To:  Residents, Family members, Volunteers and Staff

From:  Kirk Hawthorne, Administrator

Date:  10/3/22

Re:  CDC Updates, Vaccines, County Transmission levels, Outbreaks and visitation

You have likely heard that the CDC recently updated recommendations on COVID practices within healthcare facilities.  The following will outline how these updates will be handled at Saint John XXIII Home.  Please keep in mind that the Pennsylvania Department of Health has not yet updated their standards/expectations following the CDC recommendations release.  We expect this to happen over the next couple of weeks.  In the meantime, the following tweaks to OUR practices will be implemented:

VACCINES “Up to Date” status:  With the release of the “Bivalent Booster”, the CDC has updated the definition of “Up to Date”.  To be considered “Up to Date” with vaccination, you must meet ONE of the following:

• Receive the Bivalent dose.
• Received a booster within the past 2 months
• Received the Primary dose within the past 2 months.

At Saint John XXIII Home, our access to the Bivalent dose started on 9/9/2022.  At this point, our resident “Up to Date” status is 97%.  Staff “Bivalent” vaccinations are currently in process.

Not only does being “Up to Date” increase your protection from the virus, it also impacts what must occur for those of us living, working and/or visiting our facility, should you become exposed to someone who is COVID positive.  For example, residents who are NOT “Up to Date” that become exposed, will be required to quarantine for a minimum of 7 days.

COUNTY COMMUNITY LEVEL vs COUNTY TRANSMISSION LEVEL:

This standard is unchanged, however, there is a great deal of confusion regarding “how much COVID” is in our County.  Both rating systems above are determined by a formula at the CDC and Department of Health levels.  The County Community level is the rating used for the general community and non-healthcare decisions.  Healthcare facilities are directed to use the COUNTY TRANSMISSION Level to determine COVID spread probability and healthcare practices.  The County Transmission rate will typically be at a greater level than the County Community level, which is the reason for us being “more strict” than the general community.

This is simply an effort to keep our seniors as safe as possible.  (For example: Mercer County is currently in “Medium Community Level” but “High Transmission Level”)

COUNTY TRANSMISSION LEVELS:

As mentioned above, the CDC updates the County Transmission level each Thursday based on the prior week’s COVID spread in our community.  County Transmission is rated on 4 levels:  High, Substantial, Moderate and Low.  Each level has a different set of responses or requirements that we will follow at Saint John XXIII Home.  Whichever LEVEL we are following on a given day is being posted at our front entrance.  Please take a moment to become familiar with the current level and our expectations/requirements for residents, staff and visitation.  Each LEVEL defines how we will handle Mask Use, testing, visitation, etc.

At this time, Mercer County Transmission remains in HIGH status.  Mercer County has been in HIGH TRANSMISSION status for several months.  With this in mind, visitation and mask use is unchanged.

OUTBREAK STATUS:

In addition to the 4 levels of Community Transmission, we will also post “OUTBREAK STATUS” should we have COVID cases within our campus.  For our purposes, the CDC classifies an outbreak as a single case amongst residents and/or staff within a healthcare facility.  Staff members who test positive but have not worked in the prior 72 hours, would NOT create an outbreak episode for the facility.  The posting of “OUTBREAK STATUS” is to increase awareness of anyone coming in to our facility and to be diligent with your actions, social distancing and handwashing.  Again, we are simply trying to be as safe as possible to mitigate the spread. 

Should we enter an “OUTBREAK STATUS”, we will remain in “OUTBREAK STATUS” for a minimum of 14 days.  During these 14 days, additional testing requirements are in place.  We will discontinue an “OUTBREAK STATUS” only when we have successfully gone 14 days with no additional positive cases amongst staff and/or residents.

Thus far in 2022, we have had 3 positive cases amongst residents and multiple cases amongst staff.  The vaccine, mask use, handwashing and the cooperation of all involved has minimized the number of cases amongst our residents.  Thank you for continuing to be diligent.

VISITATION:

Thankfully, the times of restricting visitation are long past.  Visitation continues to be permitted throughout the facility.  We continue to require mask use when inside the facility.  The mask use requirement will evolve based on the County Transmission level.  Please monitor the posted LEVELS at the front entrance and/or beauty shop to see what will occur as the levels decrease.  Keep in mind that visitation is permitted during an “Outbreak”, however,

In addition, we have posted a “VISITATION TIP SHEET” at the front entrance and beauty shop as well.

TESTING STANDARDS:

We will continue to test residents and staff members who have been exposed and/or have signs/symptoms of COVID, regardless of the County Transmission level.  Routine/Surveillance testing frequency will be determined by the County Transmission level.   

We do not require visitors to be tested to be permitted to visit.  However, should a visitor wish to be tested, we will accommodate such, providing supplies are adequate to permit such.

