Reopening Process

Please see below for information regarding our reopening plan:

RE-OPENING PLAN – TRANSITIONS HEALTHCARE GETTYSBURG

 

Step 1 – Sept. 28-Oct.11

Step 2 – Oct. 12 – Oct. 25

Step 3 – Oct 26

 

If at any point there is a positive COVID-19 case that originates within the facility, the re-opening status will halt, communal dining will be discontinued, volunteer and all non-essential personnel will no longer be permitted within the building.  The re-opening process will resume at the beginning of the recommended incremental steps by the Pennsylvania Department of Health.

 

Baseline Universal Testing was initially completed with full results on July 31, 2020.

The facility is in a Green county per the Governor’s Reopening Plan.

 

Symptomatic COVID-19 Testing

Any resident found to have symptoms consistent with the symptoms of COVID-19 shall be tested within 24 hours after the first symptoms are observed.  There is a standing PRN order for all residents that permits testing as needed for symptoms.  All testing can be completed either by in house BD Veritor testing system, Wellspan Hospital, or Quest Diagnostics.

 

Outbreak Testing for Staff and Residents

In the event of a COVID-19 outbreak in the facility, we have secured the resources for resident and staff testing through Quest Diagnostics as well as additional testing through Wellspan Hospital.

 

Screening Testing

The level of COVID-19 activity in the community surrounding the facility has a direct impact on the risk of COVID-19 introduction into the facility.  When the facility is not experiencing an outbreak, the facility will test at a frequency based on the county positivity rate reported in the past week.  The facility will monitor the Adams County positivity rate every other week and will adjust the frequency of performing testing according to the table below.  This will only apply to testing of asymptomatic individuals.  Individuals with a prior confirmed diagnosis of COVID-19 will not be retested until at least 90 days from the positive diagnosis.

 

Level of Community
COVID-19 Activity
County
%
Positivity
Routine Testing of
Asymptomatic Residents
Routine Testing
of Asymptomatic
Staff
LOW <5% Not recommended Test all staff members every
4 weeks
MODERATE 5% to <10% Weekly testing is encouraged of all
residents with outside contact in the
last 14 days, if they have not otherwise been tested during that period.
Test all staff members once per week.
SUBSTANTIAL 10% and up Weekly testing is encouraged of all
residents with outside contact in the
last 14 days, if they have not otherwise
been tested during that period.
Test all staff members twice
per week.

 

Routine testing of residents may be considered if the resident has “outside contact”.  This may include but is not limited to outpatient health care visits including dialysis treatments, social visits in the community, receiving visitors within the facility or on facility property, and after admission to another health care facility.

 

COVID-19 Testing of non-essential staff

Refusal of COVID-19 testing by staff

All staff will be strongly encouraged to participate in mandatory testing and will be educated on the importance of testing for the wellbeing of our residents and our reopening plan.  Any employee of Transitions Healthcare LLC Gettysburg has the right to refuse COVID-19 testing.  After an employee refusal has been signed, the employee will be required to wear an N-95 mask at all times when in the building.  If at some point there is not an ample surplus of N-95 masks in the building, the employee may be placed on administrative leave without pay until either masks become available or testing is completed.

 

Refusal of COVID-19 testing by residents

All residents will be strongly encouraged to participate in mandatory testing and will be educated on the importance of testing for the wellbeing of our residents and our reopening plan.  Any resident at Transitions Healthcare LLC, Gettysburg has the right to refuse COVID-19 testing.  Any patient refusing testing will be placed in the yellow zone isolation for 14 days.  If at any time they become symptomatic and still refuse COVID-19 testing, they will be presumed positive and placed in red zone isolation for a duration of 10 days from the onset of symptoms.  In addition to the 10 day isolation period, the resident must remain symptom free for 72 hours before isolation can be discontinued.

 

Isolation and Co-horting of residents with confirmed COVID-19

Upon discovery of an active case of COVID-19 case, the resident will be moved to a RED zone isolation and will remain under isolation for at least 10 days and the resident is symptom free for 72 hours.  More critical residents or residents with a higher number of co-morbidities may remain in isolation for a period of 20 days.  Residents that are found to be COVID-19 positive may be co-horted with other positive residents in the Red zone.  When at all possible, an asymptomatic positive resident will not be co-horted with a symptomatic resident.

