Covid-19 Information and Updates

Covid-19 Information and Updates

 

Riverside Rest Home COVID-19 Update 06.22.22

Good
Afternoon,

 
        Strafford County Community Transmission levels
continue to be high. Transmission levels are utilized for healthcare facilities
only. Community Levels for the general public are identified as medium. Please
continue to monitor yourself for symptoms and report if any start. 

 

We were
notified that 3 employees tested positive from yesterday’s (6/21) routine
testing. Most cases have been attributed to community transmission sources
however, some sources are unknown. There is no identified link between the
active employee cases. Due to the increased testing, mask use, social
distancing and overall vigilant efforts by all employees, the risk of
transmission is minimal. Although minimal, the units that the employee worked
will undergo routine testing twice weekly out of precaution. 

 

Employees
identified as close contact have been notified. These employees have been
instructed to test prior to each working shift.  TESTING REQUIREMENTS for
employees is identified further down this e-mail.

 

Last known exposure/potential
exposure:

 

Unit 1B:
greater than 14 days ago

Unit 2:
6/21/22

Unit 3:
Right hall 6/21/22, left hall: greater than 14 days ago.

Unit 4:
greater than 14 days ago

Unit 5: 6/21

Hyder Unit:
6/16

Kitchen:
6/18 and 6/21

 

Cases since 3-7-2022:

 

Employees: 

Active: 4

Recovered: 30

Total: 34

 

Residents:

Active: 0 –Last resident
case, 5-6-2022. With the Great work by all employees, there
was no transmission to other residents. 

Recovered: 1

Total: 1

 

Screening upon entry to the building is
mandatory for every individual entering, regardless of role or duties in the
building. Symptoms include runny nose, cough, fever, body aches, chills,
sneeze with congestion, congestion, sore throat. Even if you feel “it is just a
cold” or “just allergies” report these symptoms to the screener. This is our
first line of defense to keep the facility safe.

       
              Exclusion: fire and
police in the event of an emergency. 

 

Required PPE use: 

       
            – surgical/procedure masks for
people up to date on all recommended COVID-19 vaccines.  

       
            – KN95 or greater for those not up to
date on all recommended COVID-19 vaccines.  

       
            – eye protection when within 6ft
of others. 

 

Testing:

       
  employees, volunteers, and contracted individuals

Up to date: not mandatory however, HIGHLY
recommended once weekly. 

               
Mandatory as instructed if identified as close contact with a positive person.

               
Employees that worked the areas identified on the dates above mandatory
weekly.

Not up to date: mandatory twice weekly –
in the building more than 24hours in the week.

       
                   
 mandatory once weekly – in the building 24hours or less in the week.

 

Individuals with
household contact, close contact outside of work, travel, and/or other risk
factors will test at a frequency appropriate to their specific situation. 

 

Location: Hyder south side

Days: Monday, Tuesday, Friday

Times: 6:30am-10:00am and
1:30pm-3:15pm

Type of test,
PCR or Antigen, will vary depending on availability, time of collection, and
situation. 

 

Up to date on
all recommended vaccines = you receive the booster/boosters when eligible. 

 

Recommended
COVID-19 vaccines vary between age groups, medical situation, and type or
primary series. Please follow the link below to determine if you are up to
date. 

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html#recommendations

or use the
booster tool available from the CDC to determine if you’re eligible based on
your specific situation. https://www.cdc.gov/coronavirus/2019-ncov/vaccines/booster-shot.html#when-you-can-get-booster

 

Thank you, 
Brianna Haskins-Belanger, RN, BSN
Strafford County COVID-19 Operations Coordinator
Riverside Rest Home, Strafford County

