Date: March 16, 2020 Updated: June 29, 2020

Purpose: Prevent the introduction of Covid-19 virus into community; Be prepared to manage any employee or resident exposures; Allow residents the highest possible quality of life while managing Covid-19 exposure risk.

Responsibility: All Sommerset Neighborhood staff

General:

• Sommerset Neighborhood (SSN) will operate under Phase III of the reopening plan for Long- Term Care (LTC) facilities guidance issued by Oklahoma State Department of Health (OSDH).
• Should one staff member or one resident be a confirmed positive for Covid-19 AND another has symptoms, SSN will regress to Phase I of the plan.
• Information updates will be shared by signage on entrance to SSN, SSN website, and SSN Facebook page. Each resident’s responsible party will be notified by phone, to the extent possible.
• All entrance codes will be changed to prohibit entrance into the facility. The main entrance code will be available to staff only. All other entrance codes will be available to the Executive Director and Maintenance Director only. Egress on all doors will not be impacted.
• All staff will receive initial and on-going in-service training specific to Covid-19 prevention, facility processes related to Covid-19, and updates related to Covid-19 as available.
• Symptomatic or COVID-19 positive residents will be isolated immediately. An individual Personal Protective Equipment (PPE) station will be set up outside of the resident’s apartment. SSN will determine whether the individual’s health care needs can be met in the Assisted Living Facility (ALF) setting or, if needed, appropriate arrangements will be made for transfer to the appropriate setting (hospital, etc.).
• SSN Executive Director is in the process of receiving the required certification as Nursing Home Infection Preventionist.
• All plans are fluid and subject to change based on the most current statistics and/or OSDH guidance.

Visitation:

• All residents will be allowed limited visitation.
• Visitations must be scheduled through SSN Community Life Director or Executive Director only.
• Visitations will be limited to Monday through Friday between 9am and 4pm, unless otherwise approved by Life Enrichment Director or Executive Director.
• Visitations will occur in the community sunroom to enable sanitation after each visit. If a resident is unable to leave their apartment, accommodations will be arranged through the Life Enrichment Director or Executive Director to allow a controlled room visit or visit in an alternate location.
• Visitations will be limited to two visitors per resident, two visits per week, and 30 minutes per visit.
• Total number of visitations at one time, in the building, will be limited to two. This allows staff to ensure proper distancing, hygiene, source control, etc.
• Outdoor visitations are preferred.
• All visitors will be screened, utilizing the current screening protocol, prior to entrance into general areas of SSN. If a visitor does not pass the screening, visitation will not be allowed. Screening will include directions for proper use of mask, social distance, and observation of hand sanitation. Visitors will be escorted by staff to the designated visitation area and escorted out by staff after the visitation. The visitation will be monitored by staff to ensure use of mask and social distance.
• SSN sunroom will be sanitized by housekeeping after each visitation.
• Virtual visitation can be arranged through the Life Enrichment Director at least two times per week.
• Ombudsman is permitted into SSN subject to the screening, hygiene, and mask requirements for visitors.

Essential/Non-Essential Healthcare Personnel:

• All healthcare personnel will be screened upon entry using the most current protocols, hand sanitation will be observed, and directions for proper use of mask will be reviewed. These steps will be documented on the most current screening tool.
• Healthcare personnel will limit movement in building to the resident’s individual apartment and nursing office for report/communication.
• Healthcare personnel who do not pass screening will not be allowed entrance.

Non-Medically Necessary trips:

• Non-Medically necessary trips are discouraged for all residents. The overall decision for exceptions will be made collaboratively by the resident, their representative, SSN Executive Director, and if necessary, the resident’s physician.
• For medically necessary trips out of the facility:
  • The resident must wear a cloth mask covering the entire nose and mouth for the entire outing; and
  • SSN will share the resident’s COVID-19 status with the transportation service (if utilized), and entity with whom the resident has an appointment.
  • Transportation staff, or person who transports the resident will wear a facemask for the entire time with the resident.
• Failure to follow the requirements above will subject the resident to quarantine upon return to the facility.

