COVID-19 Updates

April 14, 2021

 

Dear Residents, Families & Staff,

Please be advised that as of April 14, 2021 we have a total of 2 active confirmed COVID-19 cases among non-nursing personnel. Due to the positive cases, we are in “Outbreak” mode.

When a new case of COVID-19 among residents or staff is identified, a facility immediately begins outbreak testing and suspends all visitation, until at least one round of facility-wide testing is completed. Visitation may resume based on the following criteria:  If the first round of outbreak testing reveals no additional COVID-19 cases in other areas (e.g., units) of the facility, then visitation can resume for residents in areas/units with no COVID-19 cases.

However, due to the positivity rate and percent of unvaccinated residents, indoor visitations will continue to be suspended, even if the above criteria have been met, as per direction from Center for Medicare and Medicaid Services. Please note per PA Department of Health Guidelines, outdoor visits, will be available after we have had at least one round of facility-wide testing, resulting in all negative results.

Please be advised rapid point-of-care tests were completed this morning on all residents. All residents tested negative. All active Healthcare Personnel are being tested April 15, 2021.

In the interest of protecting the health and wellbeing of all our residents and staff in accordance with CMS & PA-Department of Health, the organization has temporarily suspended all in-person visitation for all visitors at the Meadows Nursing and Rehabilitation Center. As we follow recommendations to avoid risk of transmission of COVID-19, we are being mindful of the residents’ best interest and social interactions with family and loved ones, therefore window visits and virtual visits are available during this time.

We are continuing to take steps based on guidance from the Centers for Disease Control and Prevention (CDC), the Center for Medicare and Medicaid Services (CMS), the Department of  Health to reduce the spread and impact of COVID-19, such as:  Enhanced infection control precautions, Screening residents, staff, and essential visitors for symptoms of the virus, the use of Personal Protective Equipment, Restricting visitation and entry of people to the building, Testing staff and residents for COVID-19 based on current protocols. Due to government privacy requirements, we cannot divulge specific information about the individuals who have tested positive or have symptoms of COVID-19.  Facility staff will continue to contact you directly with resident changes in condition including symptoms of COVID-19.

 

 

 

Please note that although, COVID-19 vaccines are highly effective, none are 100% effective, meaning a small number of people might become infected after being fully vaccinated. Multiple variants of the virus that causes COVID-19 have been documented in the United States and globally during this pandemic.

The organization sincerely apologizes for the impact this may have on your families. Our Social Workers are here to aid the residents and family members during this time of difficulty.

 

We will notify you if there are new cases among residents or staff are diagnosed. Please call the Meadows Information Line (570) 675-8735 for weekly updates. Information is available on our website, themeadowsdallas.com. As always, the health and safety of our residents and staff remain our highest priority.

 

Thank you for your patience and understanding.

 

Sincerely,

 

Cristina Tarbox, LNHA, MHA, MPS

Licensed Nursing Home Administrator

 

 

 

 

 

April 12, 2021

 

 

Please note As of Monday, April 12th the Current Positivity rate in Luzerne County increased to 10.3%. Unfortunately, due to the positivity rate and percent of unvaccinated residents, indoor visitations have been temporarily suspended. Please note per PA Department of Health Guidelines, outdoor visits are still permitted. If you are not able to have an outdoor visit due to inclement weather, a window or virtual visit is available. Please contact our Activities Department to schedule a visit at (570) 675-8600, ext 139.

 

As of this date, 63% of our residents have been FULLY VACCINATED. Individuals who received passive antibody therapy for COVID-19 (Monoclonal antibodies for COVID-19 treatment) in January and February were deferred to receive their vaccine for a minimum of 90 days from treatment to avoid treatment interference as per the guidelines.  The Pharmacy will be administering the 1st dose of the vaccine to these residents on May 20th. The 2nd dose is scheduled to be given on June 17th.  If you have questions regarding the status of your loved one’s vaccine, please contact the Nursing Department.

As soon as the positivity rate decreases to under 10% OR 70% of our residents are fully vaccinated, indoor visitations may resume. Fully vaccinated refers to a person who is ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine, per the CDC’s Public Health Recommendations for Vaccinated Persons.

 

Thank you for your patience and understanding.

 

 

Take Care,

Cristina Tarbox, LNHA, MHA, MPS

Licensed Nursing Home Administrator

 

 

April 8, 2021

 

Dear Resident and Resident Representative,

 

The Current Positivity rate in Luzerne County is 9.3%. Please be prepared that although facilities shall allow indoor visitation for residents (regardless of vaccination status), there are a few exceptions which would halt indoor visitations. A few circumstances when visitation shall be limited would be due to a high risk of COVID-19 transmission. The exceptions include the following scenarios when limited indoor visitation will occur:

 

  • Unvaccinated residents, if the nursing home’s COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated;2
  • Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue Transmission-Based Precautions; or
  • Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.

 

As of this date, 59% of our residents have been FULLY VACCINATED. Individuals who received passive antibody therapy for COVID-19 (BAM Therapy/monoclonal antibodies for COVID-19 treatment) in January and February were deferred to receive their vaccine for a minimum of 90 days from treatment to avoid treatment interference as per the guidelines. If you have questions regarding the status of your loved one’s vaccine, please contact the Nursing Department.