ADMISSIONS, RE-ADMISSIONS, RESIDENTS OUT OF FACILITY FOR 24+ HOURS:

Testing and Quarantine requirements for:  admissions, re-admissions and resident stays out of the facility for 24+ hours.

• All residents are tested upon admission, re-admission or upon return from being out of the facility for greater than 24 hours.
• Residents who are “Up to Date” with their vaccine are then tested in 5-7 days following admission.
• Residents who are “Not Up to Date” with their vaccine, would also be placed in quarantine for 7 days, upon admission, readmission or OOF 24+ hours.  Negative COVID test on day 7, would remove them from quarantine.

THANK YOU:

On behalf of everyone at Saint John XXIII Home, we thank you for your continued support, encouragement and trust.  Should you have additional questions/concerns, please do not hesitate to ask.  Please remember to monitor our information boards at the front entrance, beauty shop window(s) and Facebook

TO: Residents, Family members, Visitors and Staff

FROM: Kirk Hawthorne, Administrator

DATE: 4/4/2022

After 2 long years of visitation restrictions, rule changes and various levels of caution, we have reached a place and point, where “loosening” restrictions seems appropriate. I want to thank everyone who has been a part of Saint John XXIII Home over the past 2 years for your cooperation, understanding, support and prayers.

Moving forward, we will continue to base our decisions on the recommendations provided by the CDC and PA-DOH. Our decision making will be based on the Community Transmission level as issued by the CDC on a weekly basis. The Community Level is for Non-Healthcare environments, which is currently classified as LOW for Mercer County. The Community Transmission level is for Healthcare facilities, which is currently MODERATE for Mercer County. Our decision making “tree” is posted on our front doors, as well as, multiple places throughout the facility for your review.

Our goal since COVID started was to “control” traffic flow within the nursing units, as much as possible. We have finally reached a point where the spread of the virus has calmed to the point to allow us to confidently resume visits throughout the facility. Effective today (4/4/2022), we will continue to encourage Roncalli visits, however, visits throughout the facility will be permitted (including resident rooms).

Please keep in mind that we will continue to require the visitation questionnaire to be completed with each visit, require mask use by staff/visitors and require “Core Principles” to be followed. Please continue to wash/sanitize your hands frequently and restrict your visit(s) if you are not feeling well.

Please understand that should we have a COVID positive case amongst staff or residents in the future, visitation processes may need to be altered. The same applies if the Community Transmission rate rises above the MODERATE level. Please monitor our postings at the Front Entrance for the “Current Status”.

Thank you again for your understanding, cooperation and support. We are all thankful that we are finally returning to some level of “normalcy”. Please do your part to help us stay on this path

EFFECTIVE: 11/16/2021

 (CMS:QSO-20-39-NH Revised 11/12/21)

COVID MITIGATION “INDOOR VISITATION POLICY”

EFFECTIVE: 11/16/2021

 (CMS:QSO-20-39-NH Revised 11/12/21)

INDOOR VISITATION WILL BE BASED ON THE FOLLOWING STANDARDS:

• Mercer County COVID Transmission Rate
• Saint John XXIII Home resident/staff vaccination/COVID status
• Visitor vaccination status

Our goal is to provide an environment that is as COVID safe as possible. We have no desire to restrict resident/family visitation, however, we do have a need to restrict visitor traffic flow, to help mitigate this virus moving forward.

ROUTINE VISITS:

1. All visitors must adhere to the Core Principles of COVID-19 Infection Prevention.
2. Visitors who are positive for COVID-19, who have symptoms of COVID-19, or meet the criteria for quarantine are NOT permitted to enter the facility.
3. All visitors will be required to complete the COVID exposure questionnaire and verify no recent exposure, with each visit.
4. We will inquire about the visitors vaccination status.  Visitors are NOT required to be tested or to provide proof of vaccination as a condition of visitation.  Visitors who are unvaccinated OR decline to disclose vaccination status will be required to wear a face mask at all times during the visit.
5. Fully Vaccinated visitors will be required to wear their mask into the facility, during transport to/from the visit but may remove the face mask during the actual visit. (staff will verify Vaccine status, copy not needed)
6. All visitations will be conducted in Roncalli Center, front patio or designated area.
7. Visitation will not be limited to day/time.
8. Visitation will not be restricted to number of visitors during visit.
9. Visitation will not require an appointment. In an attempt to minimize wait times, we request that visitors notify/call the facility prior to their visit.  This will allow staff ample time to assist your loved one to the Front Desk area.  This will also ensure that Roncalli Center is available for visits and not occupied for a resident activity/function.  We will do our best to accommodate all visitation requests.
10. Roncalli/Patio visitors will be able to meet their loved one at the front desk and proceed to Roncalli or patio for their visit. 
11. Eating/drinking during visits will be a condition of visitor vaccination status due to the mask requirements.  Fully vaccinated visitors will be permitted to eat/drink during the visit.  Unvaccinated visitors will not be able to do so, due to the REQUIREMENT to wear a mask at all times during the visit.
12. At the conclusion of your visit, we ask that you clean your visitation area and return DIRECTLY to the front desk area.
13. When the Mercer County COVID Transmission status drops to LOW STATUS, we will resume visitation throughout our facility, including resident rooms. The Country Transmission rate is posted at the front entrance of our facility and is monitored weekly.
14. The INDOOR VISIT requirements do NOT impact Compassionate Care visits as required by the PA-DOH.

