Update September 3:
We have had two consecutive rounds of universal testing in the building and are 100% COVID-free. We are now in Step One of our Reopening Implementation Plan as directed by the state of Pennsylvania.
Because we have advanced to Step One we are resuming limited activities and communal dining tomorrow, Friday, September 4th with all recommended precautions in place. As directed by the state, activities are limited to a maximum of 5 people and dining for lunch will be offered in the main dining room for Independent Living residents with one household per table. Personal Care residents will dine in the Personal Care dining room. Unfortunately, the state order does not permit “crossovers” from Personal Care to Independent Living or vice versa at this time. As soon as that is allowed, we will notify you and you will be able to choose your dining venue.
We will progress to Step Two of our Reopening Plan following two weeks with no new facility onset COVID cases in Step One. During that phase we will open our dining rooms for dinner and can allow up to ten residents to attend activities (provided all abide by masking and socially distancing requirements). We will also permit outdoor visits for unexposed residents and their family and friends with specific precautions to ensure the safety of all residents.
Following two weeks of no positive cases of facility onset COVID-19 during Step Two, we will enter Step Three of our Reopening Plan. During Step Three, we can allow scheduled visits in specific common areas inside the building, the hair salon will re-open and we will be able to go on group outings. Each of these events will have very specific protocol to ensure the safety of all residents and team members.
Each of the three steps outlined in the Reopening Implementation Plan (available in full on our website or through request to the front desk or me) require two weeks with no new positive cases acquired in house to advance to the next step. We are not required to test weekly unless we have a new positive case during any step of the plan. Anyone with signs or symptoms will immediately be quarantined and tested. At any time in the Plan we experience a new facility onset positive case of COVID-19 or if the Governor makes any changes to the state plan, such as reverting Delaware County to the red phase, we will go back to the pre-opening plan and restart with Step One of the plan when able to do so. Additionally, if any regulatory body including the CDC or the PA Department of Human Services changes their guidelines, we will abide by those recommendations in the best interest of the safety of all.
The Summit at Glen Mills Reopening Implementation Plan
The Summit at Glen Mills (“the Community”) Reopening Implementation Plan (“the Plan”) will comply with the Order of the Secretary of the Pennsylvania Department of Health Directing Testing at Long-Term Care Facilities, issued June 26, 2020.
The Plan will be posted on the Community’s website and be available to residents, families, and advocates such as the Ombudsman and the Department of Human Services (DHS). The Community will halt the reopening steps at any stage of the reopening plan if Governor Wolf’s Reopening Plan is reverted to the Red Phase. Delaware County must be in the Yellow or Green Phase to move through the reopening process. If at any point in the process there is a new facility onset of a case of COVID-19 the Community will go back to the preopening plan and restart the 14 days once there is no new facility onset of COVID-19. The Community will then start the Plan with Step One, then Steps Two and Three following the criteria as stated in the Order.
The Community will complete the baseline universal COVID-19 diagnostic testing for all residents and team members, other than any person who has tested positive for COVID-19 in the past, by July 31, 2020. Any individual who has been tested after June 12, 2020 will not be required to test again. Any resident who refuses to be tested will be quarantined within their apartment and not permitted to engage in any activity outside their apartment. Any team member who refuses to be tested will be prohibited from working until they receive a COVID-19 test and comply with the post-testing protocol.
The Community has a relationship with Evergreen/Solaris Lab (currently licensed to perform laboratory tests in PA) who will process all specimens obtained in-house. Prior to testing, the Health Service Director’s designee will obtain completed consent forms and insurance information from all individuals who will be tested in-house. The insurance information will be entered into the Lab’s client portal with the requisition for the SARS-CoV-2019 test, with Dr. John Hopkins from CCS-Healthcare as the ordering physician.
The Health Services Director (HSD) will obtain swabs from the Lab and obtain the specimens with one designee to assist her, both utilizing gowns, face masks and eye shields (changing the eye shield if coughed or sneezed upon). Gloves will also be worn and changed after each specimen is collected and hands will be sanitized before applying clean gloves. Team members may go to an outside testing location or be tested in the Community in the Doctor’s Office at an arranged time by the HSD. Consenting residents will be tested in the alcove inside their own apartment doorway with the door closed.
Specimens will be sent by overnight mail to the Lab for testing in the packaging supplied by the Lab. The Executive Director (ED) and the HSD will monitor results and notify each person of their results.
At any time, a resident with symptoms of COVID-19 will be tested within 24 hours of onset of the symptoms. The HSD will obtain the specimen and requisition the lab within the 24-hour period. The resident will be assumed to be positive (“yellow zone”) and quarantined with full PPE required for staff (essential staff only permitted) when entering the apartment.