The Pharmacy will be administering the 1st dose of the vaccine to these residents on May 20th. The 2nd dose is scheduled to be given on June 17th. We have been reaching out to our local Government Officials and Department of Health representatives for support to procure doses for our current residents and new admissions.

On a positive note, the CDC has stated, “Quarantine is no longer recommended for residents who are being admitted to a post-acute care facility if they are fully vaccinated and have not had prolonged close contact with someone with SARS-CoV-2 infection in the prior 14 days (i.e., no known exposure to COVID-19). Therefore, new admissions or readmissions, who are fully vaccinated do not need to enter the “Yellow Zone” as long as the above criteria has been met.

 

Sincerely,

 

 

Cristina Tarbox, LNHA, MHA, MPS

Licensed Nursing Home Administrator

Visitation Requirements

 

In order to safeguard the safety of our residents and the facility’s operations the following plan has been established for visitors. In order to maintain the core principles of Infection Prevention, facility must determine the number of visitors per resident in facility at one time. Therefore, the following will be implemented for Visitors: (Subject to Change)

 

  1. The schedule of visitation hours will continue to be BY APPOINTMENT ONLY.

Monday through Sunday 9:30am-11am & 1:15pm-5pm and by special appointment for visits in the NEUTRAL ZONE. Visits in the designated outside or inside neutral zone will be scheduled for 30 minutes.

*Contact Laura Wingard, Activities Director (570) 675-8600, ext. 138

 

  1. Visitation will be available in designated neutral zone(s). Facility has determined the Chapel Area and Therapy gym, as well as Outside Pond area will be permitted for visits.

 

  1. All Visitors will be screened, which will include COVID-19 screening questions and a pre- and post-temperature. Residents will be transported to the designated neutral zone for the limited visit, as visitors will NOT be permitted to enter resident care areas/ resident floor/room. Staff will monitor visitation to ensure compliance with social distancing, universal masking and hand hygiene. Visitor and UNVACCINATED Resident must maintain social distancing of at least six-feet distance during the entire visit and wear facemask during entire visit. REGARDLESS, Visitors should physically distance from other residents and staff in the facility.

 

  1. If your loved one is FULLY Vaccinated, they can choose to have close contact (including touch, hand-holding or an embrace) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after. REGARDLESS, Visitors should physically distance from other residents and staff in the facility.

 

  1. Designated staff will wipe down visitation areas after each visit. Staff will use an EPA-registered disinfectant to wipe down visitation area between visits and ensure proper wait time in between visits.

 

  1. There shall be no more than the allowable number of visitors per resident based on the facility’s capability to maintain social distancing and infection control protoc Facility has determined there shall be no more than eight (8) resident visitations occurring simultaneously in a neutral zone.

 

  1. Only residents residing in the unexposed (Green Zones) may safely accept visi

 

  1. Visitation for residents with diseases that cause progressive cognitive decline (e.g., Alzheimer’s disease) and residents expressing feelings of loneliness will be given a priority.

 

 

  1. Each resident will be provided a facemask (if they can comply) to wear during the visit. Visitor MUST adhere with universal masking and observe social distancing during the entire visit.

 

 

 

 

 

 

 

  1. Children are permitted to visit when accompanied by an adult visitor, within the number of allowable visitors. Adult visitors must be able to manage children, and children older than 2 years of age must wear a facemask during the entire Children must also maintain strict social distancing. Facility will allow no more than two (2) adults to visit a resident OR 2 adult and 1 child. This will be strictly adhered to and visitors attempting to visit with more than the allowed number will not be permitted to visit.

 

  1. Visitors will NOT be permitted to access facility or facility grounds if they do not pass scree

 

  1. Alcohol-based hand rub will be provided to each visitor and demonstrated how to use it appropriately, if necessar

 

  1. Visitors MUST wear a face mask during the entire visit, Use Alcohol-Based Hand Rub Before & After Visit, Stay in Designated Facility Location, Sign-In & Provide Contact Information, Sign-Out Upon Departure and Adhere to & Pass Screening Protocols.

 

  1. All Visitors must adhere to the Core Principles of COVID-19 Infection Prevention

 

  • Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions about and observations of signs or symptoms), and denial of entry of those with signs or symptoms or those who have had close contact with someone with COVID-19 infection in the prior 14 days (regardless of the visitor’s vaccination status)
  • Hand hygiene (use of alcohol-based hand rub)
  • Face covering or mask (covering mouth and nose)
  • Social distancing at least six feet between persons
  • Instructional signage throughout the facility and proper visitor education on COVID-19 signs and symptoms, infection control precautions, other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene)
  • Cleaning and disinfecting high-frequency touched surfaces in the facility often, and designated visitation areas after each visit
  • Appropriate staff use of Personal Protective Equipment (PPE)
  •  Effective cohorting of residents (e.g., separate areas dedicated to COVID-19 care)
  •  Resident and staff testing conducted as required at 42 CFR § 483.80(h)

 

These core principles are consistent with the Centers for Disease Control and Prevention (CDC) guidance for nursing homes, and should be adhered to at all times