SPECIALIZED VISIT ARRANGEMENTS:

1. Compassionate Care visits remain in effect.
2. End of Life visits will be accommodated.
3. COVID positive or COVID exposed residents:  While not recommended, visits may still occur.  Visitors will be educated related to the risks of such and be required to wear full PPE at all times during the visit.  By definition, these visits would need to take place within the designated “COVID ZONES”, which imposes increase risk to the visitor.

RESIDENT OUTINGS:

1. Residents continue to be permitted to participate in outings of their choice.  In most cases, Outings will NOT result in testing, isolation or quarantine.
2. Please report any possible close contacts with COVID-19 regardless of the resident vaccination status.  This could trigger a need for the facility to test the resident and/or initiate quarantine if the resident is unvaccinated.
3. Residents who develop symptoms following an outing will be tested and placed on transmission based precautions, regardless of vaccination status.

HELP US:

The potential of increased exposure exists for both the resident and visitor with ANY type of visit or outing.  Please use good judgement during your visits related to handwashing, mask use and social distancing from other residents, visitors and staff that are NOT part of your scheduled visit.  Please understand, an outbreak can originate from any individual whether vaccinated or unvaccinated.  You may feel perfectly fine and be contagious.  Please do you part to help us prevent the spread of this virus at SJ23.

To:  Residents, Family Members and Staff

From:  Kirk Hawthorne, Administrator

Date:  10/12/21

RE:  COVID outbreak update  (update #33)

It appears that the measures that we implemented to mitigate the spread of this virus from our recent outbreak, has been relatively effective.  We continue to have 6 residents recovering within our Red Zone.  Our goal is to “close” the Red Zone on Friday (10/15/21), providing no new symptoms develop. 

We have had no new positive cases amongst staff or residents since October 1, 2021.  All staff tested negative yesterday (10/11/21).  We will continue to test all unvaccinated staff 2x/week, until the Mercer County Transmission rate reaches the “LOW STATUS”.  Resident testing will be based on symptom identification and/or any possible exposure.  Similar to our resident testing standards, our vaccinated staff will no longer be surveillance tested but will be tested with any symptoms and/or possible exposures.  The above testing standards are consistent with the PA-DOH recommendations.  The focus is to test residents and staff with exposures and/or symptoms.  Should a future outbreak occur, we will resume “outbreak” testing and visitation standards.  We have also posted the above standards on our front entrance doors for your convenience.  The postings will include the facility “COVID STATUS” by unit.

We will remove our “Outbreak Status” effective today.  This will allow us to immediately resume patio visits (unscheduled) and Roncalli visits (scheduled).  Residents who remain in the Red Zone due to isolation requirements, do not yet meet the visitation standards.   The scheduled Roncalli visits will be on Tuesday/Thursday.  We will do our best to accommodate alternative visitation times that are necessary as well.  Once the County Transmission rate decreases to the Moderate Level, we will increase indoor visitation opportunities.  Basically, as community transmission decreases, the more we will “open up”.

At this time, facility wide, we have a Resident vaccination rate of 95% and a staff vaccination rate of 84%. While this is great news, we are all aware of vaccinated “break through” cases, so, caution remains necessary.  The Pfizer “booster” was provided to residents on October 7^th and will be offered to staff on October 15^th.  Of course, our goal is 100% vaccination campus wide.  As a measure of safety, we have implemented a policy that requires all newly hired staff (as of 9/7/21) to be vaccinated.  Staff members who have chosen not to become vaccinated will be required to wear an N-95 mask at all times, regardless of county transmission rate.  In addition, ALL staff is required to wear an N-95 mask during “Outbreak” AND “High transmission” status.

Please keep in mind that our community transmission rate is currently at its peak.  While we encourage visits, we ask that you wear your mask during visits and please refrain from ANY visits if you are not feeling well and/or may have been exposed.

As always, thank you for your continued support, understanding, cooperation and prayers.