DEPARTMENT:   POLICY:                             PURPOSE or INTENT:                     PROCEDURE: Responsible Person(s): ALL	All   During the COVID-19 pandemic all new admissions, readmissions and current residents who leave the facility will be admitted/return to the facility in accordance with CDC guidance for Nursing Homes, at minimum. The COVID-19 infection and COVID-19 vaccination status will be taken into consideration on an individualized basis, per this policy, to determine if quarantine is required. Quarantine may be required beyond this policy, due to close contact with a positive person or symptom development. Quarantine may be required at the discretion of the Director of Resident Services in collaboration with the Infection Control Nurse and Director of Nursing Services. In accordance with CMS/CDC/NCAL/AHCA guidance, unless a person is tested for COVID-19 and negative before admission, the person is presumed to be positive for COVID-19 regardless of their having or not having symptoms.   ·         To accommodate for single occupancy room during quarantine period. ·         To limit contact with other residents and staff. ·         To monitor for fever and respiratory symptoms. ·         To minimize the risk of potential widespread exposure in the event the person(s) is positive for COVID-19. ·         To accommodate for the community’s need for continued admissions to Long Term Care. ·         To provide steps to be taken to reduce the spread of COVID-19 in the LTC facility.   Procedure:   1.      Follow Table 1 in accordance with each individual’s situation regarding admission/readmission/return from the hospital. a.       Licensed Nurse is responsible for monitoring for fever and respiratory symptoms with appropriate documentation. b.      All departments/personnel are required to follow appropriate precautions. 2.      Follow Residents Leaving the Facility(page4) in accordance with each individual’s situation regarding leaving the facility. a.       Residents who leave the facility must be provided education and reminded to follow all recommended infection control practices including: source control (masks), physical distancing, and hand hygiene. b.      Individuals accompanying residents (e.g., transport personnel, family members) must also be educated about the infection control practices as noted in 2.a.                                       i.      Employee such as social worker or other identified individual, arranging for resident to leave the facility must document the education provided. Include vaccination status of the people the resident is visiting with, if they are willing to provide this information. Note: RRH cannot “force/make” a visitor disclose/provide vaccination or test information.                                    ii.      Screening regarding if the resident is going to be where someone is positive is to be asked by the person arranging the visit. c.       Upon return to the facility the resident will be screened to determine risk of exposure to COVID-19 and screening for symptoms including documented temperature.  Documentation to reflect that the resident and/or family/friend was asked if the resident had exposure to someone positive for COVID-19 or suspected of COVID-19. If yes immediately notify supervisor prior to resident return to the unit/room. [Likely the nurse on the unit will be the person the resident is signed in with.]   Continued on pages 3 and 4.   d.

Table 1: New Admissions, Readmissions, and
Return from the Hospital.

1.      Documented
temperature, oxygen saturation level, absence or presence of COVID-19 symptoms
at minimum once daily.

2.      Requires 14-day
Quarantine, admit to single occupancy room on the Hyder unit.

3.      May be admitted
directly to the appropriate unit in the main building of Riverside Rest Home.

4.      Place
in contact precautions per RRH contact precaution guidance based on new
Strategies to optimize PPE supplies.

5.      Limit
contact with other residents as much as possible.

6.      Limit
the number of different staff interacting with a resident as much as possible
and limit the number of times each staff enters a resident’s room.

7.      As
the rooms on the Hyder unit are single occupancy rooms and bathrooms, this unit may
effectively manage individuals on Quarantine and those positive for COVID-19.

8.      Place
on droplet precautions per RRH droplet precaution guidance based on new
Strategies to optimize PPE supplies. Requires isolation until discontinuation of transmission
based precautions is determined in collaboration with the Director of Resident
Services and Infection Control Nurse. Isolation for a minimum of 10 days past
the start of symptoms or positive test.

 

NOTE:
PPE requirements are subject to change due to the status of a unit, building,
or whole facility. Please be advised that MEMO’s or e-mails may indicate a
different level of precautions required, those are to be followed in lieu of
this policy when increased levels of PPE are identified.

Resident is tested & COVID-19 negative with no or unknown prior infection and/or vaccination status. Resident overnight or ≥ 24 hours out of the facility.	Resident COVID positive, with symptoms, within the prior 90 days and has met CDC criteria to end transmission based precautions. i.e. Recovered positive. Fully Vaccinated resident i.e. 14 days past 2nd dose of 2 dose COVID-19 vaccines or 14days past 1st dose of 1 dose COVID-19 vaccines.	Resident tests positive for COVID-19 or has COVID symptoms.
·         #1 per shift ·         #2 ·         #4 & #5 ·         #6 ·         #7 ·         Run HEPA 500 Air Scrubber continuously at half air flow. ·         Keep Door Closed*	·         #1 ·         #3 ·         Rapid test upon arrival, if not done within 48hours prior to admission/readmission/return. ·         If positive move to identified COVID positive isolation room. ·         If negative keep on unit. ·         Precautions as directed for facility and unit.	Facility Resident Returning ·         #1 per shift ·         #5 ·         #6 ·         #7 ·         #8 ·         Run HEPA 500 Air Scrubber continuously at maximum air flow. ·         Keep Door Closed New admission ·         Do Not Admit unless to COVID positive floor. Will be determined on a case by case situation by admissions team.

