ABINGTON MANOR
AT MORGAN HILL
Senior Living & Memory Care Village
The Facilities Phased Reopening Plan
Abington Manor Senior Living and Memory Care Village are beginning a phased reopening process. The plan for this process follows the guidelines established by the CDC and the Pa Department of Health. There is one master plan and the minor difference between the Memory Care Village and Senior Living facilities are found in the detail links for each portion of the Plan. The Plan reflects our commitment to maintain the health and safety of our residents and staff.
We are entering the reopening process at Phase Two. Both Phases Two and Three have restrictions and this plan does not mean we will allow open visitations. Rather the Plan allows us more flexibility in visitation, dining, and activities while allowing for a rapid return to a Closed status should an outbreak of COVID-19 occur within either facility.
We anticipate a Phase Two reopening date of September 2, 2020.
Once we have completed all the required testing and wait the required time period, we will post the phase three date.
We sincerely hope for the development of a vaccine and treatment for this terrible disease.
Contents
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Detailed testing process information for staff and residents
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The Abington Manor plan to isolate or cohort Residents testing positive
Reopening Implementation Plan
Abington Manor developed the following plan to reopen the facilities as the threat of the COVID-19 begins to lessen, and Pennsylvania enters the green phase. Should the instances of COVID-19 infections increase or Pennsylvania mandate it, the facilities reserve the right to close again for the protection of the residents and staff.
Universal Testing
Per the Order of the Secretary of the Pennsylvania Department of Health Directing Testing at Long-Term Care Facilities, issued June 26, 2020, Personal Care Homes (PCHs), Assisted Living Residences (ALRs), and Intermediate Care Facilities (ICFs) are required to complete a baseline universal test for SARS-CoV-2, the virus that causes COVID-19, of all residents and staff no later than August 31, 2020. Universal testing includes any resident or staff person who has never been tested, and any resident or staff person who was tested prior to June 12, 2020, and whose test result was negative.
Abington Manor has contracted with Health Network Laboratories to aid in implementing the facility testing according to the following standards:
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Administer COVID-19 diagnostic tests to all residents showing symptoms of COVID-19 within 24 hours;
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Administer COVID-19 diagnostic test to all residents and staff if the facility experiences an outbreak;
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Administer COVID-19 diagnostic tests to all staff, including asymptomatic staff;
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Abington Manor will test nonessential workers on a case by case basis. The only identified nonessential staff identified with Abington are hairdressers and barbers. Hairdressers and barbers are included in the testing program.
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A procedure for addressing residents or staff that decline or are unable to be tested;
To those ends, testing supplies, and trained personnel are available to the facility at all times. The testing laboratory can meet the turnaround times required by the DOH Order. Abington Manor is testing all of its employees, regardless of position, volunteers where needed, and new hires before beginning employment at Abington. All testing procedures are consistent with PAHAN-509.
Employee Testing Procedures
Abington Manor currently has 115 active employees between the Senior Living and Memory Care units. The staff testing will be completed in five (5) sets of testings beginning the week of July 20, 2020. The method of testing is as follows:
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Each facility shall develop a grouping of staff from each department.
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The number of staff in each group will represent the total number of staff in that department divided by 5. In the event, there are fewer than five employees in a department, the Department Head will assign members to any of the five main groups until all staff within the department, including the DH, are tested.
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Testing will begin at 7 AM with staff members from the previous third shift assigned to that day’s testing. Testing will continue until all persons scheduled for that day are tested.
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The nursing staff will perform testing. Training will take place the week before testing begins.
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The HR Administrator or Facility Administrator shall review testing results.
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Should an employee test positive, either following procedures must be followed:
Time-based strategy. Exclude from work until:
10 days have passed since the date of their first positive COVID-19 diagnostic test, and they have not subsequently developed symptoms since their positive test. If they develop symptoms, then the symptom-based or test-based strategy should be used. Note, because symptoms cannot be used to gauge where these individuals are in the course of their illness, it is possible that the duration of viral shedding could be longer or shorter than 10 days after their first positive test. . Exclude from work until:
Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart (total of two negative specimens). Note, because of the absence of symptoms it is not possible to gauge where these individuals are in the course of their illness. There have been reports of prolonged detection of RNA without a direct correlation to viral culture.
