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Artis COVID-19 Protocols 484-392-5573

Artis COVID-19 Protocols

Protocols are organized into six sections that generally correspond with the chronology or life cycle of a COVID-19 event in a community.

Last Updated: 12/02/20

Protocol Activation

  • Activation

    COVID-19 protocols are activated in a community by community Executive Directors (EDs) who immediately thereafter notify Management senior executives, the Owner, and (if different) the Licensee.

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Asymptomatic or Negative Test Results

  • Building Access

    1. The main entrance is locked to the general public with all visitors, deliveries, etc. required to ring the bell at the main entrance for permission to enter. Signage with entry instructions is installed at the main entrance.

    2. Only associates and end-of-life care/visitors are permitted, unless prohibited by local and state government health officials. End-of-life care/visitors and any other permitted entrants must:

      • Satisfactorily complete a symptom questionnaire
      • Have temperature checked; only those individuals with temperatures of 99 degrees or less are granted access
      • Wash hands and don appropriate PPE prior to entering resident areas
      • Permit escort by an associate directly to the resident room
      • Remain in the resident room for the entire visit
      • Permit escort by an associate directly out of the building
      • Wear a mask inside the building

    3. Ancillary providers (i.e. home health, wound care, podiatry, etc.), are permitted unless prohibited by local and state government health officials and shall comply with entry protocols.

    4. Family visits are prohibited and they are encouraged to participate in Virtual Visits with residents via “virtual visit technology” (such as Skype, FaceTime, or similar remote technologies supported by the residence) or window visits where possible, as all communities are required to update their Facebook and other social media pages daily.

    5. All community tours are conducted via virtual visit technology. Where permitted by local regulations, limited outdoor visitation may resume, as authorized by EDS, in consultation with Management senior executives.
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  • Testing

    Testing Procedures

    1. Surveillance COVID-19 testing will be conducted weekly every five (5) days for all associates until further notice.

    2. Weekly surveillance COVID-19 testing will be required for any ancillary support staff (Private Duty Aides, PT/OT/ST, etc.) if their agency does not conduct weekly surveillance testing. Documentation of negative COVID-19 results is required if the support staff if their agency conducts weekly testing.

    3. All residents who receive outside ancillary support (i.e. hospice, home health, PT/OT/ST, Private Duty Services, etc.) will be tested weekly.

    4. DHW and/or Coordinators of Health and Wellness may conduct on-site testing use of Access DX kits or the Abbott ID NOW COVID-19 kits. Only those licensed nurses who have been trained on proper specimen collection and proper use of equipment may conduct testing; Full PPE (gown, gloves, N95/KN95 mask and face shield/goggles) MUST be worn while testing for COVID-19. Face shield/goggles may be sanitized and mask maintained but gowns and gloves must be changed between each test.

    Testing of Associates

    1. Each associate will be notified of need for COVID-19 testing.

    2. When testing occurs on-site (i.e. Access DX or Abbott ID NOW test kits), written consent will be obtained PRIOR to testing.

    3. To protect the health and wellness of our residents, any associate who declines to be tested will be treated as a voluntary resignation (unless declination due to religious beliefs).
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  • Temperature Taking

    1. Associate temperatures are checked before each shift. Any associate with a temperature greater than 99 degrees or exhibiting other symptoms is immediately sent home and directed to contact their Primary Care Physician (PCP) for further guidance prior to returning. 

    2. Resident temperatures are checked once in the morning and once in the late afternoon. Any resident with a temperature greater than 99 degrees is tested.
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  • Cleaning and Disinfection

    1. All frequently-touched surfaces (i.e. door handles, railings, office equipment, telephones, etc.) are disinfected several times during each shift.

    2. Shared community devices used by residents for connecting to family via Virtual Visits or social media are cleaned after each use.

    3. Walkie-talkies, pagers, etc. are cleaned in between shifts and in between uses.

    4. All surfaces are cleaned every shift and as needed.

    5. The entire community is periodically disinfected by an outside vendor or by the Director of Environmental Services (DES) using company provided or designated disinfection technology; all communities are provided this service with priority given to those with symptoms and/or positive cases.
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  • Personal Protective Equipement (PPE)

    1. Each community is responsible for ordering and maintaining periodic automatic replenishment levels (PAR levels) of PPE, as directed by Regional Directors of Operations (RDO). In the event a community is unable to maintain PAR levels through vendors or local providers, the community contacts the VP of Health and Wellness and/or their RDO for further guidance, who notifies the Chief Executive Officer and MCP.

    2. All associates must wear surgical masks throughout the entire building.

    3. All associates, in addition to surgical masks, must wear face shields or protective eye covering (i.e. goggles) in resident areas (i.e. behind Door 9).
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  • Resident Activities

    1. Staffing guidelines may be more restrictive (where required by local/state health officials/regulations) or less restrictive (for example when appropriate “emergency staffing” protocols are activated due to staffing shortages, if permitted by state/local officials/regulations).

