COVID-19 STATUS & RESPONSE

The health and safety of our residents, their families and our employees continue to be our top priority. As an organization we are closely monitoring developments related to the COVID-19 or Coronavirus outbreak and its impact in our community and surrounding areas. We activated our preparedness plan in early March and have been modifying our plan in relationship to the recommendations forwarded to us by the CDC (Centers for Disease Control and Prevention), CMS (Center for Medicaid and Medicare Services), ISDH (Indiana State Department of Health) and TCHD (Tippecanoe County Health Department).

In conjunction with the State Ombudsman program the ISDH has asked each Health Care Facility to give daily updates to family members concerning the Coronavirus.

We have designated two contacts in the facility should you need to voice a concern or have questions related to the Corona Virus and our procedures.

Ken Thompson, Administrator
765-423-4861 Office
317-513-2689 Mobile
Ken.thompson@sahc.net

And

Nicole Hardy, Director of Nursing
765-423-4861 Office
765-430-0005 Mobile
don@sahc.net

Should neither of these contacts be sufficient, below please find contact information for our area’s Ombudsman representative.

Andrea Smothers, Area IV Ombudsman
765-423-5327 Office
andrea.smothers@ilsi.net

COVID-19 (Coronavirus) What Residents and Families Need to Know

COVID-19 (Coronavirus disease): is an infectious disease caused by a new virus. It can lead to respiratory illness with symptoms such as a cough, fever, and shortness of breath. In growing number of cases, it can be more severe than the flu, with a higher mortality rate. Certain populations are more a risk of getting the virus. Including age 60 or older and people with serious underlying medical conditions. Some people show no signs and symptoms (asymptomatic) of the illness while carrying the virus, although they are still capable of spreading the disease.

To reduce the spread of the virus in nursing homes, the federal government has:

• Focused efforts and resources only on inspections related to infection control and investigation of complaints assessed as being the most serious and harmful to residents.
• Restricted visitation of:
  • Visitors/Family members, who are only permitted in compassionate care situations, such as end of life, and only if the visitors show no signs/symptoms of COVID-19.
  • Non-essential health care workers.
  • Long-term care ombudsmen.
• Directed facilities to screen residents and staff for fevers and signs and symptoms of COVID-19.
• Instructed facilities to cancel communal dining and all group activities.

Terms to understand:

Isolation: This is when we place someone in droplet-contact isolation. Meaning we will wear personal protective equipment such as mask, gloves, gowns, eye protection and/or face shields when entering the resident’s room. The resident’s room will be closed. Resident will be moved to designated area in building.

Quarantine: This is for new residents admitted. We keep them separate from other residents for 14 days.

PPE: Personal Protective Equipment: gloves, gowns, masks, protective eye wear, face shields, etc.

Websites to find additional information:

CDC COVID-19 webpage: https://www.cdc.gov/coronavirus/

ISDH COVID-19 webpage: https://coronavirus.in.govp

What we are doing at Saint Anthony’s:

• We have limited entry into the facility where employees get screened prior to every shift. This includes filling out a CDC guided questionnaire, washing hands, changing clothes, and checking temperature.
• Staff serve all meals to the residents in their rooms. We have avoided residents gathering in big groups.
• Therapy and restorative programs are still functioning. Activity’s department continues to meet with the residents, conduct arts and crafts, make one-on-one visits, coordinate phone calls and FaceTime visits.
• Staff and residents are practicing social distancing skills to the best of their ability.
• New patients admitted to the facility are being quarantined to their rooms for 14 days and staff are using isolation precautions when entering their rooms.
• If residents are showing signs of fever, shortness of breath, coughing, diarrhea and/or headache we notify the doctor and move them to our quarantine hallway (B hall). If recommended by the doctor we order a Covid-19 test. It usually takes 24-48 hours to get the results back.
• We are wearing personal protective equipment as indicated. We are wearing facemask the entire time we are here at Saint Anthony’s.