Saint John XXIII Home:

COVID UPDATE:  Edition #30  (August 18, 2021)

• From:  Kirk Hawthorne, Administrator

I’m hopeful this update finds you well.

As you’ve likely heard on the news, COVID-19 cases are once again increasing across the Nation.  We continue to use the Mercer County COVID Positivity Rates to make decisions related to testing and process within the facility.  Unfortunately, Mercer County is also seeing a “spike” in cases recently.  At present, the County rate stands at 5.45% per the CDC data.

We continue to test our unvaccinated staff members are a regular basis, with the frequency determined by the County Positivity Rate.  Our most recent testing cycle was held on Monday 8/16/21.  Unfortunately, on Tuesday (8/17), for the first time since January 2021, we had a positive case identified amongst our staff.  This positive staff test is considered an “outbreak” by CDC definition.  As a result, we tested all staff and residents (vaccinated and unvaccinated) this week.  Fortunately, there were no additional positive cases identified in this weeks testing.  As you can imagine, we are monitoring everyone very closely for signs/symptoms of the virus.  As an on-going mitigation effort, we will test ALL staff again on Monday (8/23) and ALL residents on Tuesday (8/24).  As always, we will contact each resident and responsible party with your loved ones results.

Contact tracing determined that this positive case will NOT impact our visitation process, nor create “yellow/red zones” within the home, at this time.  SHOULD additional cases surface, additional mitigation efforts may be necessary. 

In the meantime, we encourage everyone to continue visiting their loved ones, through Roncalli Visits, virtual visits and/or patio visits.  As we see the spread of this virus increasing locally, PLEASE use good judgement when visiting.  IF you are not feeling well and/or have been exposed, please do not visit.  If you become ill following a visit, please notify us.  This allows us to implement mitigation efforts to help protect everyone here.  We have not required mask use by residents and family members during visits while outside, however, given the current spike we do ENCOURAGE mask use, while visiting.

We are beginning to receive information regarding the “COVID Booster”.  The final rule and the timing and process of the “booster” distribution has not yet been received. As soon as this information becomes available, we will be in touch.

Thank you for your support and understanding.  Please continue to pray for everyone at Saint John XXIII Home.  Please do not hesitate to contact us should you have questions.  –Thank You.

COVID-19 UPDATE: Edition #28

* April 30th, 2021

As we approach month 15 of COVID-19, we continue to receive regular updates, requirement/standards changes and “best practice” advice through the CDC, PADOH and LeadingAge PA. The majority of the recent updates focus on vaccinations, testing standards, personal protective equipment (PPE) and visitation standards.

The decision making process at Saint John XXIII Home, related to testing, visitation and quarantine requirements will be based on: Facility vaccination rate, Mercer County Positivity Rate and the facility outbreak status. Our desire to “open up” to the highest degree possible, while maintaining a level of safety. Keep in mind that the spread of the virus has “slowed” but it is NOT gone. This will be explained in more detail below.

VACCINATIONS: The CDC has established a targeted (goal) vaccination rate of 75% for Nursing Home/Personal Care providers. At this time, our resident vaccination percentage across our campus is 90%. We are very grateful to achieve the 90% level. In addition, through our partnership with MediRx pharmacy, we are able to continue to offer vaccines to new residents and staff. We continue to encourage everyone to become vaccinated.

TESTING STANDARDS: Surveillance (routine) testing standards continue to evolve as more is learned about the vaccination impact. Effective today, we will once again update our Staff Testing policy. The recommendation is to now base Staff testing frequency on the employee vaccination status. Moving forward we will test according to the Mercer County positivity rate (0-5% Every other week), (5-10% weekly) and (10+% twice weekly).

WHEN WE WILL TEST:

Surveillance Testing Vaccinated Residents: none

Surveillance Testing Unvaccinated Residents: none

Surveillance Testing Vaccinated Staff: none

Surveillance Testing Unvaccinated staff: Test according to Mercer County Rate (above)

Signs/symptoms present Vaccinated Resident or staff: Test and assess for quarantine.

Signs/symptoms present Unvaccinated Resident or staff: Test and assess for quarantine.

Exposure to COVID positive individuals Vaccinated Residents and staff : Monitor for S/S

Exposure to COVID positive individuals Unvaccinated Residents and staff: Test and quarantine

Facility Outbreak (positive case): 2x Weekly testing of ALL Staff and Residents potentially impacted.

2 consecutive weeks of negative results to discontinue and

Resume surveillance testing (above).

PERSONAL PROTECTIVE EQUIPMENT: While we encourage our residents to wear a mask during visits, we do not require such. We do require residents to wear a mask while off campus (if tolerated). Staff are required to properly wear surgical masks, when in the facility. Masks can be removed by staff when social distancing standards can be met, in designated breakrooms (for example lunch break). In the event of a facility outbreak (positive case), staff will be required to wear N-95 mask, goggles/shield and further protective equipment based on their role. Visitors are required to wear masks at all times.