Post-Testing Actions to Prevent Transmission
The Community will utilize the “Testing Guidance for COVID-19 in Long-term Care Facilities Residents and Healthcare Personnel” (PA-HAN-509) for best practice infection control measures when results are in and/or when a positive COVID-19 result is identified.
Any PC or MC resident who tests positive will be moved to the 3rd floor west wing in the PC unit, which will be the “Red Zone”. Each apartment is a private unit with a private bathroom. The room will be set up with negative air pressure and air scrubbers. There will be a physical barrier outside the door of the wing(a plastic sheet covering the alcove to the apartment, with a zipper for entry). A decontamination room, with full PPE, will be available near their apartment. Signage will indicate this is a “red zone” requiring full PPE upon entry. Only essential staff members will be permitted access inside the apartment. Residents will remain in their apartments unless there is an emergency or if they need to go out for a medically necessary appointment that cannot be accommodated through telemedicine.
In any instance when they need to exit their apartment they will be required to wear a face mask and gown. They will be exited through a path with the least amount of exposure to others. All areas in the pathway will be disinfected following their exit and entry. Positive residents will remain in isolation until free of signs or symptoms for 14 days following the date of testing if asymptomatic or 14 days following the date of the last symptom if symptomatic.
In the event a Memory Care resident should test positive, they will be moved to the red zone with monitoring around the clock.
Any resident who tests negative but is potentially exposed to COVID-19 will be moved to the 3rd floor east wing in the PC unit, which will be the “Yellow Zone”. The resident will be tested and moved to the red zone if positive. Each apartment is a private unit with a private bathroom. Full PPE will be available near their apartment. Signage will indicate this is a “Yellow Zone” requiring full PPE upon entry. Only essential staff members will be permitted access inside the apartment. Residents will remain in their apartments unless there is an emergency or if they need to go out for a medically necessary appointment that cannot be accommodated through telemedicine. In any instance when they need to exit their apartment they will be required to wear a face mask and gown. They will be exited through a path with the least amount of exposure to others. All areas in the pathway will be disinfected following their exit and entry. Residents will be kept in the yellow zone for 14 days following any known exposure
The existing apartments of residents who need to be moved to the red or yellow zones will be fogged and thoroughly disinfected once they have transitioned into the new zone. All areas of the building other than the designated red and yellow zones will be considered “Green Zone” for residents who test negative or have had no exposures.
Move-ins to the Community will be accepted on a case by case basis, depending on exposure risks, and contingent on receiving a negative COVID-19 testing result taken no earlier than 5 days before move-in, and agreeing to following the “Blue Harbor/Merrill Gardens COVID-19 Moving Checklist” protocols. The new resident will remain in quarantine in their apartment for 14 days and must have a 2nd negative result taken 10 days after move-in before release from quarantine. Signage will be posted outside their apartment stating quarantine precautions are necessary. Only essential staff will be permitted access to the apartment and will be required to wear full PPE, which will be made available just outside the apartment. In the event of a facility onset positive COVID test, all potential move-ins will be postponed for at least 14 days.
Infection Control and Personal Protective Equipment
Best practice infection control measures have been and will remain in force for the duration of the pandemic, including the following:
- PPE will be monitored for sufficient levels to meet the projected needs of the Community. In the event of supply shortages through present vendors, the Community will seek other potential vendors, contact Blue Harbor Senior Living/Merrill Gardens for additional supplies, or, if needed, will contact the local Emergency Management Coordinator for access to the County PPE stockpile.
- PPE guidelines and training will continue to be reviewed with team members.
- Staff and residents will be screened daily for fever and symptoms as described by CDC recommendations. Staff will be screened at the beginning of each shift and the results documented. Any team member with fever 100.4 or higher or symptoms will be sent home.
- Essential visitors and delivery personnel, if entering the building beyond the front desk, will also be screened prior to access, using the “Merrill Gardens/Blue Harbor COVID-19 Screening Questionnaire”. They will have their temperature read and if elevated above 100.4 degrees and/or they have had any of the symptoms on the questionnaire they will not be permitted past the desk. Delivery personnel who need to enter the building through the receiving area will need to go to the front desk for the screening process prior to entry.
- Universal masking will be required for any person entering the building and for any resident when leaving their apartment. Residents are asked to be masked when answering their apartment door.
- The “Blue Harbor Enhanced Cleaning Protocol” will be maintained.
- Vendors and Contractors entering the building must agree to follow the requirements of the “Blue Harbor COVID-19 Checklist” before entry is permitted and pass the screening requirements using the “Merrill Gardens/Blue Harbor COVID-19 Screening Questionnaire”.
