Guerin Woods Daily Update

Dear Guerin Woods Families & Friends:

 

Disappointingly, the Indiana Department of Health continues to delay it release of updates regarding visitation.  Based on CMS and CDC publications and telephone calls with state officials, it is our understanding that scheduling and infection prevention (masks, hand hygiene, social distancing, etc.) requirements will remain but that most other visitation restrictions will be lifted, eliminating -- for all practical purposes -- the various categories of visitation.  Because release is imminent, we have been told by IDH to maintain the status quo until it releases its updated guidance. 

 

I apologize for the delay.

 

1. Guerin Woods COVID-19 Statistics

Total # of Elder Cases	New Elder Cases in Last 24 Hrs	Elder Deaths in Last 24 Hrs	Instances of 3 or More Elders/Staff w/ New Onset of Respiratory Symptoms w/in 72 hours of Each Other
15*	0	0	0

 *COVID-19 positive test dates: 8/5/20 (1); 10/14/20 (1); 10/21/20 (1); 10/23/20 (2); 10/29/20 (1); 11/16/20 (1; new admission from another facility); 11/19/20 (1); 12/11/20 (3); 12/15/20 (2); 12/18/20 (1); 12/20/20 (1).

2. Examples of Facility Infection Mitigation/Prevention/Planning Measures

Visitation restrictions

Staff Competency Reinforcement/Training: Infection Control; COVID-19; Proper PPE Use; Handwashing; Social Distancing, etc.

Daily staff reminders to self-monitor for fever and symptoms of COVID-19 and to stay home if unwell

Staff use of masks and eyewear in Villas

Increased cleaning frequency & use of COVID-19/EPA approved sanitizing solutions for equipment, frequently touched surfaces and common areas

Placement of alcohol-based hand sanitizer throughout the Villas and in elders' rooms

Placement of tissues and trash cans in elder's rooms and in common areas for respiratory hygiene, cough etiquette, and source control

Elder social distancing and use of masks (for those able) when in common areas

Transition to telephonic/video meetings whenever possible, e.g., Care Plan Meetings

Use of telehealth when appropriate

Creation and use of signage to remind elders and staff re PPE usage, cough etiquette, social distancing, handwashing

Creation of signage in anticipation of positive COVID-19 cases re proper use of PPE, precautions, etc.

Adoption of pharmacy policies & practices that ensure availability of all necessary medications

Pre-shift health assessment/screening of every staff member, including all CDC-defined COVID-19 symptoms

Assessment of elders for CDC-defined COVID-19 symptoms every shift

Cancellation of all non-essential medical appointments, e.g., routine eye exams

Acquisition of additional/excess supplies, e.g., ABHS, soap, paper towels, sanitizing solutions, PPE, oxygen concentrators

Acquisition of COVID-19 testing equipment/kits and frequent testing of staff, vendors, third-party providers, elders, and EFCs

Conversion of separate on-site facility to staff sleeping quarters, including procurement of beds, linens, etc.

Conversion of separate on-site facility to accommodate COVID-19 supplies, including preparation of individual kits for ease of use

Staging of COVID-19 materials in anticipation of providing immediate response

On-site CNA course, including but not limited to staff training, licensure, procurement of necessary course materials, etc., in anticipation of potential staffing shortages

Daily meetings among executive and senior clinical staff re newest state and federal COVID-19 regulations & guidance (and changes thereto), associated changes to policies/procedures, education/training, facility changes, etc.

Extensive contingency planning, including adoption of new policies & procedures (and frequent amendment of same as guidelines from federal and state public health authorities change)

Frequent coordination with local and state public health and emergency response authorities

Exclusion of COVID-19 positive and COVID-19 exposed employees in compliance with CDC guidelines

Isolation of elders who may have had an exposure per IDH and CDC guidelines

3.  Guerin Woods Contacts

Contact (Title)	Lisa Baker (Administrator)	Susan Gernert (President & CEO)
Cell Phone	812-399-9046	502-830-4336
Email	lbaker@pssmsi.org	sgernert@pssmsi.org

4.  Elder Interactions

Unless specifically designated otherwise, the requirements descripted below apply to all Elder interactions.

1. Notification Requirement – Before any anticipated interaction with an Elder Guerin Woods must be notified, and in certain situations approve the requested interaction.  (See below.)

1. Indoor & Outdoor Visitation: In order to ensure appropriate staffing, visits must be scheduled no less than 48 hours in advance via "Simply Book Me," https://guerinwoods.simplybook.me/v2/. Visitors may schedule visits on a two-week rolling basis. Should a visitor need to cancel a visit, they should do so as soon as possible via the "Simply Book Me" application in order to make their time slot available to another family.
2. Essential Family Caregiver (EFC) Interaction: EFCs are expected to have a set schedule , visiting no fewer than two days per week.  To establish a schedule ESFs should contact Chelsea Wild, Social Services Director (812-951-9088; cwild@pssmsi.org).
3. Excursions: No less than 72 hours in advance, any family member or friend who anticipates having direct contact with an elder for purposes of escorting them on an excursion off campus, for example to a doctor's appointment, must send an email to kbell@pssmsi.org indicating (1) the destination; (2) the infection prevention practices in place at that destination; and (3) the anticipated duration.
4. End-of-Life Compassionate Care Visitation: Contact Chelsea Wild, Social Services Director (812-951-9088; cwild@pssmsi.org), Bonnie Johnston, Director of Nursing (502-396-0158; bjohnston@pssmsi.org), or Lisa Baker, Administrator (812-399-9046; lbaker@pssmsi.org).
5. Closed Window Visitation: No notification is required.