*as appropriate, with regards to the resident’s physical
safety

 

 

Residents
Leaving the Facility:

 

Medical
appointments:

·        
Regular communication between the medical facility and the
nursing home is essential to help identify residents with potential exposures
or symptoms of COVID-19 before they enter the facility so that proper
precautions can be implemented.

·        
Generally, does not require quarantine upon return unless
risk of exposure has been identified and the resident is not fully vaccinated.

·        
Masks, Hand Hygiene, and Physical Distancing should be
practiced, as able, during transportation to and from the appointment as well as
during the appointment.

 

Community
Outings with Family or Friends less than 24 hours:

·        
Masks, Hand Hygiene, and Physical Distancing should be
practiced, as able, during transportation to and from the visit/outing, as well
as during the outing.

·        
Screening of resident/family or friend, to determine if
exposure of COVID-19 occurred.

·        
RRH may consider quarantining the resident upon return
based on screening and risk of exposure determined when resident returns to the
facility.

 

Community
Outings with Family or Friends greater than 24hours (LOA):

·        
Masks, Hand Hygiene, and Physical Distancing should be
practiced, as able, during transportation to and from the visit/outing, as well
as during the outing.

·        
Screening of resident/family or friend, to determine if exposure
of COVID-19 occurred.

·        
RRH may consider quarantining the resident upon return
based on screening and risk of exposure determined when resident returns to the
facility.

·        
Residents leaving the facility greater than 24 hours will
be managed as described in Table 1.

 

Additional points to
remember:

·        
At this time Strafford County has community
transmission of COVID-19 and individuals have been positive without any known
contact or travel.

·        
Always refer to COVID-19 pandemic policies
specified for the duration of the pandemic

·        
Any questions or if unsure contact the Director
of Resident Services.

·        
Riverside Rest
Home highly encourages residents, that are not fully vaccinated, to remain in
the facility to ensure that they are in an environment that is controlled to
ensure infection control practices are adhered to.

·        
Riverside Rest
Home highly encourages All residents that choose to leave the facility to only
go with family/friends/others that are also fully vaccinated.

 

Abbreviations:

AHCA: American
Health Care Association

NCAL: National
Center for Assisted Living

CDC: Centers for
Disease Control

CMS: Center for
Medicare and Medicaid Services

LTC: Long-term
care (Riverside Rest Home for purposes of this policy)

 

 

 

 

Riverside Rest Home

Policy and Procedure

Visitations

This policy is to be instituted and maintained for the entirety of the COVID-19 Pandemic, unless updated.

03/21/2021 BHB Page 1 of 3

Updated 6/25/2021 BHB

Updated 11/30/2021 BHB

Policy:

Riverside Rest Home (RRH) will allow in-person visitation in accordance with guidance provided by the Centers for Medicare and Medicaid Services (CMS) in accordance with Centers for Disease Control and Prevention (CDC).

This policy outlines visitation at Riverside Rest Home. During the COVID-19 Public Health Emergency (PHE) RRH is required to have identified infection prevention measures in place for visitation.

Core Principles of COVID-19 Infection Prevention

 Visitors who have a positive viral test for COVID-19, symptoms of COVID-19, or currently meet the criteria for quarantine, should not enter the facility.

 Hand Hygiene

 Masks (covering mouth and nose) and physical distancing at least six feet between people.

 Appropriate use of PPE. If resident is on isolation due to COVID-19 infection, enhanced PPE will be required for the visitor. Staff to assist visitor with proper donning and doffing of PPE.

