phased reopening at lutheran home

On August 12, 2020, the Illinois Department of Public Health (IDPH) published interim guidance for residential healthcare and assisted living communities. This interim guidance provides guidelines for communities like ours to implement a phased reopening of our campus.

The guidance from IDPH follows the same phases outlined in the CMS guidance. There are three phases. There are seven eligibility criteria that must be met to advance through the three phases. There are also three tiers of mitigation strategies that can be implemented within each phase, based on resurgence of COVID-19 in our region.

 

Communities must spend a minimum of 14 days in a given phase, with no new, facility-onset COVID-19 cases, before advancing to the next phase. Facility-onset case is defined as a COVID-19 case that originated in the facility, and not a case where the facility admitted an individual from a hospital with known COVID-19 positive status, or unknown COVID-19 status that became COVID-19 positive within 14 days after admission. Residents, their families, the Long-Term Care Ombudsman, and the local health department will be notified when we move to a new phase, and of the relevant operational changes.

 

If the Lutheran Home identifies a new, facility-onset COVID-19 case in any phase of reopening, we will immediately revert back to the highest level of mitigation and start over in the phases of reopening. If any other of the criterion for the current phase is no longer fulfilled, then the Lutheran Home will revert to the previous phase until the criterion is fulfilled. Phase regression will also be communicated to residents, families, the Long-Term Care Ombudsman, and the local health department, along with the relevant operational changes.

 

The Lutheran Home will be separating the Hearthstone Assisted Living from our MyRehab, and residential healthcare. Operationally these levels of care are kept separate with no associates working in both locations. This means it will be possible in the future for these areas to be in different phases of reopening.

 

The seven criteria are as follows:

 

  1. Case status in the community. The state of Illinois is divided into eleven geographic Illinois COVID Regions for the purpose of monitoring and mitigating resurgence of COVID-19. Both of the calculated indicators for our region must have been within their target ranges for at least 14 days, before we can advance to the next Phase. The two indicators are: (a) test positivity rate; and (b) a composite metric of COVID-19 hospital admissions and hospital resource capacity.

  2. Case status in the facility. The Lutheran Home must spend a minimum of 14 days in a given phase, with no new facility-onset COVID-19 cases, before advancing to the next phase. Local health department may require an interval longer than 14 days. If a resident develops facility-onset COVID-19, the Lutheran Home will immediately revert to the highest level of mitigation.

  3. Staffing level. The facility has sufficient staffing that it is not operating with a contingency of crisis staffing strategy, as defined by CDC.

  4. PPE supply and usage and essential cleaning and disinfection supplies to care for residents. Lutheran Home must have sufficient PPE, and not be operating at crisis capacity. All staff must wear appropriate PPE when indicated.

  5. Universal Screening. The Lutheran Home must screen each person entering the community, including all staff, visitors, and other persons. Access must be denied if the person does not pass the screening. All residents must be screened at least daily.

  6. Universal Source control and hand hygiene. All staff are trained in proper hand hygiene. Everyone entering the community must perform hand hygiene. Everyone entering the community must wear facemasks or respirator, and additional PPE as appropriate. All residents must wear a cloth face covering or facemask when outside of their rooms and when staff enter their rooms.

  7. Testing plan and response strategy. A COVID-19 testing plan and response strategy is in place, based on contingencies informed by the CDC. The testing plan includes: initial (baseline) facility-wide testing: routine periodic retesting of staff; testing and repeated retesting of residents and staff in response to an outbreak or a single new, facility-onset COVID-19 case in a resident or a single new case of COVID-19 infection in a staff member.
     

Currently the Lutheran home meets all seven criteria. And will begin the phased reopening in phase 2. The implementation of the changes allowed during reopening will be happening gradually over the next week.

 

The guidance under each phase is extensive and very detailed. The Lutheran Home has reviewed this guidance to ensure the new activities introduced meet that guidance. If the Lutheran Home moves to a new phase, or has to introduce any tier of mitigation, this will be communicated to all. The current phase of opening and of tiered mitigation, along with what that means for our residents and families, will be posted on the Lutheran Home COVID-19 webpage for you to reference. (LutheranHome.org/covid19)

 

Highlighted below are some of the most important changes that phased reopening will allow for our residents and their families. The key changes within each phase are broken out into four of the most important categories of engagement: small group activities, visitation, communal dining and beauty/barber shop. The summary below does not cover every detail of the phased reopening, additional details to each phase and each category will be shared on the COVID-19 webpage, as needed. We recognize that this communication includes a lot of information. Please know that we will be communicating frequently, and in detail, as we move through the phases of reopening, so that our residents and their families understand what is allowed, and what is not allowed.

