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
This template is provided as a suggested tool for Personal Care Homes, Assisted Living Residences and private Intermediate Care Facilities to use in developing their Implementation Plan for reopening in accordance with the Pennsylvania Department of Human Service’s Interim Guidance for Personal Care Homes, Assisted Living Residences and Private Intermediate Care Facilities During COVID-19. This (or another version of an Implementation Plan) is to be posted on the facility’s website (if the facility has a website) or available to all residents, families, advocates such as the Ombudsman and the Department upon request. This is NOT to be submitted to the Department. The facility will progress to the next step of reopening only when the criteria are met as described in the Interim Guidance for Personal Care Homes, Assisted Living Residences and Intermediate Care Facilities During COVID-19. If at any point during reopening the facility fails to meet the criteria for reopening or is operating under a contingency staffing plan, the facility will cease reopening immediately.
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 William’s Manor
2. STREET ADDRESS 164 Baron Road
3. CITY Wind Gap
4. ZIP CODE 18091
5. NAME OF FACILITY CONTACT PERSON Colleen Brooks
6. PHONE NUMBER OF CONTACT PERSON 610-759-4053
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).
7.DATE THE FACILITY WILL ENTER THE REOPENING PROCESS 8/17/2020
DATE THE FACILITY WILL ENTER THE REOPENING
8. 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
9. HAS THE FACILITY EXPERIENCED A SIGNIFICANT COVID-19 OUTBREAK? (IF NO, SKIP TO #11) No, no positive cases
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).
10. 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 was done between 8/11/2020 to 8/12/2020
11. 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 William’s Manor has contracted with a CLIA-certified laboratory (ACCU Reference Medical Labs) and has the capacity to administer COVID-19 diagnostic tests to all residents showing signs and symptoms of COVID-19 within 24 hours. Wiliam’s Manor staff receive nasal swab samples from impacted residents and send to ACCU Labs to obtain results.
12. DESCRIBE THE ABILITY TO HAVE COVID-19 DIAGNOSTIC TESTS ADMINSTERED TO ALL RESIDENTS AND STAFF IF THE FACILITY EXPERIENCES AN OUTBREAK, INCLUDING ASYMPTOMATIC STAFF William’s Manor has contracted with a CLIA-certified laboratory (ACCU Reference Medical Labs) and has the capacity to administer COVID-19 diagnostic tests to all residents and staff if the facility experience a COVID-19 outbreak. William’s Manor staff will obtain nasal swab samples and send to ACCU Labs to obtain results.
13. DESCRIBE THE PROCEDURE FOR TESTING OF NON-ESSENTIAL STAFF AND VOLUNTEERS William’s Manor has contracted with a CLIA-certified laboratory (ACCU Reference Medical Labs and has the capacity to administer COVID-19 diagnostic tests to all staff and volunteers, including those who are aymptomatic. This is accomplished by universal testing of all staff in accordance with state Department of Health guidelines. William’s Manor staff obtain nasal swab samples and send to ACCU Labs to obtain results.
STRATEGY FOR TESTING, COHORTING, PERSONAL PROTECTIVE EQUIPMENT, AND STAFFING
14. DESCRIBE THE PROCEDURE FOR ADDRESSING RESIDENTS OR STAFF THAT DECLINE OR ARE UNABLE TO BE TESTED Residents who refuse or are unable to be testied will be required to isolate/quarantine in their own room for 14 days. The resident and his/her responsible partiy will be educated on the benefits of testing if they have refused. If asymptomatic, staff who decline or refuse to be tested will be educated about the benefits of testing. If symptomatic, staff who decline or refuse to be tested will be removed from the work area and be asked to quarantine at home for 14 days and be asked to be medically cleared by a doctor before returning.
15. DESCRIBE THE PLAN TO COHORT OR ISOLATE RESIDENTS DIAGNOSED WITH COVID-19 IN ACCORDANCE WITH PA-HAN-509 PURSUANT TO SECTION 1 OF THE INTERIM GUIDANCE FOR Personal Care Homes, Assisted Living Residences and Intermediate Care Facilities DURING COVID-19. Residents will be cohorted to separate units, based on test results. Residents with a positive SARS-CoV-2 PCR test and still wihn the paramaters for transmission-based precautions will be restricted to a separate bedroom to quarantine for 14 days. Residents who may have been exposed will be required to quarantine in their rooms for 14 days. Residents with a negative SARS-CoV-2 PCR test or who have not been exposted to COVID-19 will be free to access common residentiary areas, free of exposure.
16. 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) William’s Manor has a minimum seven-day stock of PPE on hand at all times, including masks, goggles, shields, gloves, and lab coats. William’s Manor staff monitor use of all PPE and continues to stockpile in case of an outbreak.
