Covid-19 Information and Updates

The NH Department of Health vaccine education outreach team shared this instructional video

Covid-19 Information and Updates


Riverside Rest Home New Visiting Guidelines
Effective December 2, 2021
Suggested Visiting Hours:
10:00am-2:00pm and 3:30pm-7:00pm
Visitors should enter through main front doors to be screened.
If a staff screener is not readily available upon entering- please call 603-509-8488.
If there is no answer at 603-509-8488 please call the nursing supervisor at
603-516-4137.

Resident visits no longer need to be scheduled.
The number of visitors is no longer limited.

Visitors must still wear required PPE.
As of 12/1/2021- surgical mask and eye protection

All visitors do need to be screened prior to entering the building.

Visitors should not visit if they are sick, have had contact with someone with COVID-19 or are suspected of having COVID-19.

Visitors must continue to adhere to core principles of Covid-19 infection prevention including hand hygiene and social distancing (most visits to continue to take place in residents’ rooms).

We continue to ask that you don’t socialize throughout the unit/building.

Residents outings
We request that resident outings continue to be scheduled through the unit and/or resident’s social worker as they were prior to COVID-19.
During the outing we continue to request that masks are worn and social distancing and hand hygiene are practiced.
 
 
Riverside Rest Home
Re-Opening Guidance for LTCF
Effective December 2, 2021
This policy is to be instituted and maintained for the entirety of the COVID-19 Pandemic.
02/21/2021 BHB Page 1 of 2
Updated 12/01/2021 BHB
Screening:
Screen 100% of all persons entering the facility.

Each person will have their temperature taken and recorded. Each person will print name, sign, and
answer truthfully, all screening questions. Screening questions consist of travel, symptoms, and contact/exposure.

Any employee answering affirmative/yes to the screening questions will NOT be permitted entry until further assessment can be completed.

Screen 100% of residents for symptoms at least daily.
Documented temperature, oxygen saturation level, absence or presence of COVID-19 symptoms.

Visitation:
Please see Visitation Policy effective December 2, 2021.

Non-essential personnel:
Hairdresser, Volunteers, Music Entertainment, etc. are permitted. These individuals are asked to coordinate with RRH Activities Director and/or Volunteer Coordinator.

Trips outside the facility:
Permitted:
 medically necessary trips
 resident outings (see visitation policy)
 individual or small group trips e.g., roommates, residents from the same unit that usually spend time together
 trips where the location allows for social distancing and mask use
Not Permitted:
 Group trips that have residents from multiple units
 Group gathering locations e.g., concerts
 Group dining. We request that all dining trips continue to be postponed at this time as social distancing and mask use cannot adequately be maintained.
Consulting Medical Professionals i.e., ophthalmologist, optometrist, podiatrist, etc.:
Permitted, must provide a copy of a negative COVID-19 test obtained within 48 hours prior to visit. PCR preferred. If unable to obtain a PCR result, medical professional is to coordinate with facility to have a Rapid Antigen test performed prior to entry.
PPE must be changed between residents.
Residents are to remain on their units for the visit.
Communal dining:
Limited communal dining is permitted.
Social distancing, 6ft or greater, must be adhered to.
Unit Solariums may be opened.
Facility main dining room remains closed at this time however is under review for opening.
Group Activities/Physical Therapy:
Limited, to ensure that social distancing can be maintain and residents are from the same unit.
No residents from different units in 1 group or room/area.
Masks must be worn by all staff and residents at all times.
Residents who cannot appropriately wear a mask are encouraged to social distance from others.
If residents (such as Unit 5) are not able to tolerate mask use, please have the activity occur on the unit.
Physical distancing, 6ft or greater, must be maintained as possible throughout.
No passing of items between residents, i.e., cards, bingo chips, balloons, paint brushes, etc.
Preferably activity will occur on the resident units.
If the activities room is utilized, residents may not travel through another unit/resident space.
Animals:
Permitted, must be leashed.
RRH does request that animals are not brought from resident to resident. If this does occur, the handler should assist the resident to sanitize hands before and after the visit. Handler should also be mindful that the resident does not touch their face or mask without sanitizing their hands first.
Testing:
Routine Surveillance testing is determined by surrounding community, facility status, and county positivity rates. Please see COVID-19 testing policy.
PPE:
 Surgical/Procedure mask to be worn by all employees, visitors, volunteers, etc. while in the building or when outside with residents. Note: Unvaccinated employees are required to wear a KN95.
 KN95s are more protective than a surgical mask however, easier to breathe through than a N95. The KN95s offer protection to the wearer and the individual they interact with. The KN95 can be used for 1 shift then discarded.
o KN95s are to be worn by unvaccinated employees. We do ask that unvaccinated visitors also wear the KN95 if vaccination status is disclosed at screening.
 N95s must be worn during aerosol generating procedures i.e., nebulizer treatments. You may choose to wear a N95 instead of the KN95. These masks are to be worn for 2 shifts as previously instructed.
o Please wear a surgical mask over the N95 when performing splash activities, i.e. baths or showers. This offers protection of the N95 as the surgical mask can be easily discarded and replaced if soiled or wet.
 Eye Protection must be worn when within 6 feet of anyone else when the community transmission level is in Substantial or High.
 Gloves for direct resident contact.
 Gowns are only required for rooms identified as on precautions.

 

Riverside Rest Home COVID-19 Update 04.06.22

Good Afternoon,
Riverside Rest Home had an employee test positive for COVID-19 this past
weekend. The transmission to the employee has been identified, this case was
contracted outside the facility. The employee did work during the 48 hours
prior to symptom development. The employee did have a negative rapid test the
morning of the last worked shift. Masks and eye protection continue to be
required and worn by all personnel, vendors, and visitors in the building. The
risk of transmission to others in the building is minimal however, not
non-existent. This notification is delayed as we are obligated to notify those
with close contact or higher risk potential exposure prior to facility
notification. All identified employees and residents have been notified of
potential exposure, and will have increased frequency of COVID-19 testing. At
this time those identified are free from COVID-19 related symptoms.

No changes to facility operations are required as a result
of this case.

 

 Current Active Cases:

 

Residents 0

Employees 1

 Please share this information with residents and their loved
ones.

 

Thank you,
Brianna Haskins-Belanger, RN, BSN
Strafford County Complex COVID-19 Operations Coordinator
Riverside Rest Home
276 County Farm Road
Dover, NH 03820

 

Riverside Rest Home
Policy and Procedure During COVID-19 Pandemic
Accepting Admission and Residents Who Leave the Facility
This policy is to be
instituted and maintained for the entirety of the COVID-19 Pandemic, unless
updated.

 

Updates
identified in orange.

 

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.

  1.  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. 14th

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

    Friday Dec. 17th

    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 2nd 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