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Coronavirus Protocols at Artis Senior Living Brick Community 732-722-1625

Coronavirus Protocols at Artis Senior Living Brick Community

ARTIS COVID-19 PROTOCOLS FOR NEW JERSEY COMMUNITIES

Revised 9/9/2021

ACTIVATION

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

INDOOR VISITATION (See “Indoor Visitation” protocol for further guidance)

Building Access

  1. The main entrance may remain unlocked during normal business hours, as long as there is front desk coverage.  The front door must remain locked at all other times.

  2. All visitors must:
    • Wear mask upon entry
    • Satisfactorily complete a symptom questionnaire
    • Have temperature checked; only those individuals with temperatures of 99 degrees or less are granted access
    • Sign in
    • Wash hands prior to entering resident areas
    • Remain in the resident room/area of visitation for the entire visit

  3. Compassionate Caregivers and Essential Caregivers must meet the criteria and adhere to the appropriate protocol.  (**See “Compassionate Caregiver” protocol and “Essential Caregiver” protocol for further details).

  4. Ancillary providers (i.e. home health, wound care, podiatry, etc.), are permitted access when authorized by local and state government health officials and shall comply with entry protocols.

  5. Compassionate Caregivers and Essential Caregivers may continue to visit even if there are positive COVID cases within the community.  (See “Indoor Visitation Protocol” for further visitation guidance).

  6. Visitation on affected neighborhood will be suspended until the community has no new cases in residents or associates for 14 days.

  7. If the first round of community-wide testing reveals no additional cases originating in any other areas of the community, then visitation can resume in those neighborhoods/areas with no cases.

  8. If testing reveals one or more additional cases originating in other neighborhoods/areas of the community, then general indoor visitation will be suspended for all residents, regardless of vaccination status, until there are no new cases identified in residents or associates for 14 days.

  9. Virtual visitation will be encouraged (i.e. Skype, FaceTime, etc.) when indoor visitation is not permitted. (See “Indoor Visitation Protocol” for further visitation guidance).

  10. Community tours will be conducted in-person, if the community’s county positivity rate is less than 10%, and where permissible by state.

  11. Community tours will be conducted virtually, if the community’s county positivity is 10 % or greater.

 Testing

  1. Surveillance COVID-19 testing of vaccinated associates will be conducted twice monthly.

  2. Weekly surveillance testing is required for all unvaccinated associates.

  3. Weekly surveillance COVID-19 testing will be required for all ancillary support staff (Private Duty Aides, PT/OT/ST, etc.), who are not fully-vaccinated, 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.

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

  5. 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. 

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 daily if the community is currently free of COVID.  If the community has a confirmed positive resident, resident temperatures will be taken twice daily.  Any resident with a temperature greater than 99 degrees is to be tested.

 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.

Personal Protective Equipment (PPE)

  1. Each community is responsible for ordering and maintaining periodic automatic replenishment levels (PAR levels) of PPE, as directed by Regional Vice President of Operations (RVPO).  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 RVPO for further guidance, who notifies the Chief Operating Officer and MCP.

  2. All associates will be fitted for the N95 mask in preparation for an outbreak.

  3. All associates must wear surgical masks/KN95 masks throughout the entire building.

  4. All associates, in addition to surgical masks, must wear face shields or protective eye covering (i.e. goggles) while providing direct resident care.

COVID-19 Vaccination Requirements for Associates

  1. Unless an earlier applicable mandate deadline applies,  all associates must be vaccinated per below guidelines

    • 1st dose must be administered by November 1st, 2021 (Pfizer, Moderna, or Johnson & Johnson)

    • 2nd dose must be administered by December 7th, 2021 (Pfizer and Moderna)

  2. All new associates hired shall have seven (7) days after their first day of work to  obtain their first dose, and five (5) weeks after their first work day to obtain any required second dose (Pfizer and Moderna).

  3. If state, local or similar mandate requires vaccination sooner than dates listed, associates must comply with earlier deadline or more stringent requirements.

  4. On or before each stated vaccination deadline, associates will be required to provide either satisfactory prof of vaccination (such as CDC COVID-19 Vaccination Record) or receipt of approved reasonable accommodation for exemption from the requirements.  Note that Artis may be required to allow inspection of associate vaccination records and approved exemption requests, and/or to report compliance with reasonable vaccination program requirements.

  5. All unvaccinated associates, who qualify and are approved for an exception, will be tested twice weekly.

Reasonable Accommodation

Employees in need of an exemption from this policy due to a medical reason, or because of a sincerely held religious belief, must contact the corporate Human Resources Department as set forth below to request an accommodation in order to begin the interactive accommodation process. If you wish to request an accommodation or exemption, please initiate that interactive process by contacting your Executive Director or Director of Business Services, preferably in writing by submitting a completed Request for Accommodation form to them. Accommodations will be granted where they do not cause Company undue hardship or pose a direct threat to the health and safety of others. Please be sure to allow sufficient time to obtain any certification needed to evaluate your request for accommodation as well as to allow the Company sufficient to review and process your request or to contact you for further information. Note that an agency or authority may impose limits on the types of accommodations and exemptions the Company may grant.

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 a resident is hospitalized or leaves the community for more than one night for any reason, and is fully-vaccinated and at least 14 days have passed since his/her 2nd COVID vaccine, there is no need to quarantine upon return, unless the state or local health department mandates otherwise.