There are no positions at Abington Manor which do not have some form of direct contact with residents. The lack of non-contact positions renders the COVID-19 testing a condition of employment and therefore refusing testing renders an individual ineligible for employment at Abington Manor.
Resident Testing Procedures
Testing of the residents of Memory Care Village and Senior Living shall be performed on different days.
The Abington Manor Medical Director will carry out the Resident testing. Each facility's nursing staff will assist the Director.
The administrative staff will compile the necessary test requisition information, including insurance information, before testing begins.
Senior Living residents who refuse testing or whose POA’s have refused to allow testing are treated as assumed positive and subject to 14 days quarantine. If during the 14 days of quarantine should a resident become symptomatic, they, or their POA, will again be approached for testing.
The Medical Director, facility Administrator, and HR Administrator will review and report test results for both employees and Residents as required by PAHAN-509.
Isolating and Cohorting Residents
Abington Manor Senior Living and Memory Care Village have different physical configurations and are treated separately for this policy. Both Facilities will follow the guidelines developed in PAHAN-509
Senior Living
The design of Abington Manor Senior Living as a three-story building lends itself to facilitating the Red, Yellow, and Green Zones as outlined in PAHAN-509. Additionally, every resident room in the building has a bathroom allowing it to function independently of the rest of the facility. Therefore, should a resident test asymptomatic positive or develop symptoms of COVID-19, the resident’s room can be designated as Red, Yellow, or Green as the resident condition warrants.
The placement of a large sign indicating COVID + RED, COVID – Exposed, and Green COVID - Unexposed on the door of a resident room indicates the status of the resident within. The floor outside of the resident’s room will also be marked with colored tape, corresponding to the resident’s status. The tape will extend six feet out from the door edges, forming a box in front of the door.
In the event of a large-scale outbreak, Senior Living has the advantage of three floors, which, while not anticipated or desired, would allow for the designation of levels to Red, Yellow, or Green. The facility will designate the first-floor entrance as a green area.
Abington Manor Senior Living will utilize empty rooms to respond to residents in shared rooms in the same manner as residents living in single rooms. The resident testing positive will remain in the room they currently occupy. The negative resident will be temporarily moved into a vacant room, treated as exposed, and the room designated Yellow. Should the resident subsequently develop symptoms and test positive, they will transfer back to their original room. When a room, used in this way, is vacated, it will be thoroughly cleaned and sanitized using an approved sanitizer.
Memory Care Village
It is acknowledged that as a personal care and secure dementia facility, Abington Manor Memory Care Village presents unique issues in accomplishing the isolating of COVID-19 positive residents. The Red, Yellow, and Green approach will be utilized while acknowledging the rights of the residents and protecting the uninfected.
Utilizing the same Red, Yellow, and Green color-coding of rooms as mentioned above, MCV will attempt to isolate any resident testing positive. MCV rooms have bathrooms in them and can function independently of the rest of the facility. The marked doors and floors in front of those doors will indicate the status of the resident living within.
The effects of dementia make moving a resident to another room less than a reasonable solution to handling shared rooms. Given the infectious rate of COVID-19 and the behaviors of someone diagnosed with dementia, it is unlikely that one positive member of a shared room will not pass it to the other. That said, it is reasonable should one member of a shared room test positive the other will soon test positive also. Therefore, if a member of a shared room test positive, it is reasonable that the other member is treated at the least exposed if not likely positive. If it is possible, move the non-positive resident to a vacant room and mark that room Yellow. If, because of dementia, the resident cannot be moved, both residents will continue to occupy the shared room, which is appropriately designated Red.
The lobby of MCV is designated green while all other areas are designated yellow.
Screening Protocol
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Abington Manor has instituted for screening everyone entering the facilities and residents of the facilities. This includes staff, visitors, service personnel, and Medical personnel. The procedure is as follows:
Non Residents
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Entrance to the facilities is limited to only one door or area. The entrance is monitored throughout the day. When not monitored, the doors are locked, and entry is granted when the person or person seeking access is temperature and travel checked by the facility staff.
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Each person entering the facilities receives a temperature check. These checks are logged, and those logs are maintained and stored by the facilities. Anyone with a temperature in excess of 100⁰ is denied access to the facility.
