Frequently asked questions for our patients, residents and visitors:
What changes have been made as the COVID-19 pandemic continues? (March 23, 2020)
As officials made clear that we are fighting a pandemic, we agree that the COVID-19 virus is a critical issue that requires strong focus and attention, and we have been working on this for several months. Our Medical Directors, Post Acute Care Hospitalists, Team Physicians and Nurse Practitioners are regularly updated on the COVID-19 clinical measures and monitoring that HCR ManorCare is taking in our facilities.
In addition to the precautionary measures we have in place to protect the safety and health of patients, employees and authorized visitors, we are:
- Following our enhanced COVID-19 risk admission screening which remains in place for all locations that are currently accepting patients.
- Patients who screen positive for any risk factors go through additional medical screening for final review before an admission can be approved.
- Admission holds will be put in place any time a facility has a Person Under Investigation (PUI), presumptive case, or confirmed case is identified as a potential risk. Testing for COVID-19 is not criteria in itself for an admission hold, but is taken into consideration.
- We are continuing our restricted visitation policy which includes:
- Visitors are restricted with the exception of compassionate care and end-of-life situations.
- All outside vendors have been restricted with the exception of those that are required for immediate health and life safety measures.
- Non-Critical Medical Provider Restrictions are also in place.
- We are continuing our monitoring and screening processes which include:
- Minimum of daily temperature checks on all employees, patients and authorized visitors
- Minimum of daily symptom monitoring (cough and/or dyspnea) on all employees, patients and authorized visitors.
We will continue to assess our protocols and adjust as needed to meet our goal of reducing the spread of this dangerous virus.
What visitation restrictions have you implemented?
Following a declaration of a State of Emergency by the President March 13, 2020, all of our skilled nursing centers and assisted living communities will be restricting all visitors, volunteers and non-essential health care personnel except for certain compassionate care situations, such as end-of-life situations.
Beginning March 14, 2020, we implemented these restrictions:
- All visitors will have limited access to our facility (only visiting the resident’s room or location designated by our care team) and must abide by our screening and monitoring processes. Please contact our center before visiting.
- Cancel all group activities and communal dining. Where group engagement is required, we will adhere to the social distancing guidelines of no less than 6 feet.
- Continue our active screening of residents and health care personnel for respiratory symptoms including checking temperatures for a fever.
We sincerely apologize for this extreme inconvenience, but we must abide by these guidelines and implement the most stringent precautions possible to protect everyone. We will do everything possible to ensure your loved one’s safety and make every opportunity to help you communicate with them during this time.
Why are you restricting individuals from entering your center or community?
The current COVID-19 outbreak situation means that it is critical that we take every precaution possible. We must prevent this virus from entering our center. Protecting our residents’ health and safety is our top priority.
Experts are recommending we act to limit individuals from entering our centers and communities and to ensure sick employees and visitors stay home.
There is a risk that people who appear healthy will enter nursing homes and infect residents. Studies of past viral epidemics where recommending prevention was delayed were not effective. These studies show that the sooner we limit interactions with each other and wash your hands frequently, virus spreads more slowly.
These facts have led many to recommend severe limitations on visitors. This describes why we have taken this action
We hope this explains to you why we are asking people to limit their visits. This may prevent you from physically seeing your family member or friend and we will make every effort to help you communicate with them. Our patients’ and residents’ health and safety are our top concern. We are committed to doing everything we can to protect them.
Why are we taking such precautionary measures?
We are taking these precautions to protect you, our patients and our staff. We realize it may be an inconvenience and concerning, but it is the right thing to do to ensure everyone’s safety. We are taking a thorough and cautious approach to reducing the risk of transmitting flu, cold and Corona virus to our patients and staff.
What should visitors do?
Please let us know if you are experiencing any cold or flu like symptoms. This would include a dry cough, shortness of breath, fever, aches or chills. If you are experiencing any of these symptoms, we ask that you refrain from visiting today so we can avoid passing on any viruses to our patients. We are happy to keep you updated about your loved one and connect you with them as well while you recover.
Why are we asking to take your temperature?
The CDC has advised health care facilities such as ours to take additional precautionary measures to help ensure the safety of our patients and staff. In addition to our regular infection control precautions we implement every year during flu season, we are taking the temperature of all patients, staff and visitors. This is the best way to prevent the spread of infection.
Should I be concerned?
We do not feel you should be concerned, these efforts are intended to err on the side of precaution and make sure that we maintain a healthy environment for all. We have systems in place to help prevent the spread of infection. This is very important to protect our patients. We will continue to update you, but in the interim, we remind you to take the simple precautions, such as:
- Cover your nose and mouth with a tissue when you cough and sneeze. Throw the tissue in trash after you use it.
