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Outbreak Response Plan


It is the policy of the facility to limit the risk of spread of the Coronavirus Disease (COVID-19) in the event of
exposure and to follow CDC and DOH recommendations/guidelines in the event of an outbreak while decreasing
the risk of social stigma against any person or group of people. This policy shall continue to change as new
guidelines are received and implemented as per CDC and CMS.
The most updated guidelines from CDC, CMS State and/or Local Health departments shall supersede any previous
policies and procedures related to COVID-19.
Facility Visits: Family Members/Vendors/Volunteers
1. All visitors, unnecessary vendors, volunteers will be restricted from visiting and entering the facility until
further notice.
2. Exceptions will be made on a case to case basis. Residents at end of life shall be allowed to have family visits
while adhering to strict infection control and Covid-19 screening procedures.
3. If families are approved for visitation due to end of life, each person shall be screened for any respiratory
symptoms. Any person presenting with such may not be allowed to enter facility Approved family visitors
will be escorted to resident room by a staff member and will be instructed by nursing to don required PPE.
Upon completion of visit, nursing will instruct family member on removing PPE appropriately, perform hand
hygiene and escort family member to exit the building.
4. Any deliveries scheduled must be dropped off at designated area specified by administrator.
5. Consultants will perform their duties remotely when appropriate & only enter building when necessary.
6. No facility tours will take place at this time.
7. Residents that insist on going OOP with family shall sign AMA form and not readmitted back into facility.
8. See Visitation Policy—6/23/20
Family/Resident/Staff Notification:
9. Facility website, text messaging, phone calls, standard mail, email, and/or any other means of electronic
communication shall be the method to inform families, residents, and staff to keep them updated of facility’s
status regarding Covid-19.
10. Inform staff, residents and visitors of any updates and new cases as required via in-person notifications, in-services, memos,
SmartLinx, website updates, or facility TV channel.
11. In the event a resident/resident’s test positive for COVID-19 report to home office and the local and state

Universal Masking:
12. All residents will be encouraged to wear a mask during care and if they absolutely must be out of their room.
Eg: high risk to fall residents will be in the dayroom at least 6 feet from others, Wandering residents.
13. Staff shall wear surgical masks on non-resident areas at all times while inside the facility.
PPE: Specific Use of PPE based on unit—See Cohorting Plan Policy
Surveillance-Visitor and Staff Screening:
a. All visitors (vendors, family, non-employees, consultants) entering building will be screened and
will complete questionnaire
b. All staff entering the building will be screened and will complete questionnaire
c. Receptionist/Screener will take temperatures and provide the questionnaire to ALL visitors, staff
and outside consultants.
d. Receptionist/Screener shall prohibit entry and notify the DON/ADON/Designee to screen and
assess a temperature of 99.9 or above, cough, sore throat, body aches, fatigue, nausea, vomiting,
diarrhea, loss of taste and smell.
Surveillance-Resident Active Screening:
14. Residents shall be actively monitored for temperature, vitals and covid-19 related signs and symptoms.
15. The Unit managers and Supervisors will review the symptom monitoring sheets and report abnormal values
to the DON/ADON immediately.
16. Residents identified with fever and respiratory symptoms, or any of the other symptoms of Covid-19 will be
placed on isolation PUI unit for testing as per MD and treated accordingly based on CDC/CMS guidelines.
17. Local and State Health Department will be immediately notified regarding any resident or Staff member that
tests positive or is highly suspected to have COVID-19, or if there are any resident or staff deaths.
18. Initiate and update the DOH respiratory illness line list for staff and residents for all experiencing any of the
symptoms noted above.
Infection Control:
19. Ensure staff adherence to appropriate PPE per CDC recommendations.
20. Follow CDC guidelines regarding the discontinuance of transmission-based precautions isolation
precautions-see policy
21. Provide on-going education of staff regarding the importance of proper hand hygiene, donning and doffing
PPE, Covid-19 S/S, CDC updates, types of isolation precautions; use of appropriate PPEs; Infection control
22. Have hand sanitizer, soap, paper towels readily available for staff and resident use.
23. Visual Signs/Flyers regarding respiratory etiquette, handwashing, PPE, Covid-19 s/s will be posted
throughout the facility, including the facility entrance, unit entrances, nursing stations, time clocks. Etc.