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The facilities also maintain travel and physical condition questionnaires for visitors and other first-time persons entering the facilities.
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The entry stations also have hand sanitizer and masks available at all times.
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The facility residents are temperature checked twice daily:
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In the morning before breakfast.
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In the evening at bedtime
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Should a resident develop a temperature over 100⁰, the shift supervisor is immediately notified. The shift lead will contact the resident’s physician and follow the instructions of that physician.
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Abington Manor maintains the ability to COVID-19 test a resident 24 hours a day.
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Personal Protective Equipment
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Abington Manor maintains a reserve 30-day supply of PPE. This supply is in addition to the standard quantity of PPE stocked for daily operation.
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The Emergency PPE includes:
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Masks including, both KN-95, and surgical
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Isolation gowns
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Face Shields
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Gloves
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Sanitizer, both hand, and surface
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Sanitizing wipes
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Thermometers
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Any other item deemed necessary moving forward.
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To accomplish the 30-day reserve supply, Abington Manor is using all possible sources and suppliers. Items in the reserve supply are replenished as they are used, thereby maintaining that 30 days supply level.
Reverting to Closed Status
Should Northampton County revert to Red Phase, the following actions will immediately commence:
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Both facilities will post “No Visitors” on all access doors.
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All pending scheduled visits will be canceled.
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Admission to the facilities is restricted to staff and as defined by below:
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Physicians, nurse practitioners, physician assistants, and other clinicians;
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Home health and dialysis services;
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The Department of Aging/Area Agency on Aging including the Ombudsman and the Department of Human Services where there is concern for serious bodily injury, sexual abuse, or serious physical injury;
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Visitors to include but not be limited to family, friends, clergy, and others during end of life situations;
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Hospice services, clergy and bereavement counselors, who are offered by licensed providers within the SNF; and
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Department of Health or agents working on behalf of the Department, such as Long-Term Care Ombudsman, or local public health officials.
4. Dining and Activities will revert to pre-reopening operations.
5. All daily operations within both facilities will revert to pre-reopening status.
6. The facilities’ Administrator is responsible for the implantation of the above actions.
Screening Processes
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All persons entering the facility must:
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Sign in and have their temperatures taken
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Use the provided hand sanitizer before continuing into the facility
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Wear a face mask at all times within the facility
Residents: Facility residents are screened in the morning and evening. The Director of Resident Care reviews the temperatures report daily and tracks any changes. If a resident develops a rising temperature, the resident is isolated, marked as “Yellow” status, and tested for COVID-19. The results of the testing determine the residents status moving forward. All residents are COVID-19 tested for a baseline.
Staff: All staff members are temperature tested upon entry into the facilities. Temperature logs are maintained, and subject to review. Anyone with a temperature at or above 100° is not allowed into the facility and tested for COVID-19. All staff are baseline tested for COVID-19.
Healthcare Personnel, not staff: Health care personnel not employed by the facility, are temperature tested upon entering the facility. HCP with temperatures at or above 100° are denied access to the facilities.
Non-Essential Personnel: Non-Essential personnel is temperature tested upon entry to the facility. Individuals with a temperature at or above 100° are denied entry into the facilities.
Visitors: In addition to the temperature testing, visitors are asked to complete a brief questionnaire concerning recent travels. Visitors returning from designated “hot spots” less than 14 days before requesting entry into the facility are denied access to the facility.
Volunteers: Regular volunteers are part of the facilities’ baseline testing program. Volunteers are screened daily for increased temperature, and if a volunteer’s temperature is at or above 100°, they are refused entry until a new COVID-19 negative test result is provided. All volunteers are oriented to the Red, Yellow, and Green area’s restrictions. Volunteers are only allowed to participate in activies involving COVID-19 negative residents.
Abington Manor Senior Living
Outdoor Visitation Policy
Outdoor visiting will be offered when the facility enters the re-opening phase 2, on Sept 2, 2020. Visits will be conducted in a tented area on Wednesdays, Thursdays, Saturdays, and Sundays from 10am-3pm.
Outside visits must be arranged for Senior Living residents by appointment only. Please schedule a day/time to visit at least 72 hours in advance with the Activities Director at robinr@abingtonmanor.com or 610-829-0100 ext. 17 during office hours of Mon-Fri 9am-5pm. No drop by visits will be accommodated. Please include a callback phone number in all correspondence.