By Signing below, you are acknowledging to adhere and comply with the Core Principles of COVID-19 Infection Prevention and Facility Visitation Protocol:

PRINT NAME____________________________

SIGNATURE:____________________________ 

Name of Resident you are visiting: _______________________________

 

 

 

 

 

 

 

March 11, 2021

 

 

Dear Resident and Resident Representative,

 

This letter is to inform you of the important changes to the Visitation Guidance issued by CMS and CDC on March 10th. While CMS guidance has focused on protecting nursing home residents from COVID-19, they recognize that physical separation from family and other loved ones has taken a physical and emotional toll on residents and their loved ones. CMS understands that nursing home residents derive value from the physical, emotional, and spiritual support they receive through visitation from family and friends. In light of this, CMS is revising the guidance regarding visitation in nursing homes during the COVID-19 Pandemic

Since, COVID-19 vaccines have received Emergency Use Authorization from the Food and Drug Administration. Millions of vaccinations have since been administered to nursing home residents and staff, and these vaccines have been shown to help prevent symptomatic SARS-CoV-2 infection (i.e., COVID-19). Therefore, CMS, in conjunction with the Centers for Disease Control and Prevention (CDC), is updating its visitation guidance accordingly, but emphasizing the importance of maintaining infection prevention practices, given the continued risk of COVID-19 transmission.

 

Guidance

Visitation shall be conducted in dedicated visitation spaces, outdoors, and for circumstances beyond compassionate care situations. Regardless of how visits are conducted, there are certain core principles and best practices that reduce the risk of COVID-19 transmission:

 

Core Principles of COVID-19 Infection Prevention

  • Screening of all who enter the facility for signs and symptoms of COVID-19 (e.g., temperature checks, questions about and observations of signs or symptoms), and denial of entry of those with signs or symptoms or those who have had close contact with someone with COVID-19 infection in the prior 14 days (regardless of the visitor’s vaccination status)
  • Hand hygiene (use of alcohol-based hand rub is preferred) • Face covering or mask (covering mouth and nose)-
  • Social distancing at least six feet between persons
  • Instructional signage throughout the facility and proper visitor education on COVID-19 signs and symptoms, infection control precautions, other applicable facility practices (e.g., use of face covering or mask, specified entries, exits and routes to designated areas, hand hygiene)
  • Cleaning and disinfecting high-frequency touched surfaces in the facility often, and designated visitation areas after each visit•

 

Appropriate staff use of Personal Protective Equipment (PPE)

  • Effective cohorting of residents (e.g., separate areas dedicated to COVID-19 care) •     Resident and staff testing conducted as required at 42 CFR § 483.80(h) (see QSO-

20– 38-NH)

 

These core principles are consistent with the Centers for Disease Control and Prevention (CDC) guidance for nursing homes, and should be adhered to at all times. The risk of transmission can be further reduced through the use of physical barriers (e.g., clear Plexiglass dividers, curtains). Visitors who are unable to adhere to the core principles of COVID-19 infection prevention shall not be permitted to visit and/or shall be asked to leave. By following a person-centered approach and adhering to these core principles, visitation can occur safely based on the below guidance.

 

 

Outdoor Visitation

While taking a person-centered approach and adhering to the core principles of COVID-19 infection prevention, outdoor visitation is preferred even when the resident and visitor are fully vaccinated* against COVID-19. Outdoor visits generally pose a lower risk of transmission due to increased space and airflow. Therefore, visits should be held outdoors whenever practicable. However, weather considerations (e.g., inclement weather, excessively hot or cold temperatures, poor air quality) or an individual resident’s health status (e.g., medical condition(s), COVID-19 status) may hinder outdoor visits. For outdoor visits, facilities should create accessible and safe outdoor spaces for visitation, such as in courtyards, patios, or parking lots, including the use of tents, if available. When conducting outdoor visitation, all appropriate infection control and prevention practices should be adhered to.

 

*Fully vaccinated refers to a person who is ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine, per the CDC’s Public Health Recommendations for Vaccinated Persons.

 

Indoor Visitation

Facilities shall allow indoor visitation at all times and for all residents (regardless of vaccination status), except for a few circumstances when visitation should be limited due to a high risk of COVID-19 transmission (note: compassionate care visits shall be permitted at all times). These scenarios include limiting indoor visitation for:

  • Unvaccinated residents, if the nursing home’s COVID-19 county positivity rate is >10% and <70% of residents in the facility are fully vaccinated;2
  • Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated until they have met the criteria to discontinue Transmission-Based Precautions; or
  • Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.

 

Facilities need to consider how the number of visitors per resident at one time and the total number of visitors in the facility at one time (based on the size of the building and physical space) may affect the ability to maintain the core principles of infection prevention. If necessary, facilities should consider scheduling visits for a specified length of time to help ensure all residents are able to receive visitors. During indoor visitation, facilities should limit visitor movement in the facility. For example, visitors should not walk around different halls of the facility. Rather, they should go directly to the resident’s room or designated visitation area. Visits for residents who share a room should not be conducted in the resident’s room, if possible. For situations where there is a roommate and the health status of the resident prevents leaving the room, facilities may attempt to enable in-room visitation while adhering to the core principles of COVID-19 infection prevention.

