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For information about our response to COVID-19, please click here.

For an update specific to Arbour Square in West Chester, Pennsylvania, please click here.

Re-opening Implementation Plan

 

Arbour Square at West Chester (“the Community”) reopening Implementation Plan (“the Plan”) will comply with the Order of the Secretary of the Pennsylvania Department of Health Directing Testing at Long-Term Care Facilities, issued June 26, 2020.

The Plan will be posted on the Community’s website and be available to residents, families, and advocates such as the Ombudsman and the Department of Human Services (DHS).  The Community will halt the reopening steps at any stage of the reopening plan if Governor Wolf’s Reopening Plan is reverted to the Red Phase.  Chester County must be in the Yellow or Green Phase to move through the reopening process.  If at any point in the process, there is a new facility onset of a case of COVID-19 the Community will go back to the preopening plan and restart the 14 days once there is no new facility onset of COVID-19.  The Community will then start the Plan with Step One, then Steps Two and Three following the criteria as stated in the Order.

Testing:

The community will complete a universal base line testing for all residents, team members and professional staff who treat residents on a regular basis within the community by July 31, 2020.  The only exception to this will be one team member that tested positive in the past.  Any resident or staff that was tested after June 12th will not be required to obtain a new test.  If a resident refuses the testing or is unable to be tested, they will be quarantined within their apartment for a period of 14 days starting at the time other residents are tested and only permitted to leave for a medical emergency.  Any employee who has not been tested or refuses to be tested by July 31st will be suspended and not permitted to return to work until such time as they produce Covid-19 testing results.

The community has a relationship with Atlantic Diagnostic Laboratory (ADL) which is licensed to perform testing in PA and will process all specimens obtained in-house.  Resident testing will all be processed through this lab.  Employees have the choice of using the ADL laboratory or seeking testing at any other testing site of their choice.  The community also has an additional relationship with Evergreen Laboratory (licensed to perform testing in PA) and if ADL is unable to test for any reason then Evergreen Lab will be utilized.

Staff performing the test will wear proper PPE and submit the specimens to ADL with a lab slip, prescription and copy of insurance cards.  ADL laboratory picks up the specimens from the community and places the results on a portal that can be accessed by designated staff.  Residents, staff, and families will be notified of the test results.

If, at any time, a resident presents with potential Covid symptoms, they will be tested within 24 hours. The resident will be presumed to be positive and quarantined for a 14-day period.  If a resident or staff has a known exposure, they will be quarantined for a 14-day period.  If the community experiences an outbreak, the community will be prepared to universally test all residents as stated above.

Actions to cohort or isolate residents diagnosed with Covid:

If a resident presents with symptoms in personal care, they will be immediately quarantined to their rooms and a Covid test will be administered within 24 hours. If any resident(s) test positive, they will remain in their room until 20 days following the date of last symptoms.  Designated staff will provide care to positive resident(s) and no other negative residents for all shifts.  If the resident must leave the room for a medical emergency, they will use a path of least exposure.  Prior to leaving the room, a staff member will ensure that the hallways and areas are clear of all other staff and residents.  The positive resident will be in full PPE and escorted by the designated care staff also in full PPE on the designated path.  Following the resident’s departure, the path will be sanitized and fogged.   The community will work with the local Serv Pro office to assist in the cleaning of the room.

After the resident has been quarantined for the appropriate time from the date of their last symptom, the resident’s rooms will be disinfected and sanitized as well as fogged.

If a resident presents with symptoms in memory care, they will be immediately quarantined to their rooms and a Covid test will be administered within 24 hours.  The resident will be assigned 1:1 caregiver to provide care and assist with having them remain quarantined in their room.  If any resident(s) test positive, they will remain in their room until they are symptom free for20 days.  Designated staff will provide care to any positive memory care resident(s) and no other negative residents for all shifts.  If the resident must leave the room for a medical emergency, they will use a path of least exposure.  Prior to leaving the room, a staff will ensure that the hallways and areas are clear of all other staff and residents.  The positive residents will be in full PPE and escorted by the designated care staff also in full PPE on the designated path.  Following the resident’s departure, the path will be sanitized and fogged.

If more than two resident tests positive in MC, we will contract with Serv Pro to place a temporary wall over MC with a zipper.  The neighborhood will be set up with negative air pressure and air scrubbers.  Decontamination areas will be constructed, and proper PPE will be available with appropriate trash receptacles.