In an effort to accommodate as many family visitations as possibly, we are requesting the visit last for 20 minutes and appreciate your compliance with the schedule.
No more than 3 visitors may visit their loved one at a time, no children under the age of 18 are permitted and no pets. This includes special occasions such as birthdays.
A resident may have up to 2 scheduled visits per week as the visitation schedule permits.
Residents who are Covid-19 positive or presumed positive or on room isolation will not be eligible for visitation. Any new resident or resident who has returned from a hospital stay will be ineligible for visitation for 14 days.
All visitors are screened, and a face mask must be worn AT ALL TIMES by the resident and visitors. Visitors are to provide their own facemask, and the facility will provide one for the resident. Residents are seated at a table, and the visitors maintain a 6-foot distance from the resident for the visit’s duration.
Upon arriving, remain in your car. Please do not enter the visiting area prior to the scheduled time. Visitors must agree to sign in, have their temperatures taken, and complete a health screening questionnaire upon arrival in your vehicle. If any visitor is feeling ill or having respiratory symptoms, please call and re-schedule your visit, do not come to the facility. If you have traveled on a plane, you will be required to wait 14 days before visiting.
There will be no exchange of food or items at these visits; however, items may be dropped off in the entrance vestibule after the visit and will be delivered to the resident’s room. Visitors cannot enter the building at any time for any reason.
Staff members will be present for all visits to assist with these guidelines and anything the resident or visitor may need. Staff will sanitize seating areas between each visit.
All scheduled visits are subject to weather conditions. In the event of inclement weather, we have established a neutral zone within the facility to accommodate inside visitations. This area is the only area in which a visit will take place. In the event that the visit would be moved indoors, a staff member will inform you and accompany you to the location when you arrive.
All correspondence is sent to the POA only. We are kindly asking POA’s to communicate this policy to other family members before their visit.
Thank you,
Mary Ann Smolenyak
Campus Executive Director
OUTDOOR VISITATION SCREENING
DATE OF VISIT:_____________________ TEMP:_______________
VISITOR’S NAME________________________________________
RESIDENT WHOM YOU ARE VISITING_______________________________
IF YOU HAVE ANY OF THE FOLLOWING SYMPTOMS OR TRAVEL HISTORY, VISITATION AT THIS FACILITY IS NOT PERMITTED:
*Cough, fever, shortness of breath
*Cold or Flu-like symptoms
*Known exposure to anyone with the Flu or Covid-19 in the past 14 days
*Travel outside of the United States within the last 30 days
*Travel on a plane in the last 14 days
*Travel to a Covid-19 hotspot anywhere in the continental US in the last 14 days
*Visited a resident in another facility that has experienced a Covid-19 outbreak in the past 14 days
I CERTIFY THAT NONE OF THE ABOVE CONDITIONS OR SITUATIONS APPLY
(PRINT Name)
(SIGNATURE)
Abington Manor Memory Care Village
Outdoor Visitation Policy
Outdoor visiting will take place in the Northern Patio area on “Tuesday, Wednesday, and Friday” from 10am-2:00pm.
Outside visits must be arranged for Memory Care Village residents by appointment only through the activity department. Please schedule a day/time to visit at least 72 hours in advance with the Activities Director at jennifera@abingtonmanor.com or 610-438-9400 ext. 19 during office hours of Mon-Fri. 9am-5pm. No drop by visits will be accommodated. Please include a call-back phone number in all correspondence.
Visits must be kept to a 20-minute duration only and will be timed.
No more than 3 visitors may visit their loved one at a time, no children under the age of 18 are permitted and no pets. This includes special occasions such as birthdays.
Residents who are Covid-19 positive or presumed positive will not be eligible for visitation. Any new resident or resident who has returned from a hospital stay will be ineligible for visitation for 14 days.
All visitors are to be screened, and a face mask is to be worn AT ALL TIMES by the resident and visitors. Visitors are to provide their own facemask, and the facility will provide one for the resident. Residents will be seated on a seating area or wheelchair in the Northern Patio area. The visitors will maintain a 6-foot distance behind the marked off area during the duration of the visit.