Baseline testing will be completed prior to moving into Step One. All results will be reported to the Department of Human Services within 48 hours of completion, through the Tracker report on the website designated by the Department. All data fields will be updated daily by the Executive Director or her designee as indicated by the guidelines. Any positive test results will be reported to the Chester County Department of Health, in addition to DHS.
The Community is currently staffed adequately with permanent employees. In the event of a staff shortage, staff members from the Residences at Glen Riddle or Arbour Square may be utilized if they have tested negative and exhibit no symptoms of COVID-19, or if tested positive, have been free of signs and symptoms of COVID-19 for at least 10 days. In addition, the Community has an agreement with General Healthcare Resources and with Focus One to supply staff on an “as needed” basis.
In the event of a COVID-19 outbreak and staffing needs become critical, employees who have tested positive and are asymptomatic may be utilized for care of red zone residents. Such staff will be required to use a designated, separate entrance to the building and to not leave the unit or cohort with any individuals who have not tested positive.
In the event the above measures are unable to provide safe staffing levels, the management company, Blue Harbor Senior Living/Merrill Gardens, will be contacted for potential additional resources. In the event staffing needs should continue, the Executive Director will contact the local Health Care Coalition or the Regional Response Health Collaborative Program for additional options. The Community will also notify the regional office of the Department of Human Services.
Visitation Procedures Pre-reopening
Only essential visitors will be permitted into the Community, including medical providers, HH, PT, OT, hospice, pharmacy, regulators and inspectors, life safety & compliance vendors (fire, elevators, emergency plumbing, etc.). All must be screened/temped, hands sanitized and mask in place upon entry. Hand sanitizer is available by the front desk. Resident family members and clergy will be permitted only in the event of end of life situations, after following all screening procedures.
The Community will ensure that any of the allowed visitors will have the least amount of contact with residents or staff for the duration of their visit.
The Community had opened the dining room and a daily activity on a limited basis using social distancing precautions as described in Reopening Plan Step One, prior to the Order. If the universal testing in the Community indicates any positive test results all dining room and out of room activities will cease, and the following Dining Procedures will be implemented.
Dining Procedures Pre-reopening
Meals will be delivered in disposable containers to residents in PC and IL in their apartments. Memory Care residents will eat in their main MC dining area with social distancing and staff monitoring. Any PC resident requiring assistance with meals will be assisted in their apartment.
Reopening Plan Step One
The Community will meet all the prerequisites and baseline testing for entering Step One, as listed in the “Interim Guidance for Personal Care Homes and Assisted Living Residents and Private Intermediate Care Facilities During COVID-19”. The Executive Director will then notify the DHS Regional Director via email the Community is entering Step One of the Plan.
If there are any new facility onset of COVID-19 cases with residents and staff for 14 consecutive days the Community will revert to the Pre-reopening procedures. The visitation plan will remain the same as the Pre-Reopening plan through Step One. Volunteers will not be permitted in the Community.
Limited activities will be conducted with no more than 5 residents in attendance who are unexposed to COVID-19 and who exhibit no signs or symptoms of COVID-19. Residents will always be required to wear masks, to practice social distancing and to sanitize their hands before and after attending any activity. The Activities Assistant will use the Activity Tracking Sheet to keep attendance and will disinfect the surfaces, including tables and chairs, at the end of each event. The housekeeping team will disinfect all high touch areas in the hallways before and after each event.
Residents will enter and exit the room for each activity one household at a time. Residents will be instructed not to go to any area other than where scheduled and to touch as little as possible. Staff will monitor distancing in hallways and leading into and out of designated rooms.
At any time a resident requests a mask the Community will provide one.
Reopening Communal Dining Plan
During Step One, communal dining will be permitted in any of the three dining rooms at lunch time for residents who have had no exposures to COVID-19. Lunch will be served in the main dining room for IL residents and in the PC dining room for PC residents. Residents will be assigned a table (per household) located at least 6 feet away from any other occupied table. There are 10 tables that could be seated at one time in the main dining room (with social distancing guidelines in place) and 7 in the PC Dining Room (plus 2 more patio tables in IL, weather permitting). The Summit Grille will allow 5 tables with social distancing. Residents who have had exposures or who prefer to eat in their apartment will have meals delivered.
Residents are not permitted to “crossover” between units (IL, PC and MC) for dining or activities.
Residents will be monitored en route to and from the DR to ensure social distancing guidelines are followed. Tape will be used on the flooring to designate safe social distancing spaces in the entryway to the Dining Rooms. Entrance into the dining rooms will be staggered to allow for social distancing and to allow all residents who meet the requirement the opportunity to come to the dining room. Residents will be required to wear masks from their apartment to the dining room until they are served, then will reapply the mask once they finish their meal. Residents will be provided a paper bag to place their masks in during meals. Menus will be paper (disposable). Team members will monitor that residents exiting the dining room follow the same guidelines. The dining rooms will be thoroughly disinfected after the meal and between seatings.
