Saint John XXIII Home  >  2020  >  September

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COVID UPDATE:  9/28/2020

We are now in month #7 of the COVID-19 pandemic.  

We continue to strive to remain “COVID Free” here at Saint John XXIII Home.  As mentioned in the last update, we have initiated monthly testing of all staff.  Our September 2020 testing was completed last week and I’m pleased to report that we had zero “positive” cases amongst our staff.  Unfortunately, the Mercer County COVID positivity rate has increased to 5.1%, which requires us to begin testing of all staff on a weekly basis.  Weekly testing will be required until the Mercer County rate drops below 5%.  Resident testing continues to be required for signs/symptoms of COVID, possible exposure and/or a positive case amongst staff.  Routine or surveillance testing of residents is NOT recommended.

Our outside patio visits continue on Monday, Wednesday and Friday.  We have measures in place to move indoors, into Roncalli Center, on days in which the weather doesn’t permit a comfortable visit outside.  The process will remain consistent with the process used for patio visits.  We ask that everyone continue to follow the rules which have been established to protect the well-being of our residents and staff.

In addition, we recognize the connection between mental and emotional and physical health, and that the effects of prolonged isolation may have significant mental and emotional health impacts that a resident’s physical health becomes impaired.  In such instances, our staff will work WITH the resident and family to provide the resident with access to care needed to maintain or improve their health status.  These visits are referred to as a “Compassionate Caregiver” situation.  Please understand that there is specific criteria that must be met to achieve “Compassionate Caregiver” status, including COVID testing consistent with our facility required testing (weekly at present).  The full Compassionate Caregiver Policy and standards related to such, can be reviewed on our website at www.saintjohnxxiiihome.org.  

In conclusion, I thank you for your continued trust and on-going prayers for our residents and staff.  Please do not hesitate to contact me should you have questions.

Sincerely,

Kirk Hawthorne

Administrator/CEO

Saint John XXIII Home

COMPASSIONATE CAREGIVER POLICY

UPDATED:  9/28/20

In compliance with the PA Secretary of Health’s updated standards on 9/3/20, Saint John XXIII Home has implemented a “Compassionate Caregiver Policy”.  This “Compassionate Caregiver” terminology should NOT be used interchangeably with “End of Life visitations”.  Compassionate Care visitation will be allowed in LIMITED situations per the Center of Medicare Services (CMS).

BACKGROUND:

At Saint John XXIII Home, we recognize the connection between mental and emotional health and physical health, and that the effects of prolonged isolation may have significant mental and emotional health impacts that a resident’s physical health becomes impaired.  In such instances, our staff will work WITH the resident and family to provide the resident with access to care needed to maintain or improve their health status.

STANDARDS to RECEIVE COMPASSIONATE CAREGIVER ACCESS:

Compassionate Caregiver access may be considered ONLY if there are two or more documented “SIGNIFICANT CHANGES”, in a resident’s condition. 

SIGNIFICANT CHANGE is defined as:  a MAJOR decline or improvement in a resident’s status that:

1. Will not normally resolve itself without intervention by staff or by implementing standard clinical intervention.

2. The decline is not considered “self limiting”.

3. Impacts two or more areas of the residents health status

4. Requires interdisciplinary review and/or revision of the care plan

(all 4 of the above criteria must be met)

* Interested individuals will call the facility Administrator at  (724-981-3200) to request an Interdisciplinary  Compassionate Caregiver status review.  This conference will be scheduled as soon as reasonably possible via conference call.

COMPASSIONATE CAREGIVER REQUIRED STANDARDS: (Upon Approval)

* Caregivers will show proof of a NEGATIVE COVID-19 test that was administered within the past 7 days, preferably 72 hours if testing turnaround times allow, BEFORE initiating Caregiver duties.

* The Caregiver is subject to all ongoing testing requirements that apply to Saint John XXIII Home staff pursuant to all guidance and Orders. (ie- weekly or monthly testing)

* Caregivers are responsible for arranging and covering the cost of their initial and ongoing testing.

* Caregivers who do NOT remain in good standing with (or refuse) the COVID testing requirements, will NOT be permitted to participate in the Caregiver program/process.

* Caregivers are to be screened prior to entering the facility, adhere to universal masking at all times, frequently practice hand sanitization, and social distance from ALL STAFF and OTHER RESIDENTS.

* Social distancing from the resident receiving Caregiving is strongly preferred but not required if distancing would NOT achieve the intended health outcomes of the visit.

* Caregivers are permitted to visit a maximum of 2 hours per day, and there should be no more than 2 Caregivers per resident at a time.

* Caregivers will be screen for COVID symptoms at EACH visit.  In addition, they must provide the following on the Compassionate Caregiver log:  Name, date, time in, time out, address, phone number and email address, in the event that contact tracing is necessary.

* If a Caregiver does not comply with 1 or more of these public health practices, they will be asked to leave the facility and their Caregiver status will be reassessed by facility Administration in order to protect staff and other residents.

FACILITY STAFF RESPONSIBILITIES:

* Interdisciplinary Team will participate in the Caregiver Request determination conference call.

* Nursing staff will complete a review to determine the need for Compassionate Caregiver

* The Residents Care Plan/RASP will be updated with measurable objectives and timeframes for action related to Compassionate Caregiving.

