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Coronavirus Protocols 914-228-1720

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: 02/19/21

Protocol Activation

  • Activation

    1. 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.

    2. Protocols are organized into seven sections that generally correspond with the chronology or life cycle of a COVID-19 event in a community: i) protocol activation, ii) addressing new resident move-ins, iii) procedures before associates or residents are symptomatic or test positive, iv) procedures after associates or residents are symptomatic or test positive, v) move-in procedures, vi) deactivating the protocols, and vii) individual state COVID-19 guidance and regulations.
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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 (unless prohibited) end-of-life care/visitors, Essential Caregivers and Compassionate Caregivers are permitted. 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. 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 unless prohibited by local and state government health officials and shall comply with entry protocols.

    5. Families 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.

    6. Outdoor visits and indoor visits may only occur if/when a community meets its state/county’s criteria.

    7. 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

    1. Surveillance COVID-19 testing will be conducted weekly for all associates if the community’s county positivity rate is less than 10%.

    2.  Surveillance COVID-19 testing will be conducted twice weekly for all associates if the community’s county positivity rate is 10% or greater.

    3. 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.

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

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

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

      3. 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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    3. 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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    4. 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, he/she will be placed in isolation for 10 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.

      3. Six feet of separation between residents is maintained during meals where space permits. Otherwise, community will provide staggered times for each meal to ensure proper spacing.

      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 is to begin within 24 hours of the first confirmed case.

        1. Access DX tests are Artis’ preferred tests. Abbott ID NOW tests may also be used when available. 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 and Abbott tests are unavailable, the ED asks for assistance in procuring tests from their local health department, occupational health provider, or outside laboratories.

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

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

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

        5. 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.

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

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

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

          1. they are symptom-free (no fever for at least 72 hours without use of fever-reducing medication and no other symptoms present) OR

          2. 10 days have elapsed since the positive test if asymptomatic pursuant to CDC guidelines
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      5. 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.
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      6. Associate Return to Work

        1. Associates are prohibited from working until they are:

          1. symptom-free (no fever for at least 72 hours without use of fever-reducing medication and resolution of other symptom AND

          2. 10 days have elapsed since the symptoms started pursuant to Center for Disease Control (CDC) guidelines

        2. 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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      7. 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.

        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.
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      Move-In Procedures

      • New Resident Move-Ins

        The community’s ED will decide whether to continue accepting new residents or temporarily suspend accepting new residents, in consultation with Management senior executives.  This decision is a community-specific decision informed by multiple considerations including local, state, and federal government guidance and mandates as well as circumstances particular to a community, including census, opportunities to isolate new and existing residents, incidence (if any) of symptomatic and positive associates and residents, staff availability, test availability, and secure courtyard size and configuration.

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      • 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. EDs select the method for screening new residents, either in-person or remotely using Virtual Visit technology.

        3. EDs determine the number of move-ins allowed per week.
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      • 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:

          1. Nursing notes
          2. Vital signs
          3. Medication Administration Records (MAR or eMAR)

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

          1. Testing at the prospective resident’s current residence
          2. Three-day incubation period, and
          3. Vice-President of Health and Wellness approval
          4. 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. The day prior to move-in:

          1. Families deliver clothing, furniture, and other personal items to the community, with staff transferring them to resident rooms for ultraviolet light treatment.

        6. Upon move-in, the temperatures of new residents are checked every shift for 10 days after move-in, after which temperature testing follows standard procedures for that community.

        7. All new residents will be required to self-quarantine for 10 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.

        9. If a new resident 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 if and when permitted, outdoor visits.
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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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