VISITATIONS: At long last, we are making progress toward increasing family socialization opportunities. This is possible due to our vaccination percentages. Please keep in mind that it is NOT our intent to prevent family visits. Our focus is limiting the “travel” INSIDE our facility. While there is a desire for many families to “visit in their loved one’s room”, this simply is not a safe process for our facility. Our structured visitations on Wednesdays and Fridays, allows for visits to occur, while also maintaining a designated area to ensure that proper and timely cleaning is conducted. We encourage everyone to take advantage of the scheduled visits in Roncalli Center by schedule between 9am-9pm daily (724-981-3200). We fully recognize that our designated days/times may not fit within everyone’s schedule. We are willing/able to assist in making alternative arrangements if necessary.

Effective immediately, we will also implement increased visitation opportunities . In addition to the Wednesday/ Friday “structured visitation”, families of VACCINATED residents will be able to have unstructured visits outside the facility with their loved one, without the need to quarantine upon return. For example, these visits could be off campus, utilizing the front porch or taking strolls around the outside of the facility. We do ask that masks are worn during these visits and the core principles of COVID 19 are followed. Unvaccinated residents certainly have the right to have “unstructured visits” outside the facility, however, a 72 hour isolation period will be required upon return/reentry.

In an effort to streamline the “out of facility visits” process, we ask that you give our nursing department(s) advance notice of your planned visit. Our staff will be able to assist your loved one to the front lobby area for the outside visit. This will also help to decrease the waiting period and congestion at the front lobby area.

As you know, we remain diligent related to the prevention/mitigation of this virus. We have a passion to keep our residents, visitors and staff as safe as possible. With this in mind, structured and unstructured visitation will be assessed on a regular basis. IF the county rate climbs above 10% or the facility experiences an outbreak, we will alter the visitation process as a mitigation effort. We ask that everyone use good judgement with these visitation opportunities and by all means, notify us immediately if you learn of a possible exposure following your visit.

Thank you for your support, trust and understanding during these unprecedented times.

Sincerely,

Kirk Hawthorne, Administrator

VISITATION POLICY UPDATE

DURING COVID PANDEMIC

UPDATED:  3/11/2021

QSO-20-39-NH (REVISED 3/10/21)

BACKGROUND:

(for the purposes of this policy, “Nursing Home” also applies to the Personal Care units.)

• In March 2020, CMS issued memorandum QSO-20-14-NH providing guidance to facilities on restricting visitation of all visitors and non-essential health care personnel.  This led to our “lockdown status” here at Saint John XXIII Home (SJ23).

•  In May 2020, CMS released Nursing Home Reopening Recommendations, which provided additional guidance on visitation for nursing homes.

•  In June 2020, CMS also released a document on visitation, which expanded on previously issued guidance on topics such as outdoor visits, compassionate care situations, and communal activities.  This led to our patio visits and later visits inside within Roncalli Center here at SJ23.

• In September 2020, CMS released (QSO-20-39-NH) COVID VISITATION standards related to; Prevention Core Principals, Indoor visits, outdoor visits, outbreak standards, etc.  This document has been our “standard” here at SJ23 since being released.

KEY DEFINITIONS:

• FULLY VACCINATED:  Fully vaccinated refers to a person who is ≥ 2 weeks following receipt of the second dose in a 2 dose series, or ≥ weeks following receipt of one dose of a single dose vaccine, per the CDC’s Public Health Recommendations for Vaccinated Persons.

• UNVACCINATED:  Individuals who do not meet ALL standards of the FULLY vaccinated definition above.

NEWEST VISITATION UPDATE:  (3/10/21)

• In March 2021, CMS released (QSO-20-39-NH revision).  This document acknowledges the impact that social isolation may have on the well-being of nursing home residents.  It further acknowledges the progress that has been made related to the COVID VACCINATION of residents and staff members of health care facilities.  At the time of this release, SJ23 had a resident vaccination rate of >95%.  
• VISITATION will now be determined by the following:
  • COVID status of the UNIT(s) within SJ23.  (Green = visitations)
  • Mercer County COVID positivity rate. (under 10%)
  • Vaccination % of residents across our campus (greater than 70%)
  • Vaccination status of an individual resident (see unvaccinated exceptions).

** Note, CMS has removed the standard of stopping visitation solely due to the Mercer County positivity rate.  As well as, implemented standards that may be implemented should an outbreak occur at SJ23, through RISK ASSESSSMENT by unit  (nursing home, personal care, special needs). 

CORE PRINCIPLES OF COVID-19 INFECTION CONTROL:

MUST CONTINUE to be followed at all times.