17. DESCRIBE THE CURRENT STAFFING STATUS AND THE PLAN TO ENSURE NO STAFFING SHORTAGES William’s Manor has 11 full- and part-time staff responsible for the care and oversight of four residents, enough to allow flexibility for any staff with personal needs or to quarantine according to state and federal guidelines, if necessary. In a worst-case scenario with multiple staff members exposed or testing positive, William’s Manor maintains an agreement with a staffing agency. Overnight accommodations, including food and shelter, are available for any staff asked to cover overnight shifts or to avoid exposure at home. Transportation for staff is available if required. William’s Manor reserves the right to decline time off if an emergency staff shortage develops.
18. 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 the governor of Pennsylvania declares Northampton County a “red” zone, William’s Manor will halt any and all activities related to reopening and revert to full restrictions in accordance with Department of Health and other state-regulated guidelines. At that time, William’s Manor will notify all residents and responsible parties by telephone and written notification of the requirement and explain the restrictions in place, and post all relevant information on the company’s website.
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.
19. RESIDENTS Residents are subject to universal testing in accordance with Department of Health guidelines. Residents exhibiting signs and symptoms of COVID-19 based upon assessment by qualified nursing or medical staff will be ohorted and tested in accordance with Department of Health guidelines and as noted in sections 11, 12, and 15.
SCREENING PROTOCOLS
20. STAFF Staff are subject to screening or signs and symptoms and have temperature checks at the beginning and end of each shift. If staff fail any part of the screening or develop signs and symptoms of COVID-19 during their shift, he/she will be tested and referred to their physician for follow-up care.
21. HEALTHCARE PERSONNEL WHO ARE NOT STAFF Health care personnel who are not staff are subject to screening of signs and symptoms and have temperature checks prior to entering resident care areas and have temperature checks prior to leaving the building. Anyone who fails any part of the screeing or who develops signs and symptoms of COVID-19 while at William’s Manor will be referred to his or her physician for follow-up care.
22. NON-ESSENTIAL PERSONNEL All non-essential staff are subject to screening of signs and symptoms and have temperature checks at the beginning and end of each shift. Anyone who fails any part of the screening or who develops signs and symptoms of COVID-19 during their shift will be tested and referred to his or her physican for follow-up care.
23. VISITORS Visitors will be subject to screening of signs and symptoms and have temperature checks prior to entering the facility. Any visitor who fails any part of the screening or who develops signs and symptoms of COVID-18 during a vist will be asked to leave and to contact his or her physician for follow-up care.
24. VOLUNTEERS Volunteers are subject to the same requirements as staff or visitors as noted in sections 20 and 23.
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.
25. DESCRIBE COMMUNAL DINING MEAL SCHEDULE, INCLUDING STAGGERED HOURS (IF ANY) Dining hours are staggered or residents are separated via social distancing protocols to avoid close proximity during meals.
26. DESCRIBE ARRANGEMENT OF TABLES AND CHAIRS TO ALLOW FOR SOCIAL DISTANCING Tables and seating are separated by a minimum of 6 feet and located in different residential/community rooms to allow appropriate spacing of residents.
27. DESCRIBE INFECTION CONTROL MEASURES, INCLUDING USE OF PPE BY STAFF Staff wears appropriate PPE during meal services. Tables and chairs are sanitized prior to and after each seating. Salt and pepper shakers, condiments, creamers, and other items are not on tables during meal times, but are available upon request
28. DESCRIBE ANY OTHER ASPECTS OF COMMUNAL DINING DURING REOPENING Staff oversees all services throughout meal times, ensuring social distancing.
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 involved. Describe how social distancing, hand hygiene, and universal masking will be ensured. Also include precautions that will be taken to prevent multiple touching of items such as game pieces.
29. DESCRIBE ACTIVITIES PLANNED FOR STEP 1 (FIVE OR LESS RESIDENTS UNEXPOSED TO COVID-19) Staff and residents will wear masks and will sanitize their hands prior to and immediately following an activity. Activities take place in the large living room, the great room, and outside patio. Chairs are spaced appropriately. Any item used during an activity – game piece, crayons/pens/pencils/coloring books, puzzles – are sanitized immediately after the activity. No activities are scheduled that involve multiple people touching the same item. Singing activities, singalongs, and group readings have been suspended.
30. DESCRIBE ACTIVITIES PLANNED FOR STEP 2 (TEN OR LESS RESIDENTS UNEXPOSED TO COVID-19) Same as above
31. DESCRIBE ACTIVITIES PLANNED FOR STEP 3 Same as above
32. DESCRIBE OUTINGS PLANNED FOR STEP 3 Outings are to be restricted to invidual trips with family or responsible-party supervision only. Prior to outing, residents, staff, and responsible party(ies) will wear masks and utilize hand sanitizer as appropriate.
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.