Communal Dining:

• Residents will be allowed to have meals in common dining areas unless under quarantine or isolation restrictions, subject to space limitations.
• Residents will be seated one per table which will allow for social distancing.
• Proper hand hygiene and social distancing must occur when staff is assisting residents with eating (progressive care unit and memory care unit).
• Residents in isolation or quarantine will have meals in their apartments and utilize disposable dishware.

Screening:

• Residents living in phases one and two will be screened for signs/symptoms of COVID-19 daily. Residents living in progressive care or memory care will be screened three times per day. New residents in all units are considered quarantined for 14 days and will be screened three times daily. The Wellness Director will be notified immediately if any resident triggers a screening concern. Screening will be documented on most current tool and documents retained.
• Staff will be screened at the beginning and end of their shifts using the most current screening tool. This requirement applies to agency staffing also. Any staff member triggering a screening concern will be referred to the Wellness Director or Executive Director before being allowed to move past the entrance. Further assessment will determine whether the staff member will be allowed to work.
• If any staff member or essential provider demonstrates or reports symptoms of potential COVID-19 illness while in the building, the individual will be required to leave the building.

• If any staff member or essential provider is symptomatic or positive for COVID-19, the individual will not be allowed back into building until it is deemed safe to do so per current CDC guidance.
• Any suspected or known cases of COVID-19 will be reported to OSDH and any other required entities.

Universal Mask and PPE:

• All SSN staff/agency will always wear a procedure mask while in the building. Failure to comply will result in one warning. If the employee is non-compliant again, they will be subject to termination of employment. Agency staff will not receive a warning, will be escorted out and placed on the “do not return” list. Cloth masks will not be acceptable unless a shortage of procedure masks is demonstrated.
• Additional PPE will be worn to provide resident care as appropriate for the situation.
• Alcohol based hand sanitizer is available throughout the facility.
• N-95 masks, face shields, gowns, gloves, and shoe coverings are secured for use as needed.

Group Activities:

• Group activities are preferred outdoors when possible
• Group activities will be monitored by the activities staff to ensure social distancing of at least six feet, hand hygiene, and face masks are used.
• Group activities that encourage multiple residents to handle the same object will be prohibited.
• Outside entertainers will be screened before entrance and escorted to the outdoor area designated for the event. Social distance of at least 12 feet will be required between entertainer and residents during the event. The entertainer will be escorted out of facility to ensure social distance from any resident.

Salon:

• The cosmetologist will be tested for COVID-19. A positive result will prohibit the individual from providing services in facility.
• The cosmetologist will be screened, using the most current screening tool upon, upon entrance to SSN and at the end of each workday.
• If the cosmetologist triggers any concern during the screening process, they will be denied entrance.
• If the cosmetologist develops symptoms consistent with COVID-19, they will immediately leave the facility and not return until demonstrated negative for COVID-19.
• Cosmetologist will remain in the salon area and avoid common areas of SSN.
• Only one resident at a time will be allowed in the salon.

• Salon door will remain closed during services.
• Staged appointments will be utilized to maintain distance and allow for infection control. No residents will be allowed to wait outside of the salon.
• Cosmetologist will be responsible for properly sanitizing equipment and salon chairs between each resident; and MUST perform hand hygiene before and after each resident.
• Cosmetologist will routinely sanitize high touch areas.
• Residents must wear a face mask during entire salon visit.

Testing:

• SSN will arrange testing for any employee or resident who exhibits symptoms of COVID-19.
• SSN will cooperate with any regulatory entity requesting testing of employees and/or residents
• SSN will report any confirmed or suspected cases of COVID-19, resident or employee, to appropriate regulatory entity.

Survey Activity:

• Surveyors and Ombudsman will be allowed into the facility subject to screening and PPE requirements outlined for staff/visitors in this plan.

Dear Sommerset residents and family,

The Governor has issued an amended Executive Order allowing Long Term Care facilities to begin opening in stages starting June 15^th. It is very important for everyone to understand our doors will not be opening right away. This is a staged opening which requires planning and training. There are a couple of items that need to be addressed before we can move forward with these stages:

• A nursing home infection preventionist certification must be completed
• A risk analysis must be submitted to the Oklahoma State Department of Health (OSDH)

These items take time and we need to continue with caution at this time. We understand that family, staff, and residents are very excited to begin receiving visitors We will begin to allow visitation as soon as safely possible.

