Guerin Woods Daily Briefings: July 2021

Friday, July 30, 2021

CHANGES in IDH Mask Guidance & Guerin Woods's Visitation Protocols

Dear Guerin Woods Families & Friends:

The following was released by the Indiana Department of Health (IDH) late this afternoon: "In the past four weeks, Indiana has seen a significant increase in COVID-19 cases fueled by the Delta variant, which spreads equal to or more than twice as easily from one person to another compared with earlier strains. Indiana's positivity rate has gone from just over 2 percent in late June to more than 6 percent at the end of July, and our daily case counts are climbing again. …. Total 14-day long-term care (LTC) case counts in Indiana have more than quadrupled from June to July, and at least 20 facilities have more than 3 cases in the month of July. Almost all outbreaks that were sequenced in July were caused by Delta variant. Some fully vaccinated residents and staff have tested positive, but they tended to exhibit much milder symptoms than unvaccinated persons. In the larger population to date, 98 percent of all new COVID-19 cases have occurred in people who are not vaccinated."

Because of this increase in activity IDH has altered its previous guidance. To help keep elders, staff and families safe, masks must be worn at all times – regardless of vaccination status – while on Guerin Woods's campus.

Please note the following corollary changes (in all-caps, underlined, and in bold) to Guerin Woods's visitation protocols for vaccinated visitors:

You must wear a surgical mask as you enter and when you pass through the Villa to your Elder's room. If you are vaccinated, you are NO LONGER permitted to remove your mask when in your Elder's room ~~with the door closed~~~~, but we strongly encourage you to wear it~~.

Unvaccinated visitors have never been permitted to remove their masks. This prohibition will also continue until further notice.

IDH's recent guidance also states:

"Get tested if experiencing COVID-19 symptoms.
For additional information, visit https://coronavirus.in.gov.
Isolate if tested positive for COVID-19 in the prior 10 days or are experiencing COVID-19 symptoms.
Even if asymptomatic, get tested 3-5 days after exposure to someone with suspected or confirmed COVID-19 and wear a mask in public indoor settings for 14 days after exposure or until have had a negative test result – regardless of vaccination status.
. . . .Remember, getting vaccinated for COVID 19 is the most effective way to prevent severe disease and complications from COVID-19, including hospitalization and death.
More information on the free vaccine is available at ourshot.in.gov."

VISITATION

Notification Requirement – NONE. You no longer need to schedule visits.

*Previously, with scheduled visits, our therapists and CNAs were able to schedule around visitation. Because this will no long be possible, please be prepared to be flexible. Your visit may be interrupted or need to be postponed for a short period of time if therapy or some other intervention is underway or scheduled during your visit.

Visitor Screening Form – Prior to moving to an elder's room, all visitors must complete a Screening Form. WE CANNOT ALLOW VISITATION IF A VISITOR'S SCREENING RESPONSES OR SYMPTOMS INDICATE A RISK OF EXPOSURE.

Infection Control

Hand hygiene – Visitors must adhere to hand hygiene requirements upon entry and during their visit, with the use of alcohol-based hand rub being preferred. You must continue to clean your hands frequently with either alcohol-based hand rub or soap and water, both of which are readily available in the Villas. Visitors should clean their hands after touching potentially contaminated surfaces, using soap and water after using the restroom.

Surgical Mask (covering BOTH mouth and nose) – All visitors must wear a surgical mask at all times while on the Guerin Woods campus.

Social Distancing – All visits are limited to Elders' rooms and visitors may not be present in common areas other than to make their way to an Elder's room. Visitors are not permitted to interact with other Elders and must maintain social distancing when communicating with staff. Unvaccinated visitors must maintain social distancing at all times, both in the common areas and their Elder's room.

Hours – Daily, 7 a.m. – 7 p.m.

Location – Indoor visitation is restricted to Elders' rooms. Families and friends may also use the Villas' garden areas. If a visitor wishes to speak with a staff member, they should simply use their Elder's call button and not wander through the common area.

Number of Visitors – If appropriate social distancing is maintained, Elders may have up to 4 visitors at a time.

Age Restrictions – Because all visitors must be able to comply with infection prevention protocols, Guerin Woods strongly discourages any visitor under the age of 12.