 

 

Note: CMS and CDC continue to recommend facilities, residents, and families adhere to the core

principles of COVID-19 infection, including physical distancing (maintaining at least 6 feet between people). This continues to be the safest way to prevent the spread of COVID-19, particularly if either party has not been fully vaccinated. However, we acknowledge the toll that separation and isolation has taken. We also acknowledge that there is no substitute for physical contact, such as the warm embrace between a resident and their loved one. Therefore, if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after. Regardless, visitors should physically distance from other residents and staff in the facility.

 

Indoor Visitation during an Outbreak

An outbreak exists when a new nursing home onset of COVID-19 occurs (i.e., a new COVID-19 case among residents or staff). This guidance is intended to describe how visitation can still occur when there is an outbreak, but there is evidence that the transmission of COVID-19 is contained to a single area (e.g., unit) of the facility. To swiftly detect cases, we remind facilities to adhere to CMS regulations and guidance for COVID-19 testing, including routine staff testing, testing of individuals with symptoms, and outbreak testing.

 

When a new case of COVID-19 among residents or staff is identified, a facility should immediately begin outbreak testing and suspend all visitation (except that required under federal disability rights law), until at least one round of facility-wide testing is completed. Visitation can resume based on the following criteria:

  • If the first round of outbreak testing reveals no additional COVID-19 cases in other areas (e.g., units) of the facility, then visitation can resume for residents in areas/units with no COVID-19 cases. However, the facility should suspend visitation on the affected unit until the facility meets the criteria to discontinue outbreak testing.

o For example, if the first round of outbreak testing reveals two more COVID-19 cases in the same unit as the original case, but not in other units, visitation can resume for residents in areas/units with no COVID-19 cases.

  • If the first round of outbreak testing reveals one or more additional COVID-19 cases in other areas/units of the facility (e.g., new cases in two or more units), then facilities should suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak testing.

 

While the above scenarios describe how visitation can continue after one round of outbreak testing, facilities should continue all necessary rounds of outbreak testing. In other words, this guidance provides information on how visitation can occur during an outbreak, but does not change any expectations for testing and adherence to infection prevention and control practices. If subsequent rounds of outbreak testing identify one or more additional COVID-19 cases in other areas/units of the facility, then facilities should suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak testing.

 

NOTE: In all cases, visitors shall be notified about the potential for COVID-19 exposure in the facility (e.g., appropriate signage regarding current outbreaks), and adhere to the core principles of COVID-19 infection prevention, including effective hand hygiene and use of face-coverings.

 

Outbreak testing is discontinued when testing identifies no new cases of COVID-19 infection among staff or residents for at least 14 days since the most recent positive result. For more information see CMS Memorandum QSO-20-38-NH.

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We note that compassionate care visits and visits required under federal disability rights law should be allowed at all times, for any resident (vaccinated or unvaccinated) regardless of the above scenarios. Lastly, facilities shall continue to consult with their state or local health departments when an outbreak is identified to ensure adherence to infection control precautions, and for recommendations to reduce the risk of COVID-19 transmission.

 

Visitor Testing and Vaccination

While not required, CMS encourage facilities in medium- or high-positivity counties to offer testing to visitors, if feasible. If so, facilities should prioritize visitors that visit regularly (e.g., weekly), although any visitor can be tested. Facilities may also encourage visitors to be tested on their own prior to coming to the facility (e.g., within 2–3 days). Similarly, we encourage visitors to become vaccinated when they have the opportunity. While visitor testing and vaccination can help prevent the spread of COVID-19, visitors should not be required to be tested or vaccinated (or show proof of such) as a condition of visitation. This also applies to representatives of the Office of the State Long-Term Care Ombudsman and protection and advocacy systems, as described below.

 

Compassionate Care Visits

In addition to family members, compassionate care visits can be conducted by any individual that can meet the resident’s needs, such as clergy or lay persons offering religious and spiritual support. Compassionate care visits, and visits required under federal disability rights law, should be allowed at all times, regardless of a resident’s vaccination status, the county’s COVID-19 positivity rate, or an outbreak.

 

Lastly, visits should be conducted using social distancing; however, if during a compassionate care visit, a visitor and facility identify a way to allow for personal contact, it should only be done following appropriate infection prevention guidelines, and for a limited amount of time. Also, as noted above, if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor while wearing a well-fitting face mask and performing hand-hygiene before and after. Regardless, visitors should physically distance from other residents and staff in the facility. Through a person-centered approach, facilities shall work with residents, families, caregivers, resident representatives, and the Ombudsman program to identify the need for compassionate care visits.

 

 

 

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Required Visitation

Facilities shall not restrict visitation without a reasonable clinical or safety cause, consistent with 42 CFR § 483.10(f) (4) (v). A nursing home must facilitate in-person visitation consistent with the applicable CMS regulations, which can be done by applying the guidance stated above. Failure to facilitate visitation, without adequate reason related to clinical necessity or resident safety, would constitute a potential violation of 42 CFR § 483.10(f) (4), and the facility would be subject to citation and enforcement actions.