 

 

 

Small Group Activities
 

Phase 1: There will be no small group activities.

Phase 2: Small group activities may take place, with a maximum of 10 residents per activity. No activities that require strenuous activity or exertion will be conducted. No activities will involve any shared items among residents. Activities will preferably take place outdoors, but can be moved indoors due to weather. All residents will wear a mask.

Phase 3: Small group activities may take place, and can exceed 10 participants. Participation will be limited to the maximum number of persons that can be accommodated in the designated space while maintaining at least a six-foot distance. All residents will wear a mask.

 

Visitation
 

Phase 1: Visitation is restricted to virtual visitation and compassionate care visitation.
 

Phase 2: Virtual visitation and compassionate care visitation is still allowed. Additionally, outdoor visitation is permitted in Phase 2.

Outdoor visitation must comply with the following:

  • Visitation will take place at the designated outdoor visitation pavilion.

  • Signage indicating the maximum occupancy in the designated outdoor area, and cues for six-feet of separation will be provided.

  • Residents and visitors will wear a face covering throughout the visit.

  • Visits must be scheduled by appointment only, with a specific start time, end time and location.

  • Visitors may not enter the facility at any time.

  • Visitors are limited to two visitors at a time per resident. The visitors, if two, must be from the same household. An exception to this limitation may be made for compassionate care situations, at Lutheran Home’s discretion.

  • Visitors will be pre-screened by phone less than 24 hours in advance of their visit. They will be screened upon arriving at the visit as well. If a visitor develops symptoms of COVID-19 within 3 days after visiting, they must notify the Lutheran Home.

  • Visits will be supervised.
     

Phase 3: Indoor and outdoor visitation is permitted. Outdoor visitation is strongly preferable, as a result, weather permitting, visits will take place in the outdoor visitation pavilion. In the event weather does not permit outdoor visits, there will be designated indoor locations. These common areas are close to the entrance, and will limit traffic through the community. Lutheran Home will follow all requirements for outdoor visitation as outlined in Phase 2.

Indoor visitation must comply with the following:

  • In-room visits will only be allowed for bed bound patients, and in certain compassionate care situations.

  • All visitation locations will be set-up to maintain six feet of separation.

  • Lutheran Home will designate visitation hours. Visitation will be by appointment only.

  • Residents and visitors will wear a face covering throughout the visit.

  • Visitors are limited to two visitors at a time per resident. The visitors, if two, must be from the same household. An exception to this limitation may be made for compassionate care situations, at Lutheran Home’s discretion.

  • Visitors will be pre-screened by phone less than 24 hours in advance of their visit. They will be screened upon arriving at the visit as well. If a visitor develops symptoms of COVID-19 within 3 days after visiting, they must notify the Lutheran Home.

  • Visits will be supervised.

Visitation in Hearthstone Assisted Living in Phase 3, does not need to be supervised, and can be in common areas or in residents’ apartment, with six-foot separation. Resident and visitor need to wear a face covering throughout the visit.
 

 

Communal Dining
 

Phase 1: There will be no communal dining, except as deemed necessary for resident safety for those resident who cannot eat safely in their rooms.
 

Phase 2: Communal dining may take place for all residents; provided the maximum number of residents who will participate in any one sitting will be based on 25% of seating capacity in the applicable dining area. Tables and chairs will be set up in a configuration so that each resident is at least 6 feet apart.
 

Phase 3: Communal dining may take place for all residents; provided that the maximum number of residents who will participate in any one sitting will be based on the number of residents that the applicable dining room can accommodate with each resident maintaining at least 6 feet of social distance.  During Phase 3, all of the other requirements of Phase 2 shall be followed.
 

 

Beauty/Barber Shop
 

Phase 1: Salons will remain closed.
 

Phase 2: Salons will remain closed.
 

Phase 3: Salons may operate, provided that the following rules are followed:

  • Only one resident and one beautician or barber are allowed in the salon at a time.

  • Resident must wear a mask during the entire service.

  • The beautician or barber must wear a mask and a face shield the entire service.

  • Hand-held blow dryers are not allowed.

  • The salons must also observe restrictions and precautions in Personal Care Services Guidelines for Restore Illinois. Where IDPH guidelines are more stringent, IDPH guidelines apply.
     

Tiered Mitigation. If health metrics indicate a resurgence in our region, IDPH will consider mitigation options for our community from a tiered menu.
 

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Arlington Heights, Illinois 60004

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