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.