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Implementation Plan for Reopening In Accordance with the Pennsylvania Department of Health

Juniper Village at Lebanon

1125 Birch Road

Lebanon, PA 17042

717-272-8782

Executive Director: Joan-Marie Norman

Step 2 Reopening: June 8, 2020

STRATEGY FOR TESTING, COHORTING, PERSONAL PROTECTIVE EQUIPMENT, AND STAFFING

  • Juniper Village at Lebanon has completed baseline testing of all residents and associates as of July 13, 2020.
  •  Juniper has access to COVID-19 diagnostic tests through Magnolia Laboratory for testing of all residents and staff.
  • Juniper has access to COVID-19 diagnostic tests on-site that equal or exceed associate and resident total number.
  •  Juniper Village at Lebanon currently has no volunteers being utilized at the community.
  • Should a resident decline COVID-19 diagnostic testing, then they will be treated as a “presumed positive” and moved to our Rule-Out unit for no less than 14 days of self-isolation. It is currently a requirement of employment for all Juniper associates to receive COVID-19 diagnostic testing until determined no longer necessary.
  • A Rule-Out unit has been created to cohort and self-isolate residents with a positive diagnosis of COVID-19.
  • Adequate PAR levels have been established for Personal Protective Equipment (PPE) based on burn levels set over the past 16 weeks.
  • Juniper is well staffed and associates have been cross-trained for non-clinical tasks such as housekeeping, dining, and maintenance.
  • Juniper Village at Lebanon is located in Lebanon County and will revert back to all restrictions and limitations set by CMS & PA DOH should the County change outside of the Green Phase.
  • All associates have been deemed “essential” and weekly associate testing occurs. Random weekly audits and on-line Relias training occurs for all associates.

SCREENING PROTOCOLS

  • A high-risk resident, defined as a person having multiple co-morbidities, has their temperature and oxygen checked every shift. If readings are outside of resident’s baseline, further nursing assessments are completed.
  • Staff undergo temperature recording at beginning and end of each shift; signature to daily attestation. Should temperature read higher than 99.9, associate is to not report to duty. All associates are to receive weekly COVID-19 diagnostic testing.
  • Outside providers undergo temperature recording when entering building, signature to daily attestation, log of time in and time out of building.
  • Non-essential personnel undergo temperature recording at beginning and end of each shift; signature to daily attestation. Should temperature read higher than 99.9, associate is to not report to duty. All non-essential personnel are to receive weekly COVID-19 diagnostic testing.
  • Visitors undergo temperature recording when entering building, signature to daily attestation, log of time in and time out of building. Visitors or residents will meet resident in a neutral location outside of resident care areas.

COMMUNAL DINING

  • Residents meal-times are based on hallway. Residents in each hallway are served meals at staggered times for both noon and evening meal; breakfast is served in their suite.
  • Residents will be seated at tables to comply with social distancing and proper infection control procedures will be used.
  • Tables are marked with a sitting space to allow for residents to maintain a 6-foot distance from each other.
  • No more than 20 residents are in the dining room at any given time.
  • Only residents who have not be exposed to COVID-19 and need a level of supervision or assistance are able to use communal dining.
  • Associates use surgical masks during dining assistance.
  • Dining spaces are disinfected following each meal.

ACTIVITIES/CONNECTIONS

  • In Step 1, residents will gather in large spaces to allow for 6 feet or more between residents. This will limit groups to no more than 5 residents at a time. Such programs include music groups, reminiscing, resident council, movie viewings. All attendees will donn a mask prior to leaving their rooms and will have their hands sanitized before and after each program.
  • In Step 2, residents will gather in large spaces to allow for 6 feet or more between residents. This will limit groups to no more than 10 residents at a time. Such programs include music groups, reminiscing, resident council, movie viewings. All attendees will donn a mask prior to leaving their rooms and will have their hands sanitized before and after each program. Cleaning of activity equipment and chairs will be completed after each session.
  • In Step 3, residents will gather in large spaces to allow for 6 fit or more between residents. This will limit groups to no more than 15 residents at a time. Such programs would include large screen movie viewing, crafts at individual tables, exercise classes. All attendees will donn a mask at the programs and will have their hands sanitized before and after each program.
  • In Step 3, residents will go for outings and sit by self in Company van. Residents will donn masks prior to leaving their rooms and will have their hands sanitized before and after the outing. Residents will not exit the Company van during the outing. Such outings will include scenic drives and drive-through ice cream.

VISITATION PLANS

  • Visitation Hours are Monday – Friday 10:00am-3:00pm and Saturday & Sunday 1:00pm – 3:00pm Visits are scheduled for 30-minute time periods.
  • No visitation during meal times.
  • Visitors are able to schedule their visits by calling the concierge, who will keep the visitor calendar.
  • Visitation areas will be located in the ‘neutral zone’ and will be disinfected using Puroxide, which is a CDC approved cleaning agent.
  • No more than 1 visitor will be permitted for face-to-face visitation due to a small gathering area in the neutral zone. Should the visitation occur outside, then no more than 2 visitors will be permitted.
  • Scheduled visits will be prioritized based on health status of the resident and outside appointments that may limit resident availability.
  • Residents will be accompanied by a Juniper associate to and from the visitation. The associate will sit by resident during the visit if the resident is not able to maintain social distance due to cognitive deficits such as dementia.
  • Two outdoor spaces will be used for outdoor visitation. Both are located next to visitor parking. In the event of severe weather, the visitation will be cancelled until the indoor visitation space is available.
  • A divider such as a table or planter will be used to create a barrier of six-feet. Ground markings will also be used to mark placement of a chair for the visitors and resident.
  • The indoor visitation space is located in the Lobby of the buildings and it not located in a resident care area. It is labeled as “lobby” and can accommodate one visitor for the resident.
  • A table will be used to provide a six-foot social distance space as well as floor markings for chair placement for the resident and visitor
  • Residents will be accompanied by a Juniper associate to and from the visitation. The associate will sit by resident during the visit if the resident is not able to maintain social distance due to cognitive deficits such as dementia.
  • All visitors going to a resident care area will need to wear proper PPE, this is only for those residents who are compromised to the degree that they are unable to leave their bed or room.
  • When Volunteers are allowed to be present, they will follow the same attestations as associates including Infection Control trainings on Relias and meeting with the Infection Control Champion for observation trainings of donning/doffing and hand hygiene.
  • Volunteers will assist in taking residents to and from visitations and will sit with residents during the visits.

COMMUNITY ATTESTATION

I attest that the information provided in this Implementation Plan is an accurate representation of the facts and that this facility will adhere to the Implementation Plan as written. I further attest that the county in which this facility is located is in a Yellow or Green phase per the Governor’s Reopening Plan. This Implementation Plan will be posted on our website (if one exists) or made available to all residents, families, advocates such as the Ombudsman and the Department upon request. This facility will progress to the next step of reopening only when the criteria is met as described in the Interim Guidance for Skilled Nursing Facilities During COVID-19. If at any point during reopening the facility fails to meet the criteria for reopening, I will ensure the facility ceases reopening immediately. Further, if at any point during reopening this facility is operating under a contingency staffing plan, I will ensure the facility ceases reopening immediately.