Testing – Visitor testing for COVID-19 is not required, but Guerin Woods strongly advises unvaccinated visitors to be tested on a routine basis to minimize the risk to Elders and their caregivers.

*Please note that end-of-life and compassionate care visitation follow different protocols. To make arrangements, simply contact Chelsea Wild, Social Services Director (812-951-9088; cwild@pssmsi.org); Jennifer Oney-Holeman, Director of Nursing (502-396-0158; joneyholeman@pssmsi.org); or Kim Smith, Administrator (812-820-6433; 812-399-9046; ksmith@pssmsi.org).

I. 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).

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

Visitation restrictions

Visitor screening

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

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

Staff use of masks 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

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

Use of telephonic/video meetings whenever required

Use of telehealth when appropriate

Creation and use of signage to remind elders and staff re: source control, cough etiquette, social distancing, handwashing

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

Pre-shift screening of every staff member

Assessment of elders for CDC-defined COVID-19 symptoms

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

Acquisition of COVID-19 testing equipment/kits and testing of staff, vendors, third-party providers, elders, and others as required

Conversion of separate on-site facility to staff sleeping quarters

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

Meetings among executive and senior clinical staff re: state and federal COVID-19 guidelines (and changes thereto), associated changes to policies/procedures, education/training, facility changes, etc.

Contingency planning, including adoption of new policies & procedures

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

III. Guerin Woods Contacts

Contact (Title)	Kim Smith (Administrator)	Susan Gernert (President & CEO)
Cell Phone	812-820-6433; 812-399-9046	502-830-4336
Email	ksmith@pssmsi.org	sgernert@pssmsi.org

IV. 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.

V. 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.

VI. 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

Thursday, July 29, 2021

Guerin Woods Weekly Update: (1) Exciting Announcement; (2) Positivity Rate, Etc.; & (3) Guerin Woods Essential Family Caregiver Program

Dear Guerin Woods Families & Friends:

GUERIN WOODS HAS A NEW ADMINISTRATOR! I am very pleased and excited to announce the arrival of our new Administrator, Kim Smith. In addition to having extensive experience as an administrator, Kim is also an RN. She has a true passion for caring for elders, and I am confident each of you will agree your elders are in excellent hands! Her office is in the Administration Building, but you are more likely to see her in the Villas. She looks forward to meeting each and every one of you.
FLOYD COUNTY POSITIVITY RATE: The positivity rate, as well as the number of cases, hospitalizations, and utilization of ICU beds continues to climb precipitously. The CDC has identified four "levels" to describe the status of community transmission in individual counties: LOW (Blue), MODERATE (Yellow), SUBSTANTIAL (Orange), and HIGH (Red). Community transmission in Floyd County is SUBSTANTIAL and climbing. I expect Floyd County will have a HIGH transmission rate very soon, joining Harrison, Washington, Clark, Scott, and Crawford Counties, which are already designated RED. The positivity rate is climbing because of the large number of citizens who are not vaccinated. Absent an increase in vaccination rates, experts predict that the U.S. will have as many as 240,000 new infections daily and 4,000 deaths daily by October, akin to the numbers we were experiencing last winter.

For those of you who are not vaccinated, please reconsider. For those of you who are vaccinated, please remain diligent in your observation of infection prevention practices. I have attached several informative publications. If you have any questions about these publications or otherwise, please let me know. Our clinical leadership team and Medical Director would be glad to field and answer questions.

ESSENTIAL FAMILY CAREGIVER (EFC) PROGRAM: As most of you know, Guerin Woods has and continues to have an Essential Family Caregiver Program. Because visitation is currently permitted, it has not been necessary to utilize this program. However, in anticipation of the need to once again impose visitation restrictions based on the public health information addressed above, please review the following summary of the program and let us know as soon as possible if you would like to re-enroll or enroll, as the case may be. If you are interested, please complete the attached application and return it to me either via email or to the Administration Building at 8037 Unruh Drive, Georgetown, Indiana 47122.

a. Purpose: The purpose of the EFC Program is to allow family members or other caregivers to continue to provide routine care during a public health emergency pursuant to state guidance.