  3. If any resident is hospitalized or leaves the community for more than one night for any reason, he/she will be placed in isolation for 14 days from the date of readmission, a duration specified by resident PCPs, or pursuant to local, state, or CDC guidance.  If asymptomatic, resident may be tested on day 7 with PCR test.  If negative, isolation may be discontinued (if permissible by state).

  4. If all residents are not fully-vaccinated in the community, six feet of separation between residents is maintained during meals and programming. Otherwise, community will provide staggered times for each meal to ensure proper spacing (unless otherwise mandated by state).

  5. Small group programs, outdoor activities, and 1:1 programming continue, if/when larger group activities, outdoor entertainment, outings, etc. are suspended, or if all residents within the community are not fully-vaccinated (unless otherwise mandated by state). 

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 is to begin immediately when a new case is identified.

  4. Access DX tests are Artis’ preferred tests. Abbott ID NOW tests may also be used when available. The Director of Health & Wellness (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 and Abbott tests are unavailable, the Executive Director asks for assistance in procuring tests from their local health department, occupational health provider, or outside laboratories.

  5. BinaxNOW tests may be used for symptomatic individuals.  BinaxNOW tests are to be followed with a PCR test within 24 hours.

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

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

  8. 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.

  9. All positive test results are reported to local health departments and other agencies as required by local and state health officials.

  10. Associates begin receiving hazard bonuses, upon approval by Management senior executives.

  11. Community-wide testing will occur weekly until there are no new cases identified for 14 days.

Associate Testing  (See “Surveillance Testing” protocol for further guidance)

  1. Written consent is obtained prior to testing.

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

  3. Un-vaccinated 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-quarantine for 10 days (or in accordance with current Centers of Disease Control (CDC) guidelines), and asked to notify the community if symptoms develop.

  6. Community’s Safety Coordinator will record all associates who have confirmed COVID-19 on OSHA COVID-19 Log, whether it was contracted within the community or elsewhere. (See “OSHA COVID-19 Log”).

  7. 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

    • 14 days have elapsed since the positive test if asymptomatic pursuant to CDC guidelines

    • If an associate who is fully-vaccinated (and at least 14 days has passed since 2nd dose) has limited exposure to a positive individual, he/she will not be required to self-quarantine.

    • If an associate lives in a household with a positive household member, the associate must quarantine for the same time period as that positive household member, regardless of vaccination status, as this is excessive/continuous exposure.

 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

 Resident Testing

  1. The Executive Director, Director of Health & Wellness, 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 and if in a community where residents are not fully-vaccinated, with access to these areas by healthy residents prohibited.

Resident Removal from Isolation

  1. Residents testing positive are isolated in a single room with dedicated staff in a designated neighborhood until 14 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, if in a community where all residents are fully-vaccinated, 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 14 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.

  7. 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.

MOVE-IN PROCEDURES

Executive Directors, consistent with local, state, and federal directives, determine when any prohibition on accepting new residents is lifted and move-ins allowed, providing notice to Management senior executives, the Owner, and (if different) the Licensee.

Prior to Accepting Move-Ins

  1. Associates and the families of existing residents are notified of the pending acceptance of new residents and associated safety protocols.

  2. In-person move-in assessments may be conducted where permissible by state.    Otherwise, virtual assessments will take place

Move-In Process

  1. Information required to evaluate new resident eligibility for move-in when coming from another health care setting/hospital includes 72 hours of:

    • Nursing notes

    • Vital signs

    • Medication Administration Records (MAR or eMAR)

  2. If symptoms are documented, the move-in is delayed to allow:

    • Testing at the prospective resident’s current residence

    • Three-day incubation period, and

    • Vice-President of Health and Wellness approval

      If no symptoms documented, proceed with move-in.

  3. Documentation of a negative PCR COVID test within 72 hours of move-in is required.

    If the resident has previously tested positive for COVID within the last 90 days, and has fully-recovered, he/she will not be required to be tested prior to move-in.  He/she will be placed in quarantine for 10 days upon move-in to be observed for symptoms.

  4. The day and time for a move-in is selected that is convenient for new resident families.

  5. Upon move-in, the temperatures of new residents are checked every shift for 14 days after move-in, after which temperature testing follows standard procedures for that community.

  6. All fully-vaccinated residents will not be required to self-quarantine upon move-in, unless otherwise mandated by state.

  7. All new residents, who are not fully-vaccinated, will be required to self-quarantine for 14 days and be observed for symptoms.

  8. If a resident is asymptomatic, he/she may be re-tested on day 7 by use of a PCR test. If result is negative, he/she may be moved out of isolation, where permissible by state.

  9. If a new residents exhibits symptoms, he/she will be tested.

  10. The families of new residents follow the same visitation protocols as the families of existing residents, remote contact through Virtual Visits, window visits, and indoor and outdoor visits (where permissible by stated and local health department)

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.

 ASSOCIATE TRAVEL DURING COVID PANDEMIC

  1. If an associate travels during the pandemic, he/she must complete a travel form and submit to ED prior to traveling.

  2. If associate has received both COVID vaccines, and at least 14 days have passed since second dose, he/she will not be required to self-quarantine for 10 days at home prior to returning to work.

  3. If an associate has not been fully-vaccinated, and least 14 days have passed since second dose, he/she will be required to self-quarantine for 10 days at home prior to returning to work.

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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