• SCREENING:  of all who enter SJ23 for signs/symptoms of COVID (temperature and questions/observation for signs of COVID).
• DENIAL OF ENTRY: for those with signs/symptoms or those who have had close contact with someone with COVID infection in the prior 14 days (regardless of the visitors vaccination status).
• HAND HYGIENE:  (use of alcohol-based hand rub is PREFERRED).
• FACE COVERINGS: Required at all times regardless of vaccination status. (cover mouth AND nose)
• SOCIAL DISTANCING: at least 6’ between persons.
• VISITOR EDUCATION:  signage displayed related to expectations of visitors.
• CLEANING/DISINFECTING:  cleaning process of designated visitation areas after each visit.
• PPE USE:  proper use of PPE by staff and visitors.  (residents recommended to wear mask but not required).
• COHORTING:  facility must have a plan in place to respond to COVID cases / COVID care.
• TESTING:  Resident and Staff testing must be conducted as per testing requirements based on County positivity and facility positivity rates.

Visitors who are unable to adhere to the core principles of COVID-19 infection prevention should not be permitted to visit or should be asked to leave

INDOOR VISITATION:

SJ23 will permit INDOOR visitation for all residents regardless of vaccination status.  At this time, we will continue to offer “visitation stations” within Roncalli Center.   We have recreated our “stations” to improve the visitation experience. 

Indoor/Outdoor Visitation Standards:

• Visitation will be limited to 2 visitors per resident per visit.
• All visitors will be required to adhere to the CORE PRINCIPLES.
• Residents will be encouraged to wear masks during visits (not required).

We will continue to utilize the “scheduled visits” process to help organize the visits, overcome resident room assignment obstacles and maintain infection control standards.  In an attempt to not disrupt meal times, visitations will continue to occur between the lunch and evening meals.  We have increased the number of “stations” for visitation, to allow for multiple visits weekly for each resident.  In addition, we have removed the “barrier screens” to allow for better communication but still encourage 6’ social distancing.  This continues to be the safest way to prevent the spread of COVID-19, particularly if either party has not been fully vaccinated.  However, we acknowledge the toll that separation and isolation has taken.  We also acknowledge that there is no substitute for physical contact, such as the warm embrace between a resident and their loved one.  Therefore, if the resident is fully vaccinated, they can choose to have close contact (including touch) with their visitor, while wearing a mask and performing hand hygiene before and after the visit.  Regardless, visitors must physically distance from other residents AND staff in the facility.  Visits can be scheduled by calling 724-981-3200 between the hours of 9am – 9pm.  Our goal is to continue to move toward visitation within resident rooms.  However, keeping a focus on risk management, we will continue to restrict the location of visitation until the vaccine is more readily available within our community. 

OUTDOOR VISITATIONS:

While taking a person-centered approach and adhering to the core principles of COVID-19 infection prevention, outdoor visitation is preferred even when the resident and visitor are fully vaccinated against COVID-19. Outdoor visits generally pose a lower risk of transmission due to increased space and airflow. Therefore, visits WILL be held outdoors whenever practicable. However, weather considerations (e.g., inclement weather, excessively hot or cold temperatures, poor air quality) or an individual resident’s health status (e.g., medical condition(s), COVID-19 status) may hinder outdoor visits. For outdoor visits, SJ23 will utilize the “front porch”, as a safe outdoor space for visitation.  When conducting outdoor visitation, all appropriate infection control and prevention practices should be adhered to.

VISITATION EXCEPTIONS:   

Circumstances when visitation will be limited due to a HIGH RISK of COVID transmission.  The following scenarios will require INDOOR/OUTDOOR visitation to be RESTRICTED:

• For Unvaccinated residents:  if the Mercer County COVID positivity rate is greater than 10% AND less that 70% of SJ23 residents are Fully Vaccinated.
• For COVID positive residents:  whether vaccinated or unvaccinated, will not be permitted visitors until they have met the criteria to discontinue Transmission-Based precautions.
• For Residents in QUARANTINE:  whether vaccinated or unvaccinated, will not be permitted visitors until they have met criteria for release from Quarantine.
• VIRTUAL VISITS:  In the event that any of the above situations arise, visitation should be limited to virtual visits, telephone calls and window visits for those residents impacted.

INDOOR VISITATION DURING AN OUTBREAK

This section is a significant deviation from the prior standards

.

An outbreak exists when a new nursing home onset of COVID-19 occurs (i.e., a new COVID-19 case among residents or staff). This guidance is intended to describe how visitation can still occur when there is an outbreak, but there is evidence that the transmission of COVID-19 is contained to a single area (e.g., unit) of the facility. To swiftly detect cases, SJ23 will continue to adhere to CMS regulations and guidance for COVID-19 testing, including routine staff testing, testing of individuals with symptoms, and outbreak testing.