Visitations:

 Indoor and Outdoor visits are permitted for all residents.

o The Core Principles of COVID-19 Infection Prevention continue to be required to reduce the risk of transmission.

o Due to screening requirements upon entry, suggested visitation is 10:00am-2:00pm and 3:30pm-7:00pm.

 PPE requirements are dependent on facility COVID-19 status, individual resident COVID-19 status, and community positivity rates.

 Visits should still be conducted using social distancing.

o The resident preference for social distancing between the resident and the visitor will be on an individualized resident and/or resident representative determination.

o Examples:

 Resident vaccinated, visitor vaccinated, resident wants to be closer than 6 feet to visitor. Social distancing does not have to occur;

 Resident unvaccinated, visitor vaccinated, resident and/or resident representative requests that visitor social distance or stay 6 feet or greater away from the resident. Social distancing does have to occur;

o Visitors are asked to social distance from other residents and employees.

o Resident and/or resident representatives may request that visits not occur in the room for the roommate. If requested RRH will assist at finding another location for visits to occur, for the roommate and the resident requesting.

 Visitors must keep the mask in place for the entirety of the time within the building. Mask should cover the nose and mouth. Due to the continued transmission of COVID-19 in the community, visitors are not permitted to eat or drink in the facility at this time, as to allow for the mask to be worn properly for source control.

o End of life situations when a visitor is sitting vigil with the resident:

 The resident does not have a roommate;

 Resident is fully vaccinated;

Riverside Rest Home

 

 Visitors may briefly remove the mask to eat or drink;

 Visitors must have the mask in place when any staff enter the room.

 Fully vaccinated residents who are not on quarantine or isolation may have a visitor assist them with eating their meal (ensure all other policies regarding assisting a resident to eat are followed).

o Individual assisting the resident to eat must:

 Wear a well-fitting face mask covering the nose and mouth;

 Perform hand hygiene before and after assisting with the meal;

 Must maintain social distancing (6ft) from other residents and staff.

o While the community transmission level is at substantial or high, we request that unvaccinated visitors do not assist the resident with meals.

 If both the resident and resident’s visitor are not able to wear a well-fitting facemask due to health related concerns, a full face shield is sufficient during the visit.

o If the resident is not vaccinated, we do ask that physical distancing be maintained during the visit.

 Residents, who are safe to do so, are encouraged to wear a mask when they have visitors.

 Physical contact is permitted, based on the resident and/or resident representative preferences. If physical contact does occur, please ensure that the visitor and the resident perform hand hygiene before and after the contact.

o Due to the length of the COVID-19 pandemic and nursing home restrictions on visitation, RRH presumes that all residents permit physical contact with their visitors. If the resident and/or resident representative choose not to permit physical contact, please notify the unit or social worker to ensure the proper plan of care is established.

o Physical contact can be allowed as long as both resident and visitor wear a well-fitting face mask and perform hand hygiene before and after contact. Regardless of resident or visitor vaccination status.

 Residents and visitors may go on a walk together.

o The resident and visitor must wear a well-fitting mask at all times during the walk.

The following criteria must be met:

Facility Requirements:

 RRH will provide PPE, we do ask that if a visitor has been supplied with eye protection that they please sanitize it and bring it to their next visit.

o The mask must cover the nose and mouth of all parties during the transit to and from the visit space as well as throughout the visit.

o PPE requirements are determined by facility issued memo’s. The requirements are subject to change often due to the community transmission rates, facility status, vaccination status, quarantine status, etc.

 Staff must carry, or have available, alcohol-based hand sanitizer with them to the visitation, and everybody (staff, resident, visitors) must sanitize their hands before and after visitation.

 Facility must maintain a log with contact information for all visitors to enable accurate public health contact tracing should there be a need.

 Animals are permitted.

o All animals must be leashed throughout the visit.

 

Additional Information:

 A resident who is suspected or confirmed to be infected with COVID-19 may have visitors.

o Visitors will be provided education on risk of transmission and provided appropriate PPE with staff assistance to properly donn and doff the PPE.

o Visitors will be provided education and required to sign that they understand the risks associated with the visit and will honor the state quarantine requirements after close contact with someone suspected or confirmed of COVID-19.