After the resident has been quarantined for the appropriate time from the date of their last symptom, the resident’s rooms will be disinfected and sanitized as well as fogged.  The community will work with the local Serv Pro office to assist in the cleaning of the room.

For a shared MC apartment, if one resident is positive then the roommate will be moved to a private room until such time as they are safely able to return to that apartment.  If there is no open MC apartment, that resident will be placed in a personal care apartment with a 1:1 caregiver.

Alert signs will be placed on the door of any resident who is positive directing others not to enter the room and report to administration.  A cart with full PPE will be assembled at each door of a positive resident for staff to be able to properly don, doff and dispose of all PPE while providing care.  Staff will be monitored frequently for the proper donning and doffing of PPE and infection control practices.

Dining Services will prepare meals utilizing disposables and deliver to the neighborhood.  The designated care staff will deliver the meal to the resident apartment.

Mandatory Reporting:

Once the community has completed Universal testing, the results will be reported to the Department of Human Services.  The community will continue to submit the tracking form ongoing with all testing results to the DHS headquarters.   Any new cases will be reported within 24 hours by the Executive Director or designee.

Staffing:

The community is currently staffed adequately with permanent employees.  In the event of a staffing shortage, we would work with sister communities to have staff transfer to our location temporarily for assistance.  We also maintain contacts with three staffing organizations who can provide additional staff upon request.

In the event the community is unable to provide adequate staffing levels, Blue Harbor and Merrill Gardens, the management company will be notified so that they may provide additional assistance to the community.

Visitation:

Only essential personnel will be permitted into the community including physicians, home health nursing, therapy staff, hospice staff, regulatory personnel, and emergency vendors for repairs.

Any visitor entering the community will complete the screening for fever or symptoms and wash their hands appropriately with hand sanitizer.  Any visitor that has potential symptoms or exposure will not be allowed to enter the community.  Visitors must wear a mask when in any area of the community.

The community will continue to request telemedicine visits when possible to avoid resident exposure.  We have also narrowed the number of providers entering the community by working closely with one hospice and therapy/nursing provider to allow us consistent providers limiting their exposure to other communities.

All deliveries and packages are left outside of the community by vendors and families.  Packages are sanitized prior to delivery to a resident room.

Infection Control:

Stringent infection control practices to remain in place during this pandemic.

PPE levels will be maintained through continued purchases to provide adequate PPE for day to day infection control practices or handle an outbreak. Blue Harbor/Merrill Gardens continues to also have a supply of PPE that can be shipped to communities when a need arises.

Continued training and monitoring of staff on handwashing, preventing the spread of infection, proper use of PPE and donning and doffing PPE.

Staff and resident to have screening daily for fever and Covid symptoms.  Staff are screened at the start of their shift and if they are experiencing symptoms, have a temp greater than 100.4 or have had an exposure will be excused from work.

Staff to complete the vacation questionnaire when submitting a vacation request.  Upon return from vacation, all staff will remain quarantined for a 72-hour period and require a negative Covid test result in to return to work.

Essential visitors entering the community will be screened as well and if they report symptoms, fever, or exposure at another community or personally, then they will not be permitted access to the community. Vendors and contractors will agree to the requirements of the Covid 19 checklist.

Universal masking will be required for any person entering the community and for residents leaving their apartment unless they are medically unable to wear a mask.

Blue Harbor enhanced cleaning protocols will remain in effect and weekly we will use the fogger to sanitize all hallways, common areas, offices, and stairwells.

New move-ins will be required to have a negative Covid test within 5 days of their move in date.  They will remain isolated in their apartment for 14 days and a second Covid test will be obtained between day 11 and 13.  They will have the moving personnel scheduled a time with the community to ensure that we have cleared a path to avoid other residents.  Following the move in, the hallways accessed will be sanitized and fogged.

Re-opening Plan:

Step One:

The community will have completed the universal testing, reported the results to DHS and wait the designated 14 days.

During this time there will be no changes to the visitation plan.  Meals will continue to be served to residents in their apartments in personal care.  For those residents in personal care designated at risk with meals, they will be brought to the dining room and placed at separate tables with staff present for supervision.

Memory Care residents will have meals in the dining room while maintaining social distances with supervision.  Activities will also be done in groups with social distancing being maintained.