 

Residents who are on transmission-based precautions for COVID-19 should only receive visits that are virtual, through windows, or in-person for compassionate care situations, with adherence to transmission-based precautions. However, this restriction should be lifted once transmission-based precautions are no longer required per CDC guidelines, and other visits may be conducted as described above.

 

Access to the Long-Term Care Ombudsman

As stated in previous CMS guidance QSO-20-28-NH (revised), regulations at 42 CFR § 483.10(f)(4)(i)(C) require that a Medicare and Medicaid- certified nursing home provide representatives of the Office of the State Long-Term Care Ombudsman with immediate access to any resident. During this PHE, in-person access may be limited due to infection control concerns and/or transmission of COVID-19, such as the scenarios stated above for limiting indoor visitation; however, in-person access may not be limited without reasonable cause. We note that representatives of the Office of the Ombudsman should adhere to the core principles of COVID-19 infection prevention as described above. If in-person access is deemed inadvisable (e.g., the Ombudsman has signs or symptoms of COVID-19), facilities must, at a minimum, facilitate alternative resident communication with the ombudsman, such as by phone or through use of other technology. Nursing homes are also required under 42 CFR § 483.10(h)(3)(ii) to allow the Ombudsman to examine the resident’s medical, social, and administrative records as otherwise authorized by State law.

 

Federal Disability Rights Laws and Protection & Advocacy (P&A) Programs Section 483.10(f)(4)(i)(E) and (F) requires the facility to allow immediate access to a resident by any representative of the protection and advocacy systems, as designated by the state, and as established under the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (DD Act), and of the agency responsible for the protection and advocacy system for individuals with a mental disorder (established under the Protection and Advocacy for Mentally Ill Individuals Act of 2000). P&A programs authorized under the DD Act protect the rights of individuals with developmental and other disabilities and are authorized to “investigate incidents of abuse and neglect of individuals with developmental disabilities if the incidents are reported to the system or if there is probable cause to believe the incidents occurred.” 42 U.S.C. § 15043(a)(2)(B). Under its federal authorities, representatives of P&A programs are permitted access to all facility residents, which includes “the opportunity to meet and communicate privately with such individuals regularly, both formally and informally, by telephone, mail and in person.” 42 CFR § 51.42(c); 45 CFR § 1326.27.

 

Additionally, each facility must comply with federal disability rights laws such as Section 504 of the Rehabilitation Act and the Americans with Disabilities Act (ADA).

 

 

 

 

For example, if a resident requires assistance to ensure effective communication (e.g., a qualified

interpreter or someone to facilitate communication) and the assistance is not available by onsite staff or effective communication cannot be provided without such entry (e.g., video remote interpreting), the facility must allow the individual entry into the nursing home to interpret or facilitate, with some exceptions. This would not preclude nursing homes from imposing legitimate safety measures that are necessary for safe operations, such as requiring such individuals to adhere to the core principles of COVID-19 infection prevention. Any questions about or issues related to enforcement or oversight of the non-CMS requirements and citations referenced above under this section subject heading should be referred to the HHS Office for Civil Rights, the Administration for Community Living, or other appropriate oversight agency.

 

Entry of Healthcare Workers and Other Providers of Services

Health care workers who are not employees of the facility but provide direct care to the facility’s residents, such as hospice workers, Emergency Medical Services (EMS) personnel, dialysis technicians, laboratory technicians, radiology technicians, social workers, clergy, etc., must be permitted to come into the facility as long as they are not subject to a work exclusion due to an exposure to COVID-19 or showing signs or symptoms of COVID-19 after being screened. We note that EMS personnel do not need to be screened, so they can attend to an emergency without delay. We remind facilities that all staff, including individuals providing services under arrangement as well as volunteers, should adhere to the core principles of COVID-19 infection prevention and must comply with COVID-19 testing requirements.

 

Communal Activities and Dining

While adhering to the core principles of COVID-19 infection prevention, communal activities and dining may occur. Residents may eat in the same room with social distancing (e.g., limited number of people at each table and with at least six feet between each person). Facilities should consider additional limitations based on status of COVID-19 infections in the facility. Additionally, group activities may also be facilitated (for residents who have fully recovered

from COVID-19, and for those not in isolation for observation, or with suspected or confirmed COVID-19 status) with social distancing among residents, appropriate hand hygiene, and use of a face covering (except while eating). Facilities may be able to offer a variety of activities while also taking necessary precautions. For example, book clubs, crafts, movies, exercise, and bingo are all activities that can be facilitated with alterations to adhere to the guidelines for preventing transmission.

 

Survey Considerations

Federal and state surveyors are not required to be vaccinated and must be permitted entry into facilities unless they exhibit signs or symptoms of COVID-19. Surveyors should also adhere to the core principles of COVID-19 infection prevention, and adhere to any COVID-19 infection prevention requirements set by state law.

 

 

AN UPDATE FROM MEADOWS NURSING AND REHABILITATION CENTER

The information is as follows as of THURSDAY 3/4/2021 as of 8AM            Census: 75

We are relieved to report there have been no new cases of COVID19 since 2/17/2021.