    2. If any resident is hospitalized or leaves the community for more than one night for any reason is put in isolation for 10 days from the date of readmission, a duration specified by resident PCPs, or pursuant to local, state, or CDC guidance.

    3. Six feet of separation between residents is maintained during meals through multiple seatings at staggered times for each meal.

    4. Small group programs, outdoor activities, and 1:1 programming continue, while larger group activities, outdoor entertainment, outings, etc. are suspended.
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Symptoms or Positive Test Results

  • General Guidance

    1. When one associate or resident tests positive, all associates and residents in the community are tested, beginning in neighborhoods with confirmed cases and for those associates and residents that were in close contact with positive residents or associates.

    2. Associates and residents exhibiting symptoms (including diarrhea, shortness of breath, new cough, fever greater than 99 degrees, acute change in mental status, myalgias, or new onset loss of sense of taste or smell), unless otherwise noted, are presumed to have been infected with COVID-19 and are treated accordingly.

    3. Testing begins within 48 hours of the first confirmed case or as soon as testing supplies are secured if not initially available.

    4. Access DX tests are Artis’ preferred tests. Abbott ID NOW and Everlywell tests are suitable for screening new residents and if Abbott and Everlywell tests are unavailable. The DHW, Coordinators of Health and Wellness (CHW), and licensed nurses trained on proper specimen collection and equipment operation may conduct on-site specimen collection and testing.  When Access DX, Abbott and Everlywell tests are unavailable, the ED asks for assistance in procuring tests from their local health department, occupational health provider, or outside laboratories.

    5. Full PPE (gown, gloves, N95 mask (the preferred mask, when available) or KN95 mask and face shield) must be worn while administering tests.

    6. Gowns and gloves must be changed and face shields sanitized between each test. Masks may be reused unless visibly soiled or damaged.

    7. Associates and resident families are notified by telephone of the positive test result, followed by regular communication to ensure they are informed of further positive tests, added COVID-19 protocols, and progress as the incidence of infection is reduced and eventually eliminated. 
    1. All positive test results are reported to local health departments and other agencies as required by local and state health officials.

    2. All associates begin receiving hazard bonuses, upon approval by Management senior executives.
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  • Associate Testing

    1. Written consent is obtained prior to testing.

    2. Associate testing requires signed legal releases that extend beyond the Access DX, Abbott, and Everlywell tests and to other test brands, unless mandated by state or local authorities.

    3. Associates who refuse testing are treated as having provided a voluntary resignation, unless the refusal is due to religious beliefs.

    4. Associates are notified of positive test results, followed by regular communication to ensure they are informed of further positive tests, added COVID-19 protocols, and progress as the incidence of infection is reduced and eventually eliminated.

    5. Associates testing positive that are asymptomatic are sent home, directed to self-isolate for 10 days (or in accordance with current Centers of Disease Control (CDC) guidelines), and asked to notify the community if symptoms develop. 

    6. Associates are prohibited from working until the later of:

      • they are symptom-free (no fever for at least 72 hours without use of fever-reducing medication and no other symptoms present) OR
      • 10 days have elapsed since the positive test if asymptomatic pursuant to CDC guidelines

    1. All associates testing negative are re-tested in 7 days from the date of the first associate or resident tested positive.

    2. All associates testing positive are re-tested 90 days after the date of their positive test.
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  • Resident Testing

    1. The ED, DHW, and/or their designee obtains written or verbal consent from community advisory physicians to administer the tests, notifies all resident responsible parties of the testing, and adds the testing consent to resident records.

    2. If resident responsible parties refuse the test, residents are placed in isolation for 10 days and treated as having tested positive.

    3. Resident responsible parties and PCPs are provided with test results that are added to resident records maintained at the communities, receive regular communication on further positive tests, added COVID-19 protocols, and progress as the incidence of infection is reduced and eventually eliminated.

    4. All residents testing positive are isolated in the same neighborhood or portion of a neighborhood and separately from symptomatic residents, whenever possible, with access to these areas by healthy residents prohibited.

    5. All residents testing negative are re-tested 7 days from the date of the first associate or resident positive test.

    6. All residents testing positive are re-tested 90 days after the date of their positive test.
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  • Associate Return to Work

    1. Associates are prohibited from working until they are:

      • symptom-free (no fever for at least 72 hours without use of fever-reducing medication and resolution of other symptoms) AND
      • 10 days have elapsed since the symptoms started pursuant to Center for Disease Control (CDC) guidelines
    1. All associates must wear an N95 masks (the preferred mask, if available) or KN95 masks, with face shields, gowns, and gloves while providing resident care to positive residents.
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  • Resident Removal from Isolation

    1. Residents testing positive are isolated in a single room with dedicated staff in a designated neighborhood until 10 days after they first tested positive or such longer period as may be required by the state or local health department.