Residents may enjoy a fresh air walk outside while remaining socially distant from others.     All residents must wear a mask until they are outdoors.

Activities for personal care will be done in small groups at the resident’s doorway or outside on the roof top deck weather permitting.   Residents exiting their apartment to the roof top deck will wear a mask.

Currently, the only open communal dining is for Independent Living residents with multiple seating’s and one resident per table (couples may dine at the same table).

No crossover is permitted between Independent Living, Personal Care and Memory Care.

Outings will not be permitted and any resident that leaves the building for an outing that is not of medical or emergency nature will be required to have Covid test prior to their return.

Step Two:

Following the 14-day period from the day of testing and with no new cases, the community will notify DHS that they are moving in to step two.  If there is an outbreak at any time, the community will revert to the pre-opening plan.

Communal dining at dinner time will resume for personal care resident with multiple seating’s and one person per table (couples may dine together).  Residents may choose to dine in the second floor Runway Café or the Grille on the first floor and be assigned seating times.  Resident may opt out and continue to receive room service.

Memory care will continue with communal dining and activities while socially distancing the residents.

Activities will start with second and third floor separated and no more than 10 residents at each activity.  Resident’s will wear masks and practice social distancing when participating.  An activity log will be maintained to monitor attendance at all activities.

Visitation will be permitted at this time and be conducted outside (weather permitting).  All visits will be by appointment only.  Visiting times will be from 10 am to noon, 1 pm to 4 pm and 6 pm to 7 pm.  No more than two adult family members or one adult and two children may visit at any one visit.  All visitor must wear a mask except for children under the age of 2 and be able to practice social distancing.  Any family violating the rules will be asked to leave the property immediately.  Tables will be set up with sneeze guards diving the space between the resident and the family member(s).  Each visitor will be screened for symptoms and fever prior to the visit and asked to wash their hands.

In the event of inclement weather, visits will be held in the Discovery Room, Pub and Game Room.  Each room will be sanitized and sprayed between visits.

Visiting will not be permitted in resident rooms unless the resident is on hospice and unable to leave the room.

If residents have a doctor’s appointment, they will utilize our driver and a family member may meet them at the appointment.  Our driver will return the resident to the community.  The vehicle will be disinfected and sanitized after each trip.  One resident per ride only (couples may go together).   Resident will continue to be encouraged to utilize telemedicine when possible.

Salon services will be made available to our residents with the use of one stylist with a negative Covid test.  One resident at a time in the salon.  The resident will wear a mask from the time they leave their room until they return.  The stylist will wear a mask when in the community.   There are three salons within the community and the stylist will ensure that she uses the Memory Care Salon for the MC residents, Personal Care Salon for the PC resident and Independent Living Salon for the IL residents.  She will not travel between the salons on any given day but remain in one salon each day.  The salon will be sanitized and disinfected between each customer.

Outings will not be permitted and any resident that leaves the building for an outing that is not of medical or emergency nature will be required to have Covid test prior to their return.

Step Three:

After moving in to step two and remaining there for a period of 14 days with no positive cases, the community will notify DHS of the plan to move in to step three.

Dining in Step 3 will include the opportunity to attend breakfast and lunch in the Runway Café or the Grille.  Residents will continue to be seated one per table with staggering mealtimes (couples may dine together).

Activities will continue to be separated for the second and third floor and allow as many as a room can accommodate while socially distancing.  We will also offer scenic bus rides for personal care residents and staggering the seating for social distancing.

Memory Care will continue with dining and activities while social distancing the residents.

Following each event or bus ride the room/bus will be sanitized and disinfected.  Activity logs will be maintained for every activity or event inside or outside of the community that involves a group activity.

Visitation is allowed both indoor and outdoor with the same protocol as step two.  No visitors will be permitted in a resident’s room unless the resident is on hospice and unable to leave the room.  Visitors will practice social distancing, be screened on admission, and wear a mask.  All rooms will be disinfected and sanitized after the visit.

Salon services continue with the same restrictions in place for step two.

We will not be offering social outings off the property at this time.  Residents wishing to attend an appointment outside of the community may go with a family member and they will follow the Blue Harbor/Merrill Gardens outing protocol.

If at any time, there is a positive case of Covid, DHS will be notified and the community will move to the pre-opening protocol and follow the steps outlined above to move through the process of step one, two and three.