- Wash your hands often with soap and water for no less than 20 seconds, especially after you cough or sneeze. Alcohol based hand cleansers are also effective.
- Try to avoid contact with sick people.
- Stay home if you do get sick, and limit contact with others so you don’t infect them.
- Avoid touching your eyes, nose or mouth. Germs spread this way.
Why are you asking for my contact information?
As a precaution, we are ensuring contact information for family members and resident representatives are up-to-date should we need to contact you.
Should families who are worried move their loved ones out of skilled nursing centers or assisted living communities?
No. Moving the elderly or frail is risky and often has long-lasting impacts. Research around natural disasters and other emergency events has proven this over time. CDC does not currently recommend transferring residents either home or to the hospital.
How concerned are you for skilled nursing center or assisted living residents?
Just like the flu, we know that the frail and elderly are especially susceptible to this virus. That’s why we are in close communication with our local health department, CDC and CMS to ensure we have the latest information and resources available.
What face mask protocols are you implementing?
Per CDC engineering and administrative guidelines we are prioritizing the use of unexpired FDA-cleared surgical masks and Personal Protective Equipment (PPE) for all of our healthcare providers in procedures where CDC guidelines require them. Masking of health care providers who are not themselves contagious for routine patient care has not been demonstrated to decrease the risk of spread.
Are you having trouble getting things like masks and gowns?
Long term care providers are having some of the same difficulties as other health care providers getting masks and gowns. Providers should contact their state and local health departments if they are unable to place orders for equipment they need. It’s important to note that CDC does not recommend masks for the general public at this point.
What activities are you doing to help reduce social isolation during restricted visitations?
As part of our continued efforts to decrease the risk of spread of COVID-19 to our patients and in response to federal mandates, we are currently suspending non-essential group activities including group dining and other social activities in our centers, as well as group outings. The activity and recreation department will continue to provide one-to-one Programming to patients who fit the criteria and offer friendly visits to all other patients within the center. The activity and recreation department will also continue to encourage patient self-initiated leisure pursuits. Friendly visits will be related to the patient’s past and current interest. The activity and recreation department will continue to provide and offer patients with activities and leisure pursuits of interests, and opportunities for independent and individual activity involvement through this time of additional needed support.
Who are the essential personnel allowed in facilities?
Essential personnel not only include our skilled nursing and medical team members, but all employees who work in our centers/communities. We all have essential roles, even if those roles are not direct patient care. We are all able to help to keep the facility maintained and clean, help patients maintain their recovery regime, help patients stay engaged and in contact with the families, answer call bells, or assist in meal set up. In addition during these critical times, we are all needed to support and back up our nursing and medical teams by helping do things that do not require a license and certification.
I appreciate all you do to assist in our patients healing and maintaining their quality of life throughout their stay with us.
How can I stay connected with my loved one who is one of your communities or center?
We are currently working on technology options for our patients and residents to stay more connected to their loved ones. In the meantime, we are encouraging sending mail, email or making phone calls. Our staff can also help you connect via phone, facetime or skype.
CDC Frequently asked Questions
(sourced from CDC.gov):
What is a novel coronavirus?
A novel coronavirus is a new coronavirus that has not been previously identified. The virus causing coronavirus disease 2019 (COVID-19), is not the same as the coronaviruses that commonly circulate among humans and cause mild illness, like the common cold. Patients with COVID-19 will be evaluated and cared for differently than patients with common coronavirus diagnosis.
What is the source of the virus?
Coronaviruses are a large family of viruses. Some cause illness in people, and others, such as canine and feline coronaviruses, only infect animals. Rarely, animal coronaviruses that infect animals have emerged to infect people and can spread between people. This is suspected to have occurred for the virus that causes COVID-19. Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS) are two other examples of coronaviruses that originated from animals and then spread to people.
How does the virus spread?
This virus was first detected in Wuhan City, Hubei Province, China. The first infections were linked to a live animal market, but the virus is now spreading from person-to-person.
The virus that causes COVID-19 seems to be spreading easily and sustainably in the community (“community spread”). Community spread means people have been infected with the virus in an area, including some who are not sure how or where they became infected.
Can someone who has had COVID-19 spread the illness to others?
The virus that causes COVID-19 is spreading from person-to-person. Someone who is actively sick with COVID-19 can spread the illness to others. That is why CDC recommends that these patients be isolated either in the hospital or at home (depending on how sick they are) until they are better and no longer pose a risk of infecting others.
How long someone is actively sick can vary so the decision on when to release someone from isolation is made on a case-by-case basis in consultation with doctors, infection prevention and control experts, and public health officials and involves considering specifics of each situation including disease severity, illness signs and symptoms, and results of laboratory testing for that patient.