2. Testing Requirement

1. Frequency: Any family member or friend who participates in Indoor Visitation, Outdoor Visitation, EFC interactions, an Elder excursion (including routine and essential health care visits), or end-of-life Compassionate Care Visitation (unless special dispensation if given) must (a) submit to a PCR COVID-19 test no less than once weekly and (b) before the scheduled interaction provide documentation to Guerin Woods of a negative test result no more than 7 days prior to the Elder interaction. 
2. Documentation: Documentation may be electronic, in which case it must be emailed to our Infection Preventionist at kbell@pssmsi.org, or hard copy.

There is no Testing Requirement for Closed Window Visitation.  In certain circumstances, initial End-of-Life Compassionate Care Visitation may also be excepted.

3. Infection Prevention Requirements

1. Masks: All family members or friends interacting with an Elder must wear a surgical mask (and not a cloth mask) at ALL times while in the presence of the Elder, whether on or off Guerin Woods's campus.  The Elder must also wear a surgical mask during the entirety of the interaction.

Closed Window Visits are excepted from this Mask Requirement.

2. Social Distancing: All family members or friends interacting with an Elder must maintain social distancing of six feet or more at all times, whether on or off Guerin Woods's campus.  With regard to Indoor and Outdoor Visitation, Guerin Woods has installed social distancing barriers, which must be respected at all times.

Closed Window Visits are excepted from this Social Distancing Requirement.

3. Clean Hands: Frequently, and no less than immediately before and after each Elder interaction, participating family members or friends and the Elder must properly use alcohol-based hand rub or soap and water to clean their hands.  Alcohol-based hand rub is readily available on the Guerin Woods campus.  Training materials have been provided to all Elders and visitors, but if you have any questions regarding proper hand cleaning, please ask.

Closed Window Visits are excepted from this Clean Hands Requirement.  Nevertheless, we strongly encourage our friends and families to practice frequent hand hygiene.

4. Visitation Restrictions Acknowledgement & Health Survey – All family members and friends who have any interaction with an Elder must complete a Visitation Restrictions Acknowledgment & Health Survey, which includes a temperature check, prior to interacting with the Elder.  These forms are available on the front porch of each Villa.  WE CANNOT ALLOW VISITATION IF SURVEY RESPONSES OR A VISITOR'S SYMPTOMS OR BODY TEMPERATURE INDICATE A RISK OF EXPOSURE.

Closed Window Visits are excepted from this Requirement.

5. Schedule, Location, Number of Visitors, Entry Point, Frequency, Length, Age Restrictions (presuming no intervening positive COVID-19 test results)

	Outdoor*	Indoor	EFC	Elder Excursions (e.g., doctors' visits)	End-of-Life Compassionate Care	Closed Window Visit
Daily	7 – 11 am; 2 – 6 pm, as scheduled via Simply Book Me	7 – 11 am; 2 – 6 pm, as scheduled via Simply Book Me	As scheduled (& approved) with Chelsea Wild	As scheduled (& approved) with Villas Management.	As scheduled (& approved) with Villas Management	As approved by Elder; must not be disruptive to meal time, hygiene routines, etc.
Location*	Villa Garden	Villa Den	Elder's Room (door closed)	As approved	Elder's Room (door closed)	Villa Exterior
# of Visitors	£4	£2	1	As approved	£2	NA
Entry Point	Garden gate (after sign-in on Villa front porch)	Villa front door (after sign-in on Villas front porch)	Villa front door (after sign-in on Villas front porch)	Based on discussion and approval by Villas Management	Villa front door (after sign-in on Villas front porch)	NA
Frequency	£3/week	£3/week	As scheduled (& approved)	As scheduled (& approved)	As scheduled (& approved)	NA
Length	Max. 20 minutes	Max 20 minutes	Max 2 hours	As scheduled (& approved)	As scheduled (&approved)	NA
Visitor Age	Guerin Woods strongly discourages any visitor under the age of 12	Guerin Woods strongly discourages any visitor under the age of 12	18+	18+	Guerin Woods strongly discourages any visitor under the age of 12	NA

*The weather must be clear and the outdoor ambient temperature must be no less than 55°F.

**Visitors may not be in any area not specifically designated.

1. Indoor: All Indoor Visits will be in the Villa den area, adjacent to the Villa front door, where visitors will enter the Villa.  Indoor Visitors may NOT be in any other area of the Villa, including the Elder's room or a bathroom, and must avoid all interaction with other Elders.
2. Outdoor: All Outdoor Visits will be in the Villa garden.  Outdoor Visitors should remain outside the Villa at all times, and move directly to the garden area (via the garden gate, not through the interior of the Villa) when directed to do so by the Villa nurse or nurses aid. Outdoor Visitors must avoid all interaction with other Elders.
3. EFC: All EFC interactions are limited to the Elder's bedroom.  EFCs may NOT be in any other area of the Villa, and must avoid all interaction with other Elders.
4. End-of-Life Compassionate Care Visitation: All End-of-Life Compassionate Care Visits are limited to the Elder's bedroom.  Compassionate Care Visitors may NOT be in any other area of the Villa, and must avoid all interaction with other Elders.