33. DESCRIBE THE LIMITED NUMBER AND TYPES OF NON-ESSENTIAL PERSONNEL THAT HAVE BEEN DETERMINED NECESSARY AT STEP 2 Non-essential personnel is limited to house pet care whose work is restricted to outdoors; and lawn care, also restricted to outdoors
34. DESCRIBE HOW SOCIAL DISTANCING, HAND HYGIENE, AND UNIVERSAL MASKING WILL BE ENSURED FOR NON-ESSENTIAL PERSONNEL AT STEPS 2 AND 3 Non-essential personnel will be educated about proper hygiene and will be required to wear a mask during their time at William’s Manor. Pet care providers will be screened appropriately, wear masks if inside the facility, and will have areas sanitized upon departure.
35. DESCRIBE MEASURES PLANNED TO ENSURE NON-ESSENTIAL PERSONNEL DO NOT COME INTO CONTACT WITH RESIDENTS EXPOSED TO COVID-19 Unless specifically approved, all non-essential personnel perform their work outdoors. If they should need to be inside, they will be supervised in a way that ensures they are not exposed to any resident.
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.
36. DESCRIBE THE SCHEDULE OF VISITATION HOURS AND THE LENGTH OF EACH VISIT A visitation schedule will be created and families/responsible parties will be able to visit once a week, with visits limited to 30 minutes
VISITATION PLAN
37. DESCRIBE HOW SCHEDULING VISITORS WILL OCCUR Visitation is tracked via a calendar posted in staff/medical room. Staff ensures that no more than one resident visit is scheduled at a time. Visitation hours will be restricted to 1:30-2:30 p.m. and 3:00-4:00 p.m. on Tuesdays, Thursdays, and Saturdays, and 6:00-7:00 p.m. on the same days through September, at which time the evening visitation policy will be re-evaluated. No visitation will be scheduled within 30 minutes of the end of a previous visitation, allowing time for sanitation.
38. DESCRIBE HOW VISITATION AREA(S) WILL BE SANITIZED BETWEEN EACH VISIT Chairs, tables, and other visitation furniture will be sanitized with an approved cleaning solution prior to and immediately following each visitation.
39. WHAT IS THE ALLOWABLE NUMBER OF VISITORS PER RESIDENT BASED ON THE CAPABILITY TO MAINTAIN SOCIAL DISTANCING AND INFECTION CONTROL? Upon Step 2 reopening, no more than 3 visitors per resident at a time and no more than one visitation scheduled in any given hourlong period. Visitation must occur outdoors under this step. Under Step 3 of reopening, visitation will be allowed indoors, limited to 2 visitors at a time and no more than one visitation scheduled in any given hourlong period..
40. DESCRIBE THE ORDER IN WHICH SCHEDULED VISITS WILL BE PRIORITIZED Vistitation will be booked on a first-come, first-served basis with alternatives offered in case of conflict. Visitation must be scheduled by phone (610-759-4053) no less than 24 hours ahead of time.
STEP 2
41. 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) Residents will be evaluated to ensure visitation can occur safely. Staff will be assigned to the visitation areas as necessary. Residents considerd to be at risk of elopement will be accompanied by a staff member.
42. 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 will occur on the back deck, with awning or other overhead protection provided. This area can be accessed from the parking area without entering the building.
43. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING OUTDOOR VISITS Chairs will be situated a minimum of eight feet apart. Visitors will be advised about the risks of physical contact. Masks will be required during all visits.
44. 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 A great room and outdoor patio are available for visitation. The great room has a dedicated entry/exit so visitors need not pass through common areas/resident living quarters or have contact with other residents.
45. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING INDOOR VISITS Chairs will be situated no less than eight feet apart. Masks will be required during all visits.
STEP 3
46. 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) Residents will be evaluated for visitation safety. Staff will be assigned to be in the general area to assist as necessary. Residents who are considred an elopement risk will be accompanied by a staff member.
47. WILL OUTDOOR VISITATION BE UTILIZED AT STEP 3? IF NO, SKIP TO QUESTION #52 Yes
VISITATION PLAN
48. 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 described in Section 42
49. 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 described in Section 43
50. 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”) Same as described in Section 44
51. 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 described in Section 45
52. 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 Visitor(s) will be screened appropriately at back entrance, and, once cleared, accompanied to the great room. Resident will be escorted to great room following visitor screening(s). Masks will be required for visitor(s) and resident. Room will be sanitized immediately following each visit. Chairs will be situated no less than 6 feet apart during visitation.
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.
53. DESCRIBE INFECTION CONTROL PRECAUTIONS ESTABLISHED FOR VOLUNTEERS, INCLUDING MEASURES PLANNED TO ENSURE VOLUNTEERS DO NOT COME INTO CONTACT WITH RESIDENTS EXPOSED TO COVID-19 Volunteers will only be allowed to access to the area where they will be completeing their volunteer task. A William’s Manor staff member will bring residents to the activity as appropriate
54. DESCRIBE THE DUTIES TO BE PERFORMED BY VOLUNTEERS DURING STEP 2 Volunteers will only be allowed to assist with resident activities with residents who have not been expoed to COVID-19 Colleen M Brooks August 21, 2020 ____________________________________________ _____________________________ SIGNATURE OF ADMINISTRATOR