* Care plan decision makers will determine:  number of days per week (frequency) the visits are needed to maintain or improve the resident’s health status WITHOUT introducing unnecessary risk posed by increased number of individuals entering Saint John XXIII Home

* The FIRST Compassionate Caregiver visit for each Caregiver will be observed by facility staff in the setting deemed appropriate for the visits to orient Caregivers to specific safety measures the Caregivers need to take to protect residents and staff.

(Hand sanitizer areas, proper hand hygiene, proper mask compliance, demarcation requirements, social distancing, etc.  Visits will be restricted to the designated resident ONLY.

* Staff should correct any deficiencies.  Staff only need to observe the visit until the Caregiver is fully oriented and any deficiencies resolved.

* SUBSEQUENT VISITS: staff should check in, as possible, to ensure adherence to the universal masking, hand sanitizer has been recently used, distancing from other residents is being practiced, etc.

* Screen Caregivers with EACH visit.  A log of visit must be maintained including:  Name, Date, Time in, Time out, address, phone number and email address, in the event contact tracing is necessary.

COMPASSIONATE CAREGIVER ASSESSMENT FORM:

Resident Name:____________________________________   Date:_________________

Caregiver Request Name:____________________________________________________

Reason for the Request:

Staff Assessment of Area(s) of Decline:

Requested Frequency/Time of Visits:

Objective of visits:__________________________________________________________

Careplan / RASP update:  DATE:___________________  by  ________________________

Compassionate Caregiver:     Approved:___________     Denied:_______________

Frequency/Days/Times approved to meet objective:_____________________________

Administrator Signature:____________________________________________________

Reassessment Date:  _______________________________________________________

COMMENTS

COVID-19 UPDATE: (9/2/2020)

At Saint John XXIII Home, we remain in Step #2 of “re-opening”.  Progressing to “Step 2” has allowed us to start the process of creating a new normal.  This includes patio visits with family/friends, return of beauty shop staff and increasing group activity size as permitted.  We are also increasing resident outside group opportunities.  We ask that families do not make this an additional visit opportunity, as this would violate our re-opening policy/process. 

In addition, we continue to take measures to progress to Step 3, which would yet again increase group activity size and allow us to reincorporate MASS a few days weekly.  Step 3 also has provisions of allowing inside visits within Roncalli Center instead of using the patio, which is the plan for inclement weather situations (fall/winter weather).  If you have not already done so, I encourage you to read the “Plan to Re-open” found on our website at www.saintjohnxxiiihome.org.  Please understand per direction from the PA Department of Health that there are no plans, in the immediate future, to return to prior (pre-COVID) visitation processes.  This step will not be implemented until it is deemed to be a safe practice.  Please understand that we are trying to strike a reasonable balance between safety and mental health, during these unprecedented times.

To date, we have experience two (2) COVID positive cases amongst staff, which were unrelated cases.  No additional staff and/or residents were found to be positive from either case.  We remain FREE of positive resident cases.  Previous updates have mentioned the involvement of the PADOH and the recently formed Regional Response Health Collaboration Program (RRHCP).  The PADOH conducted an Infection Control focused survey at the facility from July 8th – July 13th and results determined the facility was in Full Compliance with COVID standards.  In addition,  on August 20th, we had our initial on-site review with the RRHCP to review policies and procedures related to COVID-19. 

On September 1st, 2020, Saint John XXIII Home received a “Rapid COVID testing device”, known as the BD Veritor System from the PA Department of Health.  This is an antigen testing system that uses nasal swab (dual nares collection method) for detection of SARS-CoV-2 nucleocapsid antigen.  THIS TEST GIVES US RESULTS IN APPROXIMATELY 15 MINTUES!  We are only permitted to test residents of Saint John XXIII Home and all employees of the facility, including contracted service personnel.  The facility has an updated CLIA certificate and tests will be administered by our facility Registered Nurses, on site.  With this device, new standards of testing must be implemented as follows:

  • All residents and/or staff who display COVID symptoms will be tested immediately.
  • A NEW positive case amongst staff or residents would require that ALL residents and staff are tested every 3-7 days for a minimum of 14 days.
  • Routine/Surveillance Testing:  Facility staff will be testing based on the Mercer County “COVID POSTIVITY RATE”, starting in September.
  • Mercer County Rate  <5% = monthly testing
  • Mercer County Rate 5-10% = weekly testing
  • Mercer County Rate >10% = 2x/week testing
  • Mercer County Rate as of 9/2/20 = 3.7%
  • **Routine/Surveillance testing of Residents is NOT recommended.
  • We will continue to utilize molecular testing should the situation dictate such.
  • Please understand that these are the testing standards as of today, should the recommendations from the PADOH, CDC and/or RRHCP change, we will respond accordingly.

The BD Veritor device will allow us to make more timely decisions to help mitigate the spread of the virus.  Of course, our priority is prevention through handwashing, social distancing and mask utilization.

In conclusion, I want to thank everyone for their incredible support and understanding throughout this pandemic.  Rest assured that we will do everything in our control to keep your loved one AND our staff as safe as possible.  Please continue to schedule patio visits and utilize any/all forms to communicate with your loved one.  Please know that we are ALL in this together.

Sincerely,

Kirk Hawthorne

Administrator/CEO

Saint John XXIII Home