When a new case of COVID-19 among residents or staff is identified, SJ23  will immediately begin outbreak testing and suspend all visitation (except that required under federal disability rights law), until at least one round of facility-wide testing is completed.

Visitation can resume based on the following criteria:

•  If the first round of outbreak testing reveals no additional COVID-19 cases in other areas (units) of SJ23, then visitation can resume for residents in areas/units with no COVID-19 cases. However, SJ23 will suspend visitation on the affected unit until the facility meets the criteria to discontinue outbreak testing.  For example, if the first round of outbreak testing reveals two more COVID-19 cases in the same unit as the original case, but not in other units, visitation can resume for residents in areas/units with no COVID-19 cases.

•  If the first round of outbreak testing reveals one or more additional COVID-19 cases in other areas/units of the facility (e.g., new cases in two or more units), then SJ23 will suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak testing.

While the above scenarios describe how visitation can continue after one round of outbreak testing, SJ23 will continue all necessary rounds of outbreak testing. In other words, this guidance provides information on how visitation can occur during an outbreak, but does not change any expectations for testing and adherence to infection prevention and control practices. If subsequent rounds of outbreak testing identify one or more additional COVID-19 cases in other areas/units of the facility, then facilities should suspend visitation for all residents (vaccinated and unvaccinated), until the facility meets the criteria to discontinue outbreak testing.

NOTE: In all cases, visitors will be notified about the potential for COVID-19 exposure in the facility  (appropriate signage regarding current outbreaks within front lobby area), and adhere to the core principles of COVID-19 infection prevention, including effective hand hygiene and use of face-coverings.

VISITOR TESTING and VACCINATION

Visitor testing and vaccination will not take place at SJ23.  We do encourage visitors to be tested on their own prior to coming to the facility (within 2-3 days), however, this is not a requirement.  Similarly, we encourage visitors to become vaccinated when they have the opportunity.  During visits, the “Screening tool” has been updated to include visitor vaccination status.  While we would appreciate visitors answering the question, we will not require such as a condition of visitation.

COMPASSIONATE CARE POLICY

The changes made regarding visitation as stated in QSO-20-39-NH does not impact Compassionate Care visitation.  See Compassionate Care policy.

COVID UPDATE: Edition #27 (2/24/2021)

* By: Kirk Hawthorne

As we approach the 1 year anniversary of our “initial COVID lockdown” here at Saint John XXIII Home, we recognize that so much has changed over the past year. Yet here we are with heavy hearts, and at long last, HOPE.

Mercer County “COVID positivity rate” has dropped below 10%. As a facility, we have gone through 6 consecutive cycles of testing all staff without any new COVID cases. We have been able to vaccinate all residents and staff, who desired to be vaccinated. We continue to work through plans to vaccinate any new residents and/or staff members. As you can imagine, this is a tedious adventure, as we are not able/permitted to vaccinate on our own. Yes, we are COVID free at this time. So, while there is HOPE, we must ALL continue to practice safe standards of wearing a mask, physical distance and frequent handwashing. Please keep in mind that while the vast majority of residents and staff have been vaccinated, this does not give us the green light to simply re-open. This re-opening will be a step by step process, much of which will mirror what happens in the general community.

We will begin the transition to “Step 2 of re-opening” on March 1st, 2021.

On March 1st, 2021, we will once again test ALL staff. Providing these results bring no new positive cases, we will proceed with reopening. The “Beauty Shop” will resume services starting on March 2nd. Resident visitation will start on March 3rd, in Roncalli Center. The initial visitation schedule will be Wednesdays and Fridays, from 12:45pm to 4:45pm. You may begin scheduling visits immediately by calling the facility at 724-981-3200, between the hours of 9am-9pm.

Please remember that we will continue to require mask use at all times. Visits will be 30 minutes in duration and limited to 2 people per visit. Each visitor will be required to complete a “COVID screening questionnaire” and have their temperature taken, with each visit. We are able to accommodate 25 visits per day, however, we anticipate a high demand, so, we ask that you only schedule 1 visit per week.

As required, we will continue to test all staff on a weekly basis (Mondays). As per the direction from the Department of Health, should we have a new positive case amongst staff or residents, we will be required to return to “lockdown status” immediately. With this in mind, we ask that everyone make good decisions related to their visit. Please use caution, if you do not feel well or have potentially been exposed, please do not come in for a visit. We are excited that our residents will finally get to see their loved ones again. Thank you in advance for your patience, cooperation, understanding, support and prayers!