 Residents who have recovered from infection (e.g. COVID-19) may be visited as long as they no longer require transmission-based precautions without additional PPE requirements or risk acknowledgements.

 There is currently no limit on the number of visitors. RRH does request that if the amount of visitors, exceeds the ability for social distancing, that the visit be arranged ahead of time; to allow for a space to be arranged that can accommodate the number of visitors.

 RRH requests that during this time, visitors are an age and/or with demeanor where the individual is able to wear a well-fitting face mask for the entire duration of the visit and does not “run/roam” around the building, unit, or rooms.

o Regardless of age the visitor must be able to wear a well-fitting face mask for the entirety of the visit.

 Visitors are encouraged to disclose their vaccination status.

o Although encouraged, this is not a requirement for visitation.

o Vaccination status will be recorded along with screening questions.

 Visitors are encouraged to participate in testing.

o A visitor will be asked about their last test date and result.

o If the visitor has not had a test for the SARS-CoV-2 in the 5 days leading up to a visit, the visitor will be offered and encouraged to have a Rapid Antigen test for COVID-19 performed at the facility.

 If the visitor chooses to have a test at the facility, they will sign a testing consent form and results will be kept on file with their screening questions.

 A visitor may request a copy of their results; the copy of results will be available 2 business days after the visit.

o Although encouraged, this is not a requirement for visitation.

o A positive test result in the 14 days leading up to visitation, the individual will not be permitted entry to the building and the visit will not occur, regardless of indoor or outdoor visitation.

8.  Good Afternoon,

    

   Last week there were newly positive employees identified. Some employees had
   been previously put out of work due to household contact which means the risk
   of transmission to the building is non-existent. We have had 2 employees test
   positive that did work the 48 hours prior to symptoms. At this time the
   residents from the units they worked on remain free from COVID-19 related
   symptoms.

    

   Although there is risk associated with the time frame that
   the employees worked, the risk of transmission to these units is minimal. As
   there is a risk to these units, we will proceed with testing the residents on
   Unit 4 and Unit 5 tomorrow (Tuesday) morning. This does not change any
   requirements regarding visitation, admission, dining, activities, etc.

   Any employee may participate in testing.

    

   Testing will be based on community level of transmission,
   which is HIGH at this time.

   Testing Requirements:

    

   Resident Testing

   Unit 4 and Unit 5 Tuesday 12/14 am.

    

   Employee Testing

   Tuesday Dec. 14^th

   6:30am-10:00am and 1:30pm-3:15pm

   Friday Dec. 17^th

   6:30am-9:00am and 1:30pm-3:15pm

    

   Mandatory for:

   ·        
   Employees notified that they were close contact
   to the newly positive employees.

   ·        
   Employees Not fully vaccinated. Reminder
   that fully vaccinated is 14 days after the 2^nd dose of Pfizer and/or
   Moderna, and 14 days after the 1 dose of J&J.

   ·        
   Not vaccinated employees must test on both
   days. If the employee only works 1-2 days a week, they can test just one
   day.

    

   Voluntary for:

   • Fully vaccinated employees that would like to be
     tested.
     
     • Testing is optional for fully vaccinated employees,
       unless identified as close contact to an individual positive for
       COVID-19.

   Testing will continue for:

   Anyone newly identified as close contacts, regardless of
   place or person of contact, will continue to be tested and quarantined if
   necessary.

   Anyone with new and unexplained signs or symptoms of
   COVID-19.

    

   RRH COVID-19 Cases since 9/14/2021
   	Recovered	Active Cases	Passed/Deaths	Total
   Employees	Fully Vacc: 20 Not Vacc: 9	Fully Vaccinated: 4 Not fully vaccinated: 2 (4 were not in the building during the 48 hours prior to symptoms)	0	35
   Residents	7	0	2	All fully Vacc. 9

   As the community continues to see a rise in COVID-19 cases,
   we are all at risk for transmission and should continue to monitor ourselves
   for symptoms.

    

   Thank you for your continued hard work.

    

   Brianna Haskins-Belanger, RN, BSN

   Strafford County Complex COVID-19 Operations Coordinator

   Riverside Rest Home

   276 County Farm Road

   Dover, NH 03820December06