Over the course of the Outbreak, which began January 1, 2021 the total cases were as follows:

45 Residents in total have tested Positive for COVID-19
8 Residents are Considered Persons Under Investigation (PUI) for COVID-19*
0 Resident has developed a new onset of Respiratory Symptoms within a 72-hour Period
0 Active Cases for Center Staff testing Positive for COVID-19
16 Resolved Cases for Center Staff Testing Positive for COVID19
0 Center Staff are Considered Persons Under Investigation (PUI) for COVID-19
0 Center Staff have developed a new onset of Respiratory Symptoms within a 72-hour period
18 Residents have passed away due to COVID-19 during this pandemic
0 Center Staff have passed away due to COVID-19 during this pandemic

*New Admits/Readmits are placed under Transmission-Based Precautions for 14 days and considered Person Under Investigation (PUI). These residents are included in the number of residents considered Persons Under Investigation. New Admissions are placed in a Yellow Zone.

As of the week ending 2/24/21, Luzerne County Positivity Rate has decreased to 6.1%

Healthcare personnel will continue to be tested Weekly as per the Frequency of Testing Requirements from CMS. Residents shall be tested upon identification of an individual with symptoms consistent with COVID-19 or if an employee or staff member tested positive for COVID-19.

 

In regards to Visitation, CMS recommends the following steps nursing homes take before reopening to visitors?

 

Nursing homes should continue to follow CMS and CDC guidance for preventing the transmission of COVID-19. In addition, they should follow state and local direction. Because nursing home residents are especially vulnerable, CMS does not recommend opening facilities to visitors (except for compassionate care situations) until phase three when:

 

  • there have been no new, nursing home onset COVID-19 cases in the nursing home for 28 days (through phases one and two)
  • the nursing home is not experiencing staff shortages
  • the nursing home has adequate supplies of personal protective equipment and essential cleaning and disinfection supplies to care for residents
  • the nursing home has adequate access to testing for COVID-19
  • Referral hospital(s) have bed capacity on wards and intensive care units

 

Please note if your loved one, should test positive for the virus, a representative from nursing will notify you.

Please continue to reach out to the Activities & Social Services staff to assist you in communicating with your loved ones. We can assist with virtual visits and phone calls for you to keep in touch. Window Visits will be available beginning Monday, March 8th (Weather Permitting).

The best way to prevent illness is to avoid being exposed to this virus. You can take steps to slow the spread.

Pandemics can be stressful, especially when you are staying away from others. During this time, it’s important to maintain social connections and care for your mental health. Please contact our Activities Department at (570) 675-8600, ext 139 to schedule a virtual visit with your loved one.

The Meadows Information Line (570) 675-8735 is updated bi-weekly. Please check our website at https://themeadowsdallas.com for updates.

Our thoughts and prayers go out to our residents, staff and family members during this very trying time. Thank you for your patience and understanding during this challenging time.

 

 

AN UPDATE FROM MEADOWS NURSING AND REHABILITATION CENTER

The information is as follows as of THURSDAY  2/25/21 as of 4:30PM            Census: 72

45 Residents in total have tested Positive for COVID-19
6 Residents are Considered Persons Under Investigation (PUI) for COVID-19
0 Resident has developed a new onset of Respiratory Symptoms within a 72-hour Period
0 Active Cases for Center Staff testing Positive for COVID-19
16 Resolved Cases for Center Staff Testing Positive for COVID19
0 Center Staff are Considered Persons Under Investigation (PUI) for COVID-19
0 Center Staff have developed a new onset of Respiratory Symptoms within a 72-hour period
17 Residents have passed away due to COVID-19 during this pandemic
0 Center Staff have passed away due to COVID-19 during this pandemic

*Please note HCP are considered Presumed Under Investigation, if they have been exposed to an individual per CDC Guidelines and are quarantined for 14 days from the date of exposure.

New Admits/Readmits are placed under Transmission-Based Precautions for 14 days and considered Person Under Investigation (PUI). These residents are included in the number of residents considered Persons Under Investigation. New Admissions are placed in a Yellow Zone.

Residents and HCP will continue to be tested weekly until 14 days have passed since the last positive on 2/17/21.

The Facility conducted RAPID Point-of-Care Antigen Tests on Monday 2/22/21 on the 36 residents eligible to be tested. All residents tested NEGATIVE via the COVID19 AG CARD Rapid POC Test. 

As of the week ending 2/17/21, Luzerne County Positivity Rate has decreased to 7.1%

Facility adheres to PA Department of Health Guidance in determining when a case of COVID-19 is resolved. We follow the Symptom-Based Strategy which states, transmission-based- precautions and isolation may be discontinued under the following conditions: • At least 10 days have passed since symptoms first appeared; and, • At least 24 hours have passed since last fever without the use of fever-reducing medications; and, • Symptoms (e.g., cough, shortness of breath) have improved.

Please note if your loved one, should test positive for the virus, a representative from nursing will notify you.

 

 

 

 

 

Please continue to reach out to the Activities & Social Services staff to assist you in communicating with your loved ones. We can assist with virtual visits and phone calls for you to keep in touch.

The Meadows Information Line (570) 675-8735 is updated bi-weekly. Please check our website at https://themeadowsdallas.com for updates.

Our thoughts and prayers go out to our residents, staff and family members during this very difficult time.

Thank you for your patience and understanding during this challenging time.