I will continue to update everyone as we enter these new stages. For now, we will allow controlled, outdoor visitation. We may be able to accommodate indoor visitation for extreme cases where a resident cannot leave their apartment. These will need to be scheduled and evaluated. We will continue to work with OSDH to ensure the safety of everyone at Sommerset Neighborhood. Please feel free to call me with any questions throughout this reopening process.

Jessica Guillory

Executive Director/Administrator

(405)691-9221

Dear Sommerset residents and family,

Thanks to staff, residents, and family members, Sommerset Neighborhood continues to be COVID-19 free!

Yesterday, I participated in a conference call with the Oklahoma State Department of Health (OSDH) regarding current updates. The Governor’s executive order restricting visitation has been extended through June 30^th. We know that extending the original date may be difficult, but we fully support these decisions knowing that information and directives pertaining to COVID-19 remain fluid.

We will continue to coordinate window visitations as well as controlled, end of life visitations with your loved ones. If you have any concerns, visitation ideas, or would like to discuss the OSDH directive with me, please give me a call.

We will all get through this together and as always, thank you for your patience and understanding during this time.

Jessica Guillory

Executive Director/Administrator

(405)691-9221

Dear Sommerset residents and family,

We continue to be 100% COVID-19 free! Thank you to all staff, residents, and family members for your efforts that got us where we are today!

Today we received a call from the Oklahoma State Department of Health (OSDH) with updates. The Governor’s executive order restricting visitation continues to remain in effect. This order is set to expire on June 11^th. We will be working with OSDH in the interim to develop guidance and conditions to “open up”.

I will also be working closely with the management team here at Sommerset Neighborhood to develop protocols for visitation. We will provide these protocols to OSDH ahead of opening Sommerset for visitation. Examples of these protocols are as follows:

1. Visitation days/hours
2. PPE
3. Screening protocol
4. Areas of the community approved for visitation
5. Sanitation measures for areas approved for visitation

Our goal here at Sommerset Neighborhood is to open safely. The virus is still a threat and we want to be sure that we have proper precautions.

Thank you for your patience and understanding during this crisis. If you have any questions, please feel free to reach out to me.

Jessica Guillory

Executive Director/Administrator

(405)691-9221

Well, it’s certainly been a tough couple of weeks.

THANK YOU to those valued employees who are coming to work and dedicated to serving our Residents. I realize many of you are working extra shifts and doing work not normally within your regular job duties. It is valued! You have my most heartfelt thanks and appreciation.

THANK YOU to our Residents who are doing their part to stay healthy and safe. I realize every day you get information about what is changing. That’s not easy for you, it’s difficult to know what to plan and what to expect. THANK YOU for being patient and understanding as we work through how to maintain service to  you and how that’s being accomplished. We know it’s hard and not easy. I know your families are also concerned because they are concerned about your wellbeing and they can’t visit you. This won’t last forever, and together let’s try and be kind and patient with each other.

You are all in my thoughts and prayers. DeAnn

Currently, there are no known COVID-19 cases or exposures among residents and staff of Sommerset Neighborhood. Staff members have been amazing during this time. They are all working hard to keep residents and each other safe from COVID-19. Management continues to monitor our processes, discuss resident status five days per week, and screen staff members at least one time per day. Our housekeeping and Focus on Function Therapy team continue to clean handrails, and door handles regularly, while the wonderful housekeeping department continues to enhance their usual cleaning responsibilities.  All staff members, and any essential providers who enter the building, are screened upon entrance and are required to wear a mask.

The Governor has signed an emergency training waiver that will allow Sommerset to hire and train people who want to be Certified Nursing Assistants (C.N.A.s). C.N.A.s are required to have formal training, State testing, and certification. Since all schools and State testing sites are closed, it is even more difficult to find certified staff at this time. We are currently reviewing the curriculum and associated requirements and plan to hire our first two trainees in the next week or two.