24. Covered trash bins and soiled linen containers available inside resident room by door exit.
25. Ensure staff are cleared to enter by ensuring staff screening form is completed and reviewed.
26. Clean and disinfect frequently touched objects and surfaces using EPA registered products daily as per the
CDC guidelines.
27. Check CDC website and DOH releases to update policy/protocol as indicated.
28. The Local and State Health Department will be notified immediately regarding any staff member highly
suspected or positive for having COVID-19.
29. Any employee who has symptoms of COVID-19 will be immediately sent home and instructed to call the
DON//designee for clearance to return to the facility.
30. Staff will adhere to appropriate hand hygiene and use PPE appropriately per CDC recommendations.
31. Staff will be re-educated regarding importance of proper hand hygiene and PPE use.
32. Fact sheets about COVID-19 will be posted throughout the facility
33. Encourage staff to refrain from work while sick with respiratory illness. Actively encourage sick employees
to stay home:
a. Employees who have symptoms of acute respiratory illness are recommended to stay home and
not come to work until they are free of symptoms and screened by the DON/designee for
b. During an outbreak / Pandemic = Do not require a healthcare provider’s note for employees who
are sick with acute respiratory illness to validate their illness or to return to work, as healthcare
provider offices and medical facilities may be extremely busy and not able to provide such
documentation in a timely way.
c. Contact your agency staff to report the same requirements to them.
34. Implement a hand shake free environment and refrain from unnecessary contact.
35. If staff may enter after proper screening, they will be given a surgical mask to keep on over their N95 mask
and will be required to wear this PPE the entire time they are in the building. Noncompliance with PPE use
will result in disciplinary action.
36. Adhere to EEOC regulations.
a. Employers have permission to ask staff the questions on the Covid-19 screen.
i. Document symptoms on appropriate log
b. Employers will send sick staff members home immediately
i. This can only be done by administrative team
c. Employers will take temperatures of ALL staff before entering the building which under ordinary
conditions would be considered a medical exam and thus barred.
d. Employees will complete questionnaire before entering the building.
37. Encourage staff to work on preparedness plans for state directed events that might include closing schools,
limiting public transportation or canceling large gatherings.
38. Inform staff of any updates as necessary.
39. Employees who are well but who have a sick family member at home with COVID-19 should notify their
supervisor and refer to CDC guidance for how to conduct a risk assessment of their potential exposure.
40. In the event an employee test positive for COVID-19, notify the DON/designee asap.
41. If an employee is confirmed to have COVID-19, employers should inform fellow employees of their possible
exposure to COVID-19 in the workplace but maintain confidentiality as required by the Americans with
Disabilities Act (ADA).
42. All sick calls will be directed to the DON/ADON during business hours, Nursing Supervisor/Designee on
weekends and off shifts.
43. All department heads and supervisors accepting sick calls will maintain call out log.
44. Symptomatic staff members that cannot report to work will be referred to their physician and they will not
return until cleared by them and the DON/ADON following the return to work criteria policy.
45. All screening forms shall be submitted to DON/Designee for daily review and monitoring.
Activities and Psycho Social:
46. Outside activity trips, entertainers, volunteer groups have been cancelled.
47. Large activity groups have been cancelled. Activities will keep the residents in the small group spaced 6
feet apart at their own table in the day room.
48. Recreation calendar will be updated to provide appropriate activities to residents.
49. Activity personnel shall provide resident 1:1 visits, and coordinate video chats and phone calls as appropriate
to ensure residents’ psycho-social well-being is continuously addressed during the time of pandemic.
50. Select activity staff have been trained by speech therapist to assist with feeding those residents on a regular
consistency and thin liquids diet during time of Pandemic. May also assist with the distribution of trays
51. Coordinate visual visits and phone calls for residents to communicate with their families. This will be
managed by The Activities Director and The Director of Social Services.