Current CDC guidance for when it is OK to release someone from isolation is made on a case by case basis and includes meeting all of the following requirements:
- The patient is free from fever without the use of fever-reducing medications.
- The patient is no longer showing symptoms, including cough.
- The patient has tested negative on at least two consecutive respiratory specimens collected at least 24 hours apart.
Someone who has been released from isolation is not considered to pose a risk of infection to others.
Can someone who has been quarantined for COVID-19 spread the illness to others?
Quarantine means separating a person or group of people who have been exposed to a contagious disease but have not developed illness (symptoms) from others who have not been exposed, in order to prevent the possible spread of that disease. Quarantine is usually established for the incubation period of the communicable disease, which is the span of time during which people have developed illness after exposure. For COVID-19, the period of quarantine is 14 days from the last date of exposure, because 14 days is the longest incubation period seen for similar coronaviruses. Someone who has been released from COVID-19 quarantine is not considered a risk for spreading the virus to others because they have not developed illness during the incubation period.
Can the virus that causes COVID-19 be spread through food, including refrigerated or frozen food?
Coronaviruses are generally thought to be spread from person-to-person through respiratory droplets. Currently there is no evidence to support transmission of COVID-19 associated with food. Before preparing or eating food it is important to always wash your hands with soap and water for 20 seconds for general food safety. Throughout the day wash your hands after blowing your nose, coughing or sneezing, or going to the bathroom.
In general, because of poor survivability of these coronaviruses on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.
Can the virus that causes COVID-19 be spread by touching other surfaces?
It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads.
Will warm weather stop the outbreak of COVID-19?
It is not yet known whether weather and temperature impact the spread of COVID-19. Some other viruses, like the common cold and flu, spread more during cold weather months but that does not mean it is impossible to become sick with these viruses during other months. At this time, it is not known whether the spread of COVID-19 will decrease when weather becomes warmer. There is much more to learn about the transmissibility, severity, and other features associated with COVID-19 and investigations are ongoing.
How can I help protect myself?
There is currently no vaccine to prevent coronavirus disease 2019 (COVID-19). The best way to prevent illness is to avoid being exposed to this virus. However, as a reminder, CDC always recommends everyday preventive actions to help prevent the spread of respiratory diseases, including:
- Avoid close contact with people who are sick.
- Avoid touching your eyes, nose, and mouth.
- Stay home when you are sick.
- Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
- Clean and disinfect frequently touched objects and surfaces using a regular household cleaning spray or wipe.
- Follow CDC’s recommendations for using a facemask.
- CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory diseases, including COVID-19.
- Facemasks should be used by people who show symptoms of COVID-19 to help prevent the spread of the disease to others. The use of facemasks is also crucial for health workers and people who are taking care of someone in close settings (at home or in a health care facility).
- Wash your hands often with soap and water for at least 20 seconds, especially after going to the bathroom; before eating; and after blowing your nose, coughing, or sneezing.
- If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol. Always wash hands with soap and water if hands are visibly dirty.
What should I do if I had close contact with someone who has COVID-19?
Close contacts should monitor their health; they should call their healthcare provider right away if they develop symptoms suggestive of COVID-19 (e.g., fever, cough, shortness of breath).
Does CDC recommend the use of facemask to prevent COVID-19?
CDC does not recommend that people who are well wear a facemask to protect themselves from respiratory illnesses, including COVID-19. You should only wear a mask if a healthcare professional recommends it. A facemask should be used by people who have COVID-19 and are showing symptoms. This is to protect others from the risk of getting infected. The use of facemasks also is crucial for health workers and other people who are taking care of someone infected with COVID-19 in close settings (at home or in a health care facility).
What are the symptoms and complications that COVID-19 can cause?
Current symptoms reported for patients with COVID-19 have included mild to severe respiratory illness with fever1, cough, and difficulty breathing.
Should I be tested for COVID-19?
Call your healthcare professional if you feel sick with fever, cough, or difficulty breathing, and have been in close contact with a person known to have COVID-19, or if you live in or have recently traveled from an area with ongoing spread of COVID-19. Your healthcare professional will work with your state’s public health department and CDC to determine if you need to be tested for COVID-19.
Can a person test negative and later test positive for COVID-19?
Using the CDC-developed diagnostic test, a negative result means that the virus that causes COVID-19 was not found in the person’s sample. In the early stages of infection, it is possible the virus will not be detected.
For COVID-19, a negative test result for a sample collected while a person has symptoms likely means that the COVID-19 virus is not causing their current illness.