So many family members and others in the community have been dropping off masks, hand sanitizers, and other supplies. These items and kind gestures are greatly appreciated. We know that families and residents miss each other tremendously. Residents are trying their best to comply with our room restrictions. They are allowed breaks from their rooms and are monitored for social distancing. Sommerset residents have been amazing and are the best among us. Thank you, residents, family, and staff, for being so patient and supportive. We will continue to work hard every day to care for your loved ones.

Dear Sommerset residents,

As you have noticed, we have implemented protocols, some more obvious than others, to protect each of you and those who provide care to you. I meet with our department directors at least daily to discuss our strategies in this effort.

Our protocols change daily, sometimes more often, based on information we review from the CDC, industry associations, the health department, and our own assessment of our risks. Our goal has been, since the beginning, to implement the steps necessary to protect you, yet restrict your daily life as little as possible.

Sadly, today we have been instructed that we must require more extreme restrictions.

Effective today, I’m asking all residents to stay in their rooms, except mealtimes, until further notice. Starting Monday, all meals will be delivered to your rooms. Please do not come to the dining room for meals. You may come out for short exercise breaks, sitting in the courtyards, or just to get away for short moments. We will monitor your outings to ensure that you are staying at least 6 feet from other residents and you do not have symptoms of exposure. For those who may be distressed by dining in your rooms, we will try to rotate people sitting one person at a table in limited numbers.

Group activities are suspended until further notice. The activity team will be visiting rooms on an individual basis. Group therapy will now be individual visits. Salon services will be limited to one person at a time and no residents waiting outside of the salon.

I ask for your complete cooperation so we can all get through this without exposure to the Covid-19 virus. Oklahoma and Cleveland counties have the highest exposure and death rates from Covid-19 in Oklahoma. Several persons in nursing homes and assisted living communities have been exposed. We have no known exposures or symptoms at Sommerset, and our extreme restrictions are necessary to mitigate the risk. Despite all our efforts, people could become ill.

The best way to keep safe is to isolate, stay 6 feet away from others, wash your hands frequently, keeping hands away from eyes, nose, and mouth. Drinking plenty of fluids is always a great plan.

If you feel ill, feel like you have a fever, sore throat, new or changed cough, please notify staff to have a nurse visit you. We will continue to stay informed and modify our plan as needed. We all look forward to getting through this together.

Sommerset Neighborhood understands the need to combat social isolation and loneliness during the COVID-19 crisis. We would like to extend an invitation to resident families to visit their loved ones while practicing social distancing.

Please call Yvonne Gutierrez, Activity Director, at (405)691-9221 and she will schedule a time for your visit. An employee will escort the resident to our glass doors where you may contact them via a cell phone provided by Sommerset.

This arrangement will allow face to face visitation while keeping residents, family, and employees safe. Most importantly, residents and family will be able to stay connected.

Haverland Carter LifeStyle Group (HCLG) and our affiliates are committed to providing the highest quality senior housing and care. We respect the needs of our older adults who are at greatest risk.

Our company, indeed our country, has never faced a situation such as this. Each of our communities have been adhering to the daily updates and requirements issued by their local government, Center for Disease Control, World Health Organization, Centers for Medicare & Medicaid Services, LeadingAge, and the health care associations of their state. To see the latest updates at any of our communities please go to their website or Facebook page.  A link to each of our communities can be found at the “AFFILIATIONS” tab on HCLG website: www.haverlandcarter.com.

We are aware of the stress this has put on our employees who are superheroes. They are struggling to balance work, family and other stressful issues, yet are still there to provide care and services to our residents. HCLG has an experienced HR department that is keeping up with what we need to know and do to be a support to our employees.

All of our communities, as directed by the local, state and federal guidelines, have severely restricted visitors. We recognize how difficult this will be for residents and their loved ones. However, limiting residents to potential exposure is an essential element of containment. This is a dramatic change in the operation of our communities but we are dedicated to making the adjustments needed to prioritize and protect the needs of our residents and the staff who care for them.

Stay calm and WASH YOUR HANDS!