Upon arriving, please enter from the second entrance of the parking lot to your left and park at the spot marked “for Scheduled Outdoor Visits Only.” Please remain in your car and staff members will be out to meet you. Please do not enter the visiting area prior to the scheduled time. Visitors must agree to sign in, have their temperatures taken, and complete a health screening questionnaire upon arrival in your vehicle. If any visitor is feeling ill or having respiratory symptoms, please call and re-schedule your visit, do not come to the facility. If you have traveled on a plane, you will be required to wait 14 days before visiting.
There will be no exchange of food or items at these visits; however, items may be dropped off at the front entrance in the blue bin after the visit and will be delivered to the resident’s room. Visitors cannot enter the building at any time for any reason.
Staff members will be present for all visits to assist with these guidelines and anything the resident or visitor may need. Staff will sanitize seating areas between each visit.
All scheduled visits are subject to the weather. Again, please leave a contact number when you schedule your visit. In the event of inclement weather, we will need to contact you to cancel and re-schedule.
All correspondence is sent to the POA only. We are kindly asking POA’s to communicate this policy to other family members prior to their visit.
Because of limited space within the facility, inside visits will be held in the conference room, and all other conditions and precautions remain in place.
Activities
To maintain the safety of our residents group activities in Phase Two may be held with the following guidelines:
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Limited activities may be conducted with no more than ten residents unexposed to COVID-19. Social distancing, hand hygiene, and universal masking are required.
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Outings and not allowed in Phase two.
To maintain the safety of our residents group activities in Phase Three may be held with the following guidelines:
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Activities may be conducted with residents unexposed to COVID-19. Social distancing, hand hygiene, and universal masking are required.
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A determination as to allow outings will be dependent upon the infection rate at that time and our ability to protect our residents.
We continue to develop activities that engage and relax our residents during this difficult time.
Dining Services
Prior to Reopening
During the Closed phase of operation, the following guidelines are observed:
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Provide in-room meal service for residents who are assessed to be callable of feeding themselves without supervision or assistance.
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Identify residents at-risk for choking or aspiration who may cough, creating droplets. Meals for these residents should be provided in their rooms with assistance. If meals cannot be provided in their rooms, the precautions outlined below must be taken for eating in a common area in addition to ensuring the residents remain at least six more feet from each other:
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When possible, not more than one resident who needs assistance should be seated at a table at one time.
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Stagger arrival times and maintain social distancing.
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Increase the number of meal services or offer meals in shifts to allow fewer residents in common areas at one time.
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Take appropriate precautions with eye protection and gowns for staff feeding the resident population at high-risk for choking, given the risk to cough while eating.
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Staff members who are assisting more than one resident at the same time perform hand hygiene with at least hand sanitizer each time when switching assistance between residents.
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When Reopened (all steps)
Communal dining may resume. Communal dining is limited to residents unexposed to COVID-19. Those residents may eat in the same room with social distancing (limited number of people at tables and spaced by at least six feet).
The following restrictions apply:
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Provide in-room meal service for residents who are assessed to be callable of feeding themselves without supervision or assistance.
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Should the facility census exceed the capacity of the dining rooms using the established guidelines, we will begin staggered mealtimes.
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Identify residents at-risk for choking or aspiration who may cough, creating droplets. Meals for these residents should be provided in their rooms with assistance. If meals cannot be provided in their rooms, the precautions outlined below must be taken for eating in a common area in addition to ensuring the residents remain at least six more feet from each other:
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When possible, not more than one resident who needs assistance should be seated at a table at one time.
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Stagger arrival times and maintain social distancing.
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Increase the number of meal services or offer meals in shifts to allow fewer residents in common areas at one time.
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Take appropriate precautions with eye protection and gowns for staff feeding the resident population at high-risk for choking, given the risk to cough while eating.
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Staff members who are assisting more than one resident at the same time perform hand hygiene with at least hand sanitizer each time when switching assistance between residents.
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If at any time an outbreak occurs, dining reverts to the Prior Guidelines
Staffing Policy
To ensure adequate staffing levels during regular operation and in the event of a large scale COVID-19 outbreak Abington Manor has contracts with the following staffing agencies:
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Dedicated Nursing Associates
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All American Healthcare Staffing
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Healthskills Staffing
Abington Manor continues to advertise and interview new associates. All new hires are COVID- 19 tested before beginning work at either facility.