6. More About Essential Family Caregiver (EFC) Visitation - The purpose of EFC visitation is to supplement Guerin Woods's ongoing care and physical and emotional support of our elders.  Unfortunately, only one person per elder may be designated as an EFC and EFC visitation is only possible in Green Villas (with a limited exception).

1. Off Campus Requirements: Also of particular note are the "off-campus" requirements that EFCs must follow.  EFCs must agree to limit their contacts, consistently and diligently wear a mask, and clean their hands frequently per CDC guidelines, even when not on the Guerin Woods campus. 
2. Next steps: For those of you who are POA for your elder, if you wish to designate someone as an EFC, please email me.  Before you do so, however, please see the EFC Visitation Details below and confirm with your designee their ability and willingness to comply with all of  the EFC requirements.  The subject line of your email to me should read: "EFC Designation." Include in the body of your email relevant contact information, and we will follow up with the EFC as soon as possible.
3. Additional EFC Requirements:  

1. Whether and whom to designate as an EFC is at the sole discretion of the Villas Administrator and will only be implemented upon written agreement by the elder (or POA), Administrator, and EFC;
2. Only one family, friend, or volunteer may be designated as an elder's EFC;
3. The EFC must be 18 or older;
4. The EFC must be available for EFC visitation no fewer than two days per week;
5. The EFC must comply strictly with Guerin Woods's infection control protocols;
6. The EFC must wear a mask at all times when in public, whether on the Guerin Woods campus or otherwise;
7. The EFC visit is limited strictly to the elder's room, and the door must remain closed;
8. The EFC must perform frequent hand hygiene, both on and off the Guerin Woods campus;
9. The EFC must sanitize the elder's room before departing the Villa;
10. The EFC must limit interaction with Villa staff, maintaining physical social distancing at all times;
11. The EFC must have no interactions and maintain physical social distancing with other Villa elders;
12. The EFC may not enter the Villa unless specifically cleared to do so after COVID-19 testing and completion of a daily health screen and a sign-in procedure;
13. The EFC must agree to monitor their own symptoms on an ongoing basis, and to immediately notify the Administrator of any signs or symptoms of COVID-19;
14. The EFC must agree to refrain from even coming onto Guerin Woods property if he or she is experiencing signs or symptoms of COVID-19 and to follow the directives of the Administrator regarding testing, the resumption of EFC visitation, etc.;
15. The EFC must agree to severely limit their contacts, that is potential exposure to infection, outside the Villas;
16. The EFC must agree to comply with any restriction placed on or revocation of their EFC-designation, which is at the sole discretion of the Villas Administrator.

7. Facilitated Phone Calls & Video Chats - Please call your elder's Villa on the day you wish to have your call or video chat to confirm the availability of staff.  Please know that our staff remain very busy throughout the day, and they may ask that you be flexible regarding the time and length of your call or video chat.  Individual CNAs cannot commit to staff availability other than their own because they do not know what the demands may or may not be on another shift or when they are not working.
8. Closed Window Visits - Please continue your closed window visits!  Risk-free.  Mask-free.  ...and no social distancing required!

5. Elder Testing & Transfers: Guerin Woods is following the guidance and directives of the Centers for Disease Control (CDC), Indiana State Department of Health (ISDH), and Floyd County Health Department regarding Elder testing.  If an Elder were to test positive for COVID-19, the Elder would be transferred to a hospital or other appropriate facility.
6. General Information:  For more information about COVID-19, please refer to: https://www.coronavirus.in.gov/2400.htm; https://www.cdc.gov/coronavirus/2019-ncov/index.html.  You can also address general questions about COVID-19 to the ISDH COVID-19 Call Center, available 24/7, at 877-826-0011.
7. Indiana Long-Term Care Ombudsman: The Ombudsman is NOT a representative of the facility, ISDH, or any other organization. However, we do want to provide accurate information to ensure families are comfortable that their loved ones are as safe as possible and are able to make informed decisions.

Physical Address	Office of the Long-Term Care Ombudsman 402 West Washington Street, Room W451 Post Office Box 7083, MS 27 Indianapolis, Indiana 46207-7083
Phone Number	800-622-4484 or 317-232-7134
Fax Number	317-972-3285
Email	LongTermCareOmbudsman@ombudsman.IN.gov
Website	https://www.in.gov/ombudsman/2347.htm

 Susan

 

Susan Gernert

President & CEO

 

 

Providence Self Sufficiency Ministries, Inc.

Guerin, Inc.

The Meadows of Guerin, Inc.

 

sgernert@pssmsi.org

502-830-4336 (cell)

 

8037 Unruh Drive

Georgetown, Indiana 47122

 

guerininc.org