• Washing our hands and using hand sanitizer before and after contact with each resident, after using medical equipment, and after taking off masks, gowns, and/or gloves.
• Dedicated medical equipment for isolation rooms.
• Place alcohol-based hand sanitizer in all resident-care areas.
• Practicing cough etiquette/hygiene.
• Staying home when sick.
• Clean and disinfecting medical equipment between use.
• Screening staff upon arrival at work for temperature and signs and symptoms of COVID-19.
• Dedicated shoes for work.
• Changing our street clothes to scrubs upon arrival and then changing back to street clothes when leaving.
• Non-punitive sick leave time. Ability to use PTO (paid time off) to cover missed hours.
• We have completed the CDC long-term care checklist for COVID-19 Preparedness.
• Have a plan in place for when a resident or staff should start to show signs of illness or have been exposed.
• Education for staff on COVID-19.
• Encouraging staff to honor the stay at home orders, wearing masks when in public, and social distancing.
• Residents have been provided cloth masks to wear when out of room.

What do we do when residents are showing signs or symptoms of COVID-19:

• We are monitoring resident twice a day with full sets of vital signs and for signs/symptoms of COVID-19.
• If a resident starts to show signs/symptoms, the nurse will notify the Doctor and Director of Nursing. At this time, the Resident’s Representative will be notified as well.
• We place a mask on the resident and cover with a clean sheet, and we move the resident to our designated area.
• We place the resident in droplet-contact isolation.
• Doctor then decides what tests to run. Testing criteria is based on the symptoms the resident is having. Criteria for testing includes: a fever, cough, and shortness of breath. Other symptoms we take into consideration are: change in mental status, muscle aches, headache, sore throat, runny nose, chest pain, diarrhea, nausea and vomiting. We attempt to find the cause of the signs/symptoms.
  • If a COVID test is ordered, a nurse obtains the sample by a nasopharyngeal swab. The test is typically obtained with in 24-48 hours of onset of symptoms.
• The test is completed at a local hospital’s lab.
  • If necessary, facility will call in the ISDH Strike Team to assist with testing.
• Resident will remain in isolation until results are known.
  • If positive: we will complete 2 tests at least 24 hours apart once symptoms subside to remove a resident from isolation.
  • If negative: we will remove from isolation.
• Appropriate notifications are completed whether the test is positive or negative to resident, resident representative, doctor, and appropriate agencies.

When do we send someone to the hospital?

• We have reached to residents and families to know everyone’s wishes before we are dealing with a crisis. We will honor the wishes that were agreed upon if you would wish to be sent to the hospital or stay at Saint Anthony’s during the illness.
• If a decision if not made, we will send residents to the hospital if their condition should deteriorate and vitals become unstable.

Facility will continue to update families on the condition of the resident during the course to the illness.

Our Current Visitor Policy:

Visitation for family and friends will cease. The only exception for visitors will be if a resident transition to end of life care.

The following will be taken into consideration for compassionate visitors:

• Resident is thought, based on clinical impression, to be imminent risk dying with goal of allowing family member the opportunity to have a quality interaction with the resident.
• The number of family members should be limited to no more than 2
• Family members must be carefully screened for temperature and symptoms
• Family members who are in a high-risk category should be cautioned about the decision to visit a healthcare setting
• Those with respiratory symptoms (e.g. fever, cough, shortness of breath) should not be permitted to enter the facility at anytime (even in end of life situations)
• When family members who are permitted visitation will be:
  • Instruct before entry to the facility of the need to be screened for temperature and symptoms each time they enter the building
  • Instructed on risks of contracting COVID-19
  • Limited to a specific location (the resident’s room or other designated location)
  • Required to perform hand hygiene and wear personal protective equipment (PPE) including gloves, gown, and a standard surgical facemask, if available
  • Facility requires visitor to be >14 years of age
  • Length and time of visits will depend on resident’s condition and discretion of DON or designee.
  • Facility will ask family members to who enter the facility to monitor for signs and symptoms of respiratory illness for at least 14 days after leaving the facility.
    • If symptoms occur, the visitor should self-isolate at home, contact healthcare provider and immediately notify the facility of the date and person visited.

Residents and families can stay connected in several ways including:

• Using technology, such as FaceTime, Zoom, Skype, text messages, or emails.
• Making video greetings.
• Telephone calls.
• “Visiting” through a window or glass door.
• We have Ipads available for residents to use.
  • Our Activities Department will assist you with any of the above. Simply call and ask for them.