    2. All positive residents are isolated in same neighborhood or portion of a neighborhood, whenever possible, with access to these locations by healthy residents prohibited.

    3. Dedicated staff provide all care to positive residents while wearing PPE that is properly disposed of before leaving the isolated area or prior to any contact with a non-infected resident.

    4. Symptomatic residents are served meals in their room while in isolation, using disposable plates, utensils, etc. when possible.

    5. Any symptomatic resident whose family declines testing is treated as positive, the resident is isolated for a minimum of 10 days, and all other protocols are implemented.

    6. The entire community is periodically disinfected by an outside vendor or by the Director of Environmental Services (DES) using company provided or designated disinfection technology; all communities are provided this service with priority given to those with symptoms and/or positive cases. 
    1. Positive residents with symptoms remain in the community with increased monitoring if they do not have respiratory distress and can be safely managed in-house.
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Move-In Procedures

  • Prior to Accepting Move-Ins

    In preparation for move-in the following shall occur:

    1. Screenings must be done in person or via FaceTime, Skype, etc. if at home or in other health care setting/hospital.

    2. If coming from another health care setting/hospital, we require 72 hours of nursing notes, vital signs, and MAR from the location. If there is anything in these documents that indicates the resident may be symptomatic the pending move-in shall be referred to the VP of Health and Wellness for approval. This is a safeguard in case the DHW has questions about the medical information they are being provided. We would delay the move-in if symptomatic (to require a test at the location and then a subsequent test at time of move-in after the 3 day incubation period). 

    3. Families must bring in clothing, furniture, etc. the day before move-in (brought into the resident room area by our staff, not the family) and the UV light treatment must occur per manufacturer’s recommendations before moving in.

    4. Move-in paperwork must be done electronically.

    5. Move-in orders must include a script from admitting doctor for COVID-19 testing.
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  • Move-In Process

    1. Testing: All potential new residents will be required to have a 2 step test process before move-in.  An initial test must be performed to establish a baseline testing for all new residents and a re-test completed within three to seven days of the baseline test date.  Ideally, the second test is administered on the day of move-in.  Results of both tests must be provided to the community before move-in occurs.  Local Artis teams must do some research to help determine where testing can be done conveniently for families to help provide some direction and support through this process.

    2. In the event a new resident has previously tested positive for COVID and fully recovered, the following criteria must be met prior to move-in:

      • There must be at least 14 days from the time of the test result and the date of move-in
      • The resident must be symptom-free for at least 72 hours without the use of fever-reducing agents, cough suppressants, etc.
      • A copy of the positive result must be presented to Artis and verified by the ED and/or DHW to verify dates/criteria has been met.

    3. Resident will be required to self-quarantine following move-in, and monitored for symptoms. New resident will be re-tested at day 10 of quarantine and if results are negative, quarantine can be lifted and they can integrate into the general population.

    4. Temperature checks every shift for 7 days.  Temp checks will continue with normal protocol we are using on all residents after the 7 days.

    5. If showing signs or symptoms, retest upon first indication and isolate the resident until results are negative.

     

    Additional items:

    1. New families can continue to communicate with their loved ones the same way our current residents are (via FaceTime, window visits, etc.).

    2. Outdoor visits will be permitted when allowed by state and/or local agencies. Both resident and visitor(s) must adhere to outdoor visit protocols (See “Artis Senior Living Guidelines for Outdoor Courtyard Visits During COVID-19 Pandemic”)

    3. Number of move-ins per week will be determined on a case-by-case basis.

    4. At this time, all decisions on date of move-in will be determined by the local Artis team, offering families a choice of times that are convenient for our community to allow for testing.

    5. Until instructed otherwise by the CDC or local/state health departments, all staff in resident care areas shall wear surgical masks and goggles/face shield.

    6. New residents will have daily communication with their loved one via FaceTime for first 7 days (or as requested) to help ease the transition.
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Deactivating Protocols

  • Deactivating Protocols

    COVID-19 protocols are deactivated by the community ED who immediately thereafter notifies Management senior executives, the Owner, and (if different) the Licensee.

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State COVID-19 Guidance and Regulations

  • State COVID-19 Guidance and Regulations

    Management senior executives work closely with government officials and industry associations to ensure guidance and regulations particular to each state is known, understood, and followed where appropriate.  This is of particular importance where state guidance and regulations call for measures that exceed the Artis COVID-19 Protocols.

    The American Senior Housing Association (ASHA) maintains a regularly updated accounting of evolving state guidance and regulations: 

    https://www.seniorshousing.org/wp-content/uploads/2020/07/State-COVID-Policies-july-8.2020.pdf

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