COVID UPDATE: 2/11/2021 – Edition #26

* By: Kirk Hawthorne, Administrator

As we migrate into 2021, the search for the new normal continues. The challenges this virus creates related to our day to day activities, providing care/services, constant testing, continuous mitigation efforts and loss of normalcy are significant. On a daily basis, the entire crew at Saint John XXIII Home, strive to provide the best care possible, as well as, search for normalcy for our residents, family members and staff members alike. We are ALL anxious to resume family visitations.

We have been fortunate to make a great deal of progress regarding COVID vaccine administration on our campus. As of today (2/11/21), 87% of our resident population has received BOTH doses of the Pfizer vaccine. An additional, 7% of the residents will receive their second dose on February 26, 2021. This is a significant step in the right direction.

As mentioned in the past “COVID UPDATES”, words can not express my/our appreciation, respect and gratitude to each and every staff member (HERO) that works at Saint John XXIII Home. The selfless acts of love, kindness and compassion, that we all witness every day is uplifting and reassuring. With that in mind, we continue to offer the vaccine to our staff members as well. Thus far, approximately 75% of the staff has been vaccinated, with more to follow.

We continue to test staff twice weekly. Yes, even those who have been vaccinated. Over the past two weeks, we have completed 350 staff tests, with ZERO staff testing positive for COVID-19. In addition, weekly resident testing has been completed. As with staff, we continue to test residents who have been vaccinated. Over the past two weeks, we have had no additional positive cases amongst our residents.

As a Country, we wait to see how the vaccination process will impact our ability to re-establish normalcy, as a healthcare entity, we are also waiting for new/updated direction to safely move forward. We have implemented the following measures, based on the current standards. On 2/10/21, our entire campus returned to a “Green Zone”, as we no longer have active COVID cases on campus. As of today, the Mercer County positivity rate has decreased to 6.7% (Yellow). Effective immediately, we will return to WEEKLY testing of staff each Monday. Providing we have no new positive cases AND Mercer County stays below 10%, we will be able to gradually resume “scheduled visitation” with family members and return “non-essential” staff (ie- Beauty shop). Again, providing we meet all of the above criteria, our goal is to resume visitation the week of February 22nd. However, if at any time, we experience a new positive case (“outbreak”), we will be required to return to lockdown status, cease visitation and resume our current testing cycle(s) based on the current rules/guidelines.

As a facility, we want to thank everyone for their continued support, encouragement and prayers. We will continue to post updates on FaceBook, facility website and in paper form, it does appear that better days are on the horizon. Be Safe and Thank you!

COVID UPDATE: 1/22/2021 (Edition #25)

(provided by- Kirk Hawthorne, Administrator)

The past few weeks have been filled with a great deal of heartache and pain, here at Saint John XXIII Home. We continue to battle this virus on a daily basis. The impact of the virus on the residents and staff members who have tested positive, ranges from being asymptomatic to death, with most cases being somewhere in between. Perhaps the greatest challenge is the speed at which symptoms change. Our staff, has been amazing, providing compassion and love throughout this entire process. We also greatly appreciate the outpouring of love, encouragement and support.

At this time, our Special Needs unit and the Personal Care unit are COVID free (Green Zones). Our nursing home currently has 48 positive cases. Those individuals who have tested positive within the nursing home, all remain in isolation (Red Zone). We continue to monitor all residents closely for signs and symptoms of COVID. Should a sign or symptom be identified, we will conduct Point of Care testing (Antigen testing) immediately. Our weekly surveillance testing of residents (non-positive) continues as well. We remain in daily contact with the PA-DOH/RRCHP/RCAT.

We have been working closely with the RRHCP/RCAT staff for contact tracing, infection prevention, zone formulations, protocol/process reviews, etc. In fact, the RRHCP/RCAT Rapid Response Infection Prevention team has been on=site the past two days. These folks are the experts and we’re gracious enough to come on-site to assist us.

In an effort to properly mitigate our current outbreak, with the direction of the RRHCP, we anticipate that our current Red Zone will remain in place through 1/31/21. This will allow the entire nursing home to “return” to a Green Zone on 2/1/2021. Please continue to utilize the virtual visit opportunities through our Activities Department.

The timing of this outbreak and the duration of isolation (Red Zone) will impact the delivery of the vaccine. Individuals that are currently positive with COVID and/or remain in isolation (Red Zone) are not permitted to receive the vaccine, due to the possibility of further spread. With that in mind, we have established additional vaccination clinic dates with CVS pharmacy. (Dates: 1/27, 2/5, 2/17, 2/26) Members of Saint John XXIII Home staff will be contacting you, regarding your loved ones vaccine “cycle”.

These are very difficult, trying and emotional times. We have many residents, family members and staff who are ill, struggling emotionally and need your prayers, love and support at this time. Please pray for all who have been inflicted with this virus and those who continue to work endlessly to mitigate it as well. Try to be safe