 

Screening of Staff

All employees are being screened prior to getting to patient care areas and at the end of their shift.  The temperature logs will be maintained by the ICP.  Any employee who hits the temperature threshold will be released from duty until they are asymptomatic for 72 hours.  Staff traveling outside of the area may be asked to wear an N-95 mask for a period of 14 days since return to area.

 

Screening of residents

All residents are to be screened a minimum of once daily for temperature and pulse oximetry.  If values are found to be out of the normal range, an immediate nursing assessment will be completed to determine if COVID-19 testing is indicated.

 

Visitor Screening

All visitors will be screened at the front lobby or at side entrance for vendors/contractors.  Visitors will be instructed to use the alcohol based hand sanitizer, will have their temperature screened and will be asked survey questions.  This process will assist in assessing the visitors’ potential risk prior to being given permission to enter the facility.

 

Volunteer Screening

All volunteers will be screened at the front lobby. Volunteers will be instructed to use the alcohol based hand sanitizer, will have their temperature screened and will be asked survey questions.  This process will assist in assessing the visitors’ potential risk prior to being given permission to enter the facility.

 

 

PPE supply management

Facility will monitor use of and procurement of PPE supplies.  A list of PPE is available from the ICP or Central Supply Manager.  Facility will make every attempt to ensure adequate supplies are available and will continue to monitor availability and proper use.  Completed inventory of essential PPE is reviewed at least weekly.  Burn rates are used to calculate estimated usage to project future needs and avoid PPE shortages.

 

Staffing Review

The scheduler and DON meet to review each days staffing to ensure that staffing is adequate to meet the needs of the residents.  At the present time this facility is not operating under its emergency staffing contingency plan.

 

Resumption of limited communal dining

Starting in step 1, limited communal dining will resume as long as the building remains COVID-19 free.  Communal dining is limited to residents unexposed to COVID-19.  No more than 10 residents will dine at one seating and residents will be spaced at least 6 feet apart.  Communal dining is the same for all steps of reopening.

 

Volunteer Services

Resumption of Volunteer services will resume in step 2 of the reopening phase.  In step 2, volunteers will be used exclusively for the purpose of assisting with visitation protocols.  Volunteer duties with visitation will only be with residents that are unexposed to COVID-19 and not under any isolation precautions.  Screening, social distancing, hand hygiene, and universal masking will be required.

 

In step 3 of the re-opening phase, volunteers are permitted but may only conduct volunteer activities with residents unexposed to COVID-19.  Screening, social distancing, hand hygiene, and universal masking will be required.

 

Non-essential Personnel

Non-essential personnel will resume in step 2 of the reopening phase as determined necessary by the facility.  Non-essential personnel services will only be with residents that are unexposed to COVID-19 and not under any isolation precautions.  Screening, social distancing, hand hygiene, and universal masking will be required.

 

Resident Activities

Under step 1 of the reopening process, communal activities can resume in groups of 5 or less.  Group activities must be held maintaining social distancing, frequent hand hygiene and universal masking.  Residents should be provided with Alcohol Based Hand Sanitizer at the completion of the activities.

Under step 2, the group can contain 10 or less participants with the same requirements.

Step 3 will not limit the number of participants, but all social distancing guidelines and universal masking are required.  All residents in all steps of reopening must not be residents that have potential COVID-19 exposure or in any isolation status.

 

Visitation Guidelines

 

Visitation Guidelines in Step 2 of Re-opening

Visitation Guidelines in Step 3 of Re-Opening

 

Outside items

Visitors wishing to bring in personal items for residents should limit these items to items that can be decontaminated.  Items will be laundered or decontaminated with facility approved cleaner that meets CDC guidelines for killing the COVID-19 virus prior to giving to residents.  Any food items should be in a sealed package.  Arrangements should be made with the facility prior to dropping off items and to assure that they meet guidelines.  Items may be accepted by staff during visitation to be decontaminated prior to giving items to residents.

 

 

 

 

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