52. Tablets or the use of Telehealth cart will meet this requirement.
53. All Communal and dining room activities will be cancelled.
54. Disposable plates, cups, bowls, utensils shall be used for confirmed COVID-19 and PUI residents.
55. Select dietary staff have been trained by speech therapist to assist with feeding those residents on a regular
consistency and thin liquids diet during time of Pandemic. May also assist with the distribution of trays

56. Housekeeping protocols will be followed with increased cleaning schedules as per CDC recommendations,
for frequently visited and touched areas in the facility (bed rails, hand rails, door knobs, bathrooms, tables,
bed side tables, call light cords, call light buttons, kiosks, keyboards, remote controls).
57. Housekeeping directors shall perform random checks of staff members to ensure thorough cleaning is
taking place and the approved chemicals are being used. Housekeeping shall perform complete cleaning
and disinfecting of room after resident is transferred to another unit.
58. Housekeeping shall utilize EPA approved cleaning agents.
59. Housekeeping shall check the dirty face shield/goggles/eye protection bin throughout the day to disinfect
items and returned to clean bin located at unit entrances.
60. Housekeeping personnel shall wear PPE per specific unit protocol.
61. Outside vendor cleaning company shall continue with scheduled sanitation and extra cleaning. Their
personnel are screened prior to entry and wears appropriate PPE per each unit protocol.
62. New and readmits shall be tested for covid-19 per MD order.
63. Based on resident history, resident shall be placed on Covid unit or PUI unit.
64. New and readmissions shall be maintained on 14-day quarantine/monitoring regardless of negative test
results performed at facility after arrival.
Social Services:
65. Social services/designee shall maintain open communication with family members throughout the
66. Social Services/designee will notify family and residents of alternative ways to communicate with each other
with the use of a tablet, phone and video chats.
67. Social Services may schedule window visits with family members as requested if physical plant of facility
safely allows and roommate is also agreeable. Roommate’s curtain should be drawn to provide privacy.
Resident window must remain closed and a phone should be used to accomplish verbal communication.
68. Social Services/designee shall perform room visits as appropriate to address the residents’ psycho-social
Physician Services:
69. Physicians/Nurse Practitioners that must enter the facility to care for the residents will complete the
screening questionnaire, along with a temperature check upon arrival to the facility.
70. Clinicians shall adhere to unit protocols for the use of PPE and other facility policies.
71. Physicians shall be notified of Covid + results and obtain orders as appropriate.
72. Physicians shall be encouraged to utilize telehealth/telemedicine services to minimize risk for potential
73. Staff active screening for COVID-19 shall continue to include temperature checks and completing
questionnaire every shift when entering the building.
74. Unit Managers, Nursing Supervisors will collect, review and submit forms to DON/ADON/Designee.
75. Active resident screening shall be implemented to include temperature checks and evaluation of respiratory
and all Covid-19 symptoms.
76. Residents identified with any Covid-19 symptoms shall be isolated as per guidelines and treated accordingly.
77. New/re-admissions shall be screened and approved by DON/Designee prior to acceptance into facility.
78. Essential Supplies counts will be counted by the Supply Coordinator at least once a week and sent to
Administrator, DON and ADON. All attempts will be made to keep par levels. Supplies will be ordered as
79. Administrator must be notified if items are unable to be replenished.
80. N95 Masks and Surgical face masks shall be provided for all staff and replaced as needed.
81. Surgical masks are given to residents and encouraged to wear as tolerated.
82. The Nursing department shall continue to follow CDC, CMS and local/State guidelines as directed.
PPE Supply:
83. Facility shall ensure adequate PPE supplies are available.
84. PPE audits shall be conducted by central supply.
85. Isolation carts shall be checked and replenished as needed.
86. PPE supply room shall be made available for staff.
87. Therapy shall adhere to facility protocols regarding Covid-19.
88. Exercise mats and equipment shall be cleaned and wiped down with EPA approved disinfectant after each
treatment session.
89. Dwell time shall be followed as per manufacturer instructions.
90. Rehabilitation equipment shall be stored appropriately in a closet. No linen shall be stored on the floor.
91. Residents shall be maintained at minimum six feet apart when gym use is appropriate and resumed.
92. Residents shall wear masks while in therapy gym.
93. Soiled linens shall be placed in a container clearly labeled and picked up by housekeeping department for
removal daily