 

 

 

 

 

December 2, 2020

Dear Resident and Resident Representative,

This letter is to inform you, Center for Disease Control had voted to have long-term residents and healthcare workers to be the first group to have access to a COVID19 vaccine. This is very encouraging!!! Nursing home residents could receive the vaccine in the next month!

Vaccines are safe and effective and the best way to protect you and those around you from serious illnesses. Although, there is not yet an authorized or approved vaccine to prevent COVID-19, the COVID-19 vaccine is currently being developed and when available, will be distributed to Pennsylvanians in a phased approach (Source CDC.GOV).

It is important to note, the COVID-19 vaccine will not be the cure for the virus. It will be another tool in the toolbox for our fight against COVID-19, and we must continue to practice other mitigation efforts, such as wearing a mask, hand washing, physical distancing and downloading COVID Alert PA.

The enclosures in regards to the vaccine is included for your edification. Additionally, you can find more information at https://www.cdc.gov/coronavirus/2019-ncov/vaccines/faq.html. Please be aware, consent forms will be mailed to you in the near future. It is vital, these vaccination consent forms are returned in a timely manner. Walgreen’s Pharmacy has been assigned to our organization to administer COVID-19 vaccines. As we anticipate FDA approval/emergency use authorization of a COVID-19 vaccine, Walgreen’s Pharmacy is working diligently to create the essential processes to safely and seamlessly deliver and administer the vaccine to our residents as soon as the vaccine becomes available.

Please Stay Well & Stay Safe!!!

Sincerely,

Cristina Tarbox, LNHA, MHA, MPS

November 10, 2020

Dear Resident Representative,

As we enter the holiday season, it is important to understand the CDC guidelines and considerations for enhancing protection of individuals and communities and preventing spread of coronavirus disease 2019 (COVID-19).

Because COVID-19 virus circulation varies in communities, these considerations are meant to supplement—not replace—any state, local, territorial, or tribal health and safety laws, rules, and regulations with which gatherings must comply.

Guiding Principles per CDC Guidelines:

  • A gathering refers to a planned or spontaneous event, indoors or outdoors, with a small number of people participating or a large number of people in attendance such as a community event or gathering, concert, festival, conference, parade, wedding, or sporting event.
  • The more people an individual interacts with at a gathering and the longer that interaction lasts, the higher the potential risk of becoming infected with COVID-19 and COVID-19 spreading.
  • The higher the level of community transmission in the area that the gathering is being held, the higher the risk of COVID-19 spreading during a gathering.
  • The size of an event or gathering should be determined based on state, local, territorial or tribal safety laws and regulations.

The risk of COVID-19 spreading at events and gatherings increases as follows:

Lowest risk: Virtual-only activities, events, and gatherings.

More risk: Smaller outdoor and in-person gatherings in which individuals from different households remain spaced at least 6 feet apart, wear masks, do not share objects, and come from the same local area (e.g., community, town, city, or county).

Higher risk: Medium-sized in-person gatherings that are adapted to allow individuals to remain spaced at least 6 feet apart and with attendees coming from outside the local area.

Highest risk: Large in-person gatherings where it is difficult for individuals to remain spaced at least 6 feet apart and attendees travel from outside the local area.

 

If you are planning to travel, please note travel increases your chance of getting and spreading COVID-19. Staying home is the best way to protect yourself and others.

However, if you do travel:

  • Check travel restrictions before you go
  • Get your flu shot before you travel.
  • Always wear a mask in public settings and on public transportation.
  • Stay at least 6 feet apart from anyone who is not in your household.
  • Wash your hands often or use hand sanitizer.
  • Avoid touching your mask, eyes, nose, and mouth.
  • Bring extra supplies, such as masks and hand sanitizer
  • Adhere to hand hygiene and respiratory etiquette

SARS-CoV-2, the virus that causes COVID-19, is thought to be mostly spread by respiratory droplets released when people talk, cough, or sneeze. It is thought that the virus may also spread to hands from a contaminated surface and then to the nose, mouth or eyes, causing infection. Therefore, personal prevention practices (such as handwashingstaying home when sickmaintaining 6 feet of distance, and wearing a mask) and environmental prevention practices (such as cleaning and disinfection) are important ways to prevent the virus’s spread. (Source: CDC.GOV/Coronavirus)

Please call the Meadows Information Line for weekly updates at (570) 675-8735.

Thank you for your patience and understanding.

 

Sincerely,

 

Cristina Tarbox, LNHA, MHA, MPS
Licensed Nursing Home Administrator

 

 

 

 

 

 

 

 

 

CDC: Essential Highlights on Thanksgiving, Travel, and Gatherings

Below, we offer direct quotes from the CDC’s general holiday page that expand on their common COVID guidance.

 

The COVID-19 pandemic has been stressful and isolating for many people. Gatherings during the upcoming holidays can be an opportunity to reconnect with family and friends. This holiday season, consider how your holiday plans can be modified to reduce the spread of COVID-19 to keep your friends, families, and communities healthy and safe.

 

Explicit guidance on who “should not attend in-person holiday gatherings.”

