permitted in the facility in designated areas in neutral zones away from other residents such as the Personal Care Dining RoomPersonal Care Library, 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.   
  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 as #42 
  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 IN THE RESIDENT’S ROOM 
 
Visiting times must be scheduled in advance with the PSSH staff.  Visitation will be limited to 3 family members for 30 minutes total.  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 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 
 
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. 
 
Volunteers will assist in scheduling and monitoring visitations