Team members assisting residents in the dining room will wear masks and gloves. Gloves will be changed if contact is made with potentially contaminated materials and hands sanitized before new gloves are put on.
Reopening Plan Step Two
With no new facility onset of COVID-19 cases with residents and staff for 14 consecutive days, the Community will enter Step Two and notify the Department of Human Services regional office. If, at any point following entry to Step Two, there is a new facility onset of COVID-19 cases the facility will revert to the Pre-Reopening Plan.
During Step Two, the Reopening Communal Dining Plan will add dinner time, in addition to lunch time, for residents who have had no exposures to COVID-19. Residents who do not wish to dine in the dining rooms will have meals delivered.
Activities will be increased to allow up to 10 residents in attendance who are unexposed to COVID-19 and who exhibit no signs or symptoms of COVID-19. Residents will always be required to wear masks, to practice social distancing and to sanitize their hands before and after attending any activity. The Activities Assistant will disinfect the surfaces, including tables and chairs, at the end of each event. The housekeeping team will disinfect all high touch areas in the hallways before and after each event.
Visitation is permitted during Step Two for unexposed residents outside (weather permitting) in the front porch area of the building, in one of four locations and during the times of 10 am to noon, 1 pm to 5 pm and 6 pm to 7 pm. Visits must be scheduled in advance and are limited to two visitors per apartment for up to one hour per visit. Up to two children can accompany visitors if they are able to maintain social distancing and wear a mask if over the age of two. Visitors will enter the building to be screened and to sign in, then escorted to their reserved visiting area. Visitors are required to wear masks during the entire visit and use hand sanitizer before and after each visit. Sufficient social distancing will always be clearly defined and required during the visit and visitors and residents will refrain from physical contact. Staff will assist the resident to the visiting area as needed. When scheduling visits, priority will be given to residents with progressive cognitive decline or residents with depression and loneliness.
In the event of inclement weather, scheduled visits will be permitted in the library, the music conservatory, the 2nd floor PC lounge, and the coffee chat area. All visiting areas will be disinfected before and after use and have clearly defined safe social distancing parameters.
Visiting is not permitted in resident’s apartments.
Volunteers are permitted only for the purpose of assisting with outdoor visitation protocols and only with residents with no exposures or signs and symptoms of COVID-19. Volunteers will be screened upon each visit and must abide by social distancing, hand hygiene and masking protocols.
Reopening Plan Step 3
Following Step Two and with no new facility onset of COVID-19 cases with residents and staff for 14 consecutive days, the Community will enter Step Three and notify the Department of Human Services regional office. If, at any point following entry to Step Three, there is a new facility onset of COVID-19 cases the facility will revert to the Pre-Reopening Plan.
During Step Three, the protocol for dining will remain the same as Step Two for residents who have had no exposures to COVID-19.
Activities will be conducted, limiting residents to the amount who can be safely socially distanced (no less than six feet apart), and who have had no exposures to COVID-19. The Activities Assistant will disinfect the surfaces, including tables and chairs, at the end of each event. The housekeeping team will disinfect all high touch areas in the hallways before and after each event.
Salon services will be available for residents who have had no exposures to COVID-19 using the ACCORD protocol from Merrill Gardens. Residents will be seen by appointment only, with no more than one resident in the salon at any time. The resident will wear a face mask and the stylist will wear a face mask and face shield when working with hair. She will be required to wash her hands before and after each resident and to disinfect the implements, chair, sink, the countertop, handles, hoses, and any other surfaces used after each patron. Manicures will require face masks for both manicurist and resident, plus gloves and eye shields for the manicurist. In all cases, the salon personnel will wash hands before and after each resident. Linens should be immediately put in a dirty linen bag after use by each patron. Clean linens will be stored in closed containers.
Visitation is allowed both outdoors, with the same protocol as Step Two, and in specific areas inside (the library, the coffee chat area, the 2nd floor activities room in PC, and the music conservatory). Visits, including the location of the visit, will be scheduled and limited to 2 visitors at a time, one hour at a time. All parties will wear masks, except children under the age of 2. Visits are not permitted in any resident’s apartment unless the resident is unable to be transported to a visitation area. All visitation is limited to only those residents who have had no exposures to COVID-19. Visitors must be masked, screened and use hand hygiene. All visitors will be at least six feet from the resident during their visit. Visits are not allowed at mealtimes.
Outings are allowed only for residents who have had no exposures to COVID-19. All residents will be screened and temped prior to the event. Outings will be limited to no more than the number of people that can be safely socially distanced. Hand hygiene and universal masking are required.