Visitation Plans | 10-08-2020

The Health Center at Standifer Place (HCSP) is working to enable visitation within the guidance and regulations specified by the Centers for Medicare and Medicaid (CMS) and the Tennessee Department of Health (TDOH).

On September 17, 2020 both the TDOH and CMS provided guidance and instructions on Nursing Home Visitation and Visitation Options.  While there is some difference and conflict between what measurements each uses to determine what kinds of visitation is allowed and defined as safe, HCSP is taking the following steps:

CURRENTLY IMPLEMENTED

FaceTime – HCSP has been offering since the start of the pandemic in March the ability for residents and families to communicate and see each other via phone or tablet.  If anyone would like to schedule this kind of visitation, you should contact your Social Worker or the Activities staff member on the unit of the resident.

Compassionate Care and/or End of Life Visits — HCSP has been offering since the start of the pandemic in March.  If anyone would like to schedule this kind of visitation, you should contact your Nursing Unit manager or Social Worker for the unit of the resident.

Window visitation – Effective October 5th, 2020 HCSP began allowing scheduled window visits on  Mondays, Wednesdays, and soon on Fridays.  Our Social Work staff arrange the scheduling.  Barring a COVID-19 outbreak at our campus, HCSP plans on continuing to schedule such visits as long as the weather cooperates.

PENDING IMPLEMENTATION

Outdoor or Indoor visitation – HCSP will gradually introduce indoor visitation if conditions at our facility and in Hamilton County continue to improve, and hopefully ahead of cold weather that would make outdoor visitation and window visits very difficult and/or dangerous.  At a minimum, facilities must meet both requirements defined by the TDOH and CMS which are as follows:

  • TDOH requires that a nursing facility have no confirmed COVID-19 positive test results for either residents or staff for at least 14 days before offering outdoor visitation or limited indoor visitation.
  • CMS requires that in addition to the 14 days, that the county and the surrounding counties “positivity rate” be below 10%.  The “positivity rate” measures what percentage of COVID-19 tests in the county are positive.  CMS says that facilities may then implement limited visitation “according to the core principles of COVID-19 infection prevention and facility policies.”

Given the size of our facility, the number of staff who work, go home, and come back to work, as well as the number of cases we have had, HCSP will safely and methodically introduce outdoor visitation and limited indoor visitation.  Under the assumption we meet and continue to meet these 2 criteria, HCSP is setting plans to begin limited indoor visitation and outdoor visitation (weather permitting) by November 2nd.

Additional updates will be posted to our website each Friday afternoon between now and then.  Contact your Social Worker and/or Nurse Unit manager or Asst Unit Manager with any questions.  We look forward to having us all together again.  Let’s work together to make all of our communities a safe place for everyone!  Masks, sanitized hands, and social distancing are everyone’s responsibility and everyone’s best and simplest tools to stop the spread of this disease!

Instructions for Safe Visitation – Infection Control

Effective immediately, Standifer Place is restricting entry into each of our resident buildings (Hamilton Terrace, Dalton Place, and Standifer Place Assisted Living) for any visitation that is not medically necessary.

Our normal visiting hours have been suspended until further notice.  These restrictions will be reviewed on a weekly basis until concerns with the Corona Virus are resolved.

We are also taking preventative measures, completed on a daily basis, with all facility employees, contractors, and consultants whose entry into our facility is required to meet residents’ care needs and to keep residents safe.

We greatly appreciate your patience as we work to best provide care and a safe environment for all our residents.  Standifer Place is happy to assist in providing alternate means of visiting via phone and internet based communication.  Questions/concerns can be addressed by calling our facility at 423-490-1599.

Specifics on Restricting Individuals from Entering our Building 

Standifer Place is taking the following actions to help prevent the entry of COVID-19 into our facility whether or not it has been found in the surrounding community.

  1. Allow entry to only individuals who need entry.
  2. Restrict activities and visitors with potential for exposure.
  3. Actively screen individuals entering the building and restrict entry to those with respiratory symptoms or possible exposure to COVID-19.

#1 Restrict entry to only individuals who need entry, such as:

  • Facility employees, contractors and consultants who are needed to keep the operations running and assure the residents’ needs are met.
  • Government officials who in their capacity require entry (e.g., CDC or public health staff).
  • Immediate families or friends who need to visit for critical or time sensitive reasons such as end of life related visits, complete medical authorizations, etc. These visitors should be instructed to limit their movement within the facility.

#2 Restrict activities and individuals with potential for exposure, including:

  • Visitors, when there are any confirmed COVID-19 cases in the surrounding community. This does not apply to workforce needed to keep the operations going and to meet resident needs.
  • Other visitors for routine social visits, tours with prospective residents or their families, and outside group activities (e.g., school groups or bands, etc.).
  • We have canceled group activities and activities that take residents into the community to public places particularly with large gatherings, such as mall, movies, etc. (note: this does NOT apply to residents who need to leave the building for medical care such as dialysis, medical visits, etc).

#3 Actively screening all individuals entering the building, including employees, contractors, volunteers, visitors, new admissions, government officials, and health care professionals. The screening process includes asking individuals for:

  • Respiratory symptoms (fever, sore throat, cough and new shortness of breath);
  • International travel within the last 14 days to areas where COVID-19 cases have been confirmed.
  • Anyone who has worked in another health care setting with confirmed COVID-19 cases (this may change as COVID-19 spreads in your community)
  • Alcohol-based hand rub (ABHR) stations are setup immediately inside the main entryways with signage reminding people to wash before entering.

Reasons Standifer Place is Restricting Individuals from Entering our Building 

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.

The CDC has done a careful review of the death rate in the elderly, especially those with dementia or chronic diseases. Experts are recommending we take action to limit individuals from entering our building and to ensure sick employees stay home.

Early data shows that

  • The mortality rate for people over 80 in the general population is 15% in China.
  • The World Health Organization report estimates the mortality rate at 21.9% for those over 80.
  • At the nursing home in Washington state, there have been 50 residents who have tested positive for the COVID-19 virus. As of March 9, 2020, 19 of those have died. This is a high death rate.

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 visitation.

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 during this time.  Our residents’ health and safety are our top concern, and we are committed to doing everything we can to protect them.

Please feel free to contact us with any questions at 423-490-1599. Please make sure we have your latest contact information.  Thank you for supporting these efforts.

Sincerely,

Dave Boozer
Administrator
daveboozer@standiferplace.org