  • Beyond all the ‘usual’ groups who are in the high-risk categories, CDC directly states here that “if you are an older person… you should avoid in-person gatherings with people who are not in your household.” Interpretation of this for residents of aging services provider communities can vary, but many members have concluded that this means either ‘residents who live together’ or ‘residents of the same cohort,’ such as assisted living or the nursing home.

Hosting or Attending a Gathering:

  • “Getting a flu vaccineis an essential part of protecting your health and your family’s health this season.
  • Guests should avoid direct contact, including handshakes and hugs, with others not from their household.
  • Even outdoors, require guests to wear masks when not eating or drinking.
  • All attendees should have a plan for where to store their maskwhile eating and drinking.
  • Encourage guests to avoid singing or shouting, especially indoors. Keep music levels down so people don’t have to shout or speak loudly to be heard.
  • Plan ahead and ask guests to avoid contact with people outside of their households for 14 days before the gathering.
  • Treat petsas you would other human family members – do not let pets interact with people outside the household.”

 

Food and Drink at Small Gatherings:

  • “Have one person who is wearing a mask serve all the food so that multiple people are not handling the serving utensils.
  • Avoid crowded buffet and drink stations.
  • Change and launder linen items (e.g., seating covers, tablecloths, linen napkins) immediately following the event.”

Travel and Overnight Stays:

  • “Wear maskswhile inside the house. Masks may be removed for eating, drinking, and sleeping, but individuals from different households should stay at least 6 feet away from each other at all times.
  • Hosts and guests should have a plan for what to do if someone becomes sick.
  • Improve ventilation by opening windows and doors or by placing central air and heating on continuous circulation.”

If Exposed to COVID during the Holiday:

Thanksgiving Specific:

  • “Bring your own food, drinks, plates, cups, and utensils.
  • Have a small outdoor mealwith family and friends who live in your community.
  • Avoid going in and out of the areas where food is being prepared or handled, such as in the kitchen.
  • Limit the number of guests.
  • Consider other Thanksgiving alternatives, such as: getting together virtually with family and friends outside of your household, playing games or watching parades and sports together at home, shopping online on the day after Thanksgiving and using contactless delivery.
  • Safely prepare traditional dishes and deliver them to family and neighbors in a way that does not involve contact with others (for example, leave them on the porch).
  • Participate in a gratitude activity, like writing down things you are grateful for and sharing with your friends and family.”

 

 

STAY SAFE THIS HOLIDAY SEASON!!!

Dear Resident and Resident Representative,

This letter is to inform you of new testing requirements issued by Center for Medicare and Medicaid Services (CMS) for nursing homes.
As per CMS, the Testing Frequency will be as follows based on three triggers for testing:
Symptomatic, Outbreak and Routine/Surveillance

Symptomatic Testing: Facility shall test any staff or residents who have signs or symptoms of COVID-19. Facility shall continue screening all staff, residents and other visitors.

Outbreak Testing:  Facility shall test all active staff and residents in response to an outbreak (defined as any single new infection in staff or any nursing home onset infection in a resident). All staff and residents that tested negative will continue to be tested every three to seven days. This testing frequency will last until testing identifies no new cases of COVID-19 infection among staff or residents for a period of at least fourteen days since the most recent positive result.

Routine Testing:  Facility shall test all staff based on the extent of the virus in the community, using CMS’ published county positivity rate in the prior week as the trigger for staff testing frequency (see table below):

 

Community COVID-19 Activity County Positivity Rate in the past week Minimum Testing Frequency
Low <5% Once a month
Medium 5%-10% Once a Week*
High >10% Twice a Week*

*This frequency presumes availability of Point of Care testing on-site at the nursing home or where off-site testing turnaround time is within 48-hours.

You may access reports of COVID-19 county-level positivity rates at https://data.cms.gov.  Our Infection Preventionist Nurse monitors Luzerne County’s positivity rate every other week and adjust the frequency of testing accordingly. Currently, the positivity rate for Luzerne County is 4.1% based on data from 8/13-8/19/2020.

In order to comply with these testing requirements, CMS has provided skilled nursing facilities with a rapid point-of-care (POC) diagnostic testing device.  Testing results are produced within fifteen minutes. Our facility has received the BD Veritor Analyzer to conduct rapid point of care testing.
Meadows Nursing and Rehabilitation Center conducted baseline testing on all active residents and healthcare employees in July and then again in August. Additionally, we have been completing testing every two weeks as part of our surveillance program on a random sample of healthcare employees.

Please note, our facility has set-up a special Meadows Information Line (570) 675-8735.  Weekly updates will be available pertaining to the status of COVID19 cases.

Remember to continue to do your part to keep Pennsylvanians safe and take the following steps to avoid spreading COVID-19:

  • Maintain social distance (approximately 6 feet or 2 meters) from others
  • Wear a cloth face covering when in public
  • Wash your hands often, using alcohol-based hand sanitizer or soap and water for twenty secondsIn the meantime, please do not hesitate to contact me at (570) 675-8600, ext 102 with questions or concerns you may have.For the most up-to-date information on this topic, please visit the CDC website at http://www.cdc.gov/covid19.Sincerely,

Sincerely,

Cristina Tarbox, LNHA, MHA, MPS
Licensed Nursing Home Administrator