b. State Requirements

i. Each EFC applicant must be at least 18 years old; and

ii. The applicant must have regularly engaged with the elder providing supportive or direct care (e.g., help with meals, grooming, or companionship), on average twice weekly, prior to the start of the public health emergency;

iii. The Elder or POA must approve the EFC;

iv. The EFC must be able and willing to (a) take and pass any screening test required by Guerin Woods and follow all precautionary measures, such as hand hygiene, and use of masks or other PPE.

c. Approval Process: Guerin Woods will approve or reject EFC applications on a case-by-case basis. If an application is denied, we will notify the applicant in writing of our reasons and the applicant will have an opportunity to request reconsideration. When an application is approved:

i. Guerin Woods will work with the EFC to determine appropriate visitation hours and duration;

ii. Guerin Woods will provide the EFC all visitation and EFC requirements in writing in the form of an agreement; and

iii. The EFC must attest that they will abide by the EFC requirements congruent with existing guidelines, including those relating to screening, infection prevention protocols, and approved visitation locations.

For those of you visiting elders:

You may notice that our COVID-19 screening forms have changed slightly. Please be sure to read and complete them accurately. One change of note is that we are no longer required to take visitors' temperatures. Nevertheless, you may not proceed to your Elder's room until a staff member is available to oversee the screening process and ensure your responses do not require the input of our Infection Preventionist.
You must continue to clean your hands frequently with either alcohol-based hand rub or soap and water, both of which are readily available in the Villas. Please clean your hands after touching potentially contaminated surfaces, using soap and water after going to the restroom.
You must wear a surgical mask as you enter and when you pass through the Villa to your Elder's room. If you are vaccinated, you are permitted to remove your mask when in your Elder's room with the door closed, but we strongly encourage you to wear it. If you are unvaccinated, you must keep your mask on at all times. If you or your elder not fully vaccinated, both of you should wear a facemask and physically distance. If your elder is fully vaccinated and you are not and your elder would like to have close contact (physical touch), you may only do so after both of you perform hand hygiene and are wearing well-fitting facemasks.
You are not permitted to interact with other Elders and must maintain social distancing when communicating with staff. If you are vaccinated, you are not required to practice social distancing when in your Elder's room. If you are unvaccinated, you must maintain social distancing at all times, both in the common areas and your Elder's room.

I. VISITATION

Notification Requirement – NONE. You no longer need to schedule visits.

Visitor Screening Form – Prior to moving to an elder's room, all visitors must complete a Screening Form. WE CANNOT ALLOW VISITATION IF A VISITOR'S SCREENING RESPONSES OR SYMPTOMS INDICATE A RISK OF EXPOSURE.

Infection Control

Hand hygiene – Visitors must adhere to hand hygiene requirements upon entry and during their visit, with the use of alcohol-based hand rub being preferred. You must continue to clean your hands frequently with either alcohol-based hand rub or soap and water, both of which are readily available in the Villas. Visitors should clean their hands after touching potentially contaminated surfaces, using soap and water after using the restroom.

Surgical Mask (covering BOTH mouth and nose) – All visitors must wear a surgical mask as they enter and pass through the Villa to their Elder's room. Visitors who are vaccinated are permitted to remove their mask when in their Elder's room with the door closed, but Guerin Woods strongly encourages even vaccinated visitors to wear their mask at all times. Visitors who are unvaccinated, are required to keep their mask on at all times.

Social Distancing – All visits are limited to Elders' rooms and visitors may not be present in common areas other than to make their way to an Elder's room. Visitors are not permitted to interact with other Elders and must maintain social distancing when communicating with staff. Visitors who are vaccinated are not required to practice social distancing when in their Elder's room. Unvaccinated visitors must maintain social distancing at all times, both in the common areas and their Elder's room.

Hours – Daily, 7 a.m. – 7 p.m.

Location – Indoor visitation is restricted to Elders' rooms. Families and friends may also use the Villas' garden areas. If a visitor wishes to speak with a staff member, they should simply use their Elder's call button and not wander through the common area.

Number of Visitors – If appropriate social distancing is maintained, Elders may have up to 4 visitors at a time.

Age Restrictions – Because all visitors must be able to comply with infection prevention protocols, Guerin Woods strongly discourages any visitor under the age of 12.

Testing – Visitor testing for COVID-19 is not required, but Guerin Woods strongly advises unvaccinated visitors to be tested on a routine basis to minimize the risk to Elders and their caregivers.

II. 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

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