COVID-19

Spring Oak of Toms River
COVID-19 Outbreak Plan
Rev. 10.07.2020
In response to the current Covid-19 Public Health Emergency, New Jersey Department of Health is requiring all Assisted Living facilities to develop and implement an outbreak plan as required by N.J.S.A 26:2H-12.87. This plan pertains to Spring Oak Assisted Living of Toms River located at 2145 Whitesville Road, Toms River, NJ (NJ ALF License #65A113). It is a collaboration of lessons learned through out our first outbreak of COVID-19 (March 31,2020-June 2, 2020) and our recent outbreak (August 27, 2020-September 30, 2020) new and existing policies and procedures, and new initiatives being put into place.
The information provided in this COVID-19 Outbreak Plan accurately reflects the policies in effect at Spring Oak of Toms River Assisted Living Facility (‘the community”) for the safe care and treatment of residents during the COVID-19 pandemic.
This plan represents a summary of our policies and procedures that have been implemented at the community to mitigate the spread of COVID-19 and control or prevent an outbreak.
1. SCREENING, TESTING and COHORTING
 Residents, team members and visitors will be screened for symptoms of COVID-19 by completion of daily screening criteria as per guidelines. The completed screening logs will be retained for visitors and staff and kept on file in Executive Director’s (ED’s) office. The screening logs for residents will be maintained in the electronic chart/eMar and managed by the Director of Nursing (DON).
 Residents with any suspected respiratory or infectious illness will be tested for COVID-19 and checked on every shift (including documentation of respiratory rate, temperature, and oxygen saturation) in order to quickly identify residents who may require transfer to a higher level of care.
 The community has partnered with Ridgewood Labs to provide regular testing for COVID-19 to residents and team members.
 The community will conduct testing in intervals as recommended by the CDC, NJ Department of Health and the Ocean County Health Department. Testing will include community wide testing of all residents and team members, followed by weekly testing of residents and team members until 14 days have passed with no further positive test results and during this 14 day period, 2 rounds of weekly testing have been conducted.
 Residents under investigation for or with active COVID-19 infection confirmed by testing, or those residents who are recovering from COVID-19 infection, have been separated from residents who are not infected or have unknown infection
status by remaining in their apartments until such time as they are not exhibiting symptoms and have been deemed recovered by the PCP.
 A resident cohort plan is developed and monitored by the Director of Nursing and implemented based on results of any of the following: surveillance testing, temperature checks, and symptom screening in accordance with the CDC recommendations. Multiple resident positives in the community at one time may have us put our cohort area into effect depending on circumstances, staffing and PPE availability. We are able to cohort up to 10 residents at this time.
 The community has implemented a staffing plan to limit transmission. This plan includes:
 Dedicated staff members to attend to COVID-19 positive residents.
 Limited rotation of staff between floors or wings during the period they are working each day when active COVID cases are in the community.
 Minimize the number of staff interacting with each positive or suspected resident.
 COVID-19 positive team members will be directed to self-quarantine at home.
 All staff have been educated on the Cohort Plan.
2. INFECTION PREVENTION AND CONTROL
 The Executive Director is designated to address and improve infection control based on public health advisories (CDC and DOH) and ensures the community is focused on activities dedicated to infection control.
 The community will ensure all team members, residents & visitors will receive infection prevention and control training.
 The Executive Director in collaboration with the Director of Nursing maintains a line list of all residents who have been confirmed to meet clinical criteria of presumed COVID-19 including testing and results and reports to department of health as required.
 All cleaning products used within the community at this time for disinfecting are documented as able to kill all strains of Corona Virus. All frequently touched areas are cleaned multiple times per day by facility housekeeping staff utilizing an intensified cleaning schedule.
 All staff, residents and visitors will be in-serviced on proper hand hygiene, infection control protocols, PPE requirements and cover your cough.
 Hand sanitizing stations and hand hygiene signage are strategically placed throughout the community.
3. PERSONAL PROTECTIVE EQUIPMENT (PPE)
 The community has a plan for adequate provision of PPE, including types that will be kept in stock, duration the stock is expected to last.
 The community has initiated measures for procuring their own PPE supply (e.g., facemasks, respirators, gowns, gloves, and eye protection such as face shield or goggles) across all PPE items.
 The community has existing contracts or relationships with PPE vendors to facilitate the replenishment of stock.
 The community has a contingency plan to address PPE supply shortages and has secured and will maintain a 2 month supply of PPE.
 Resident Care Staff has been trained on selecting, donning and doffing appropriate PPE and demonstrate competency of such skills during resident care.
 For residents under suspicion or with confirmed Covid cases, signs are posted immediately outside of resident rooms indicating appropriate infection control and prevention precautions and required PPE in accordance with CDPH guidance.
 Necessary PPE is immediately available outside of the resident room when there are units with separate cohort spaces for both COVID-19 units and in other areas where resident care is provided.
 Trash disposal bins are positioned as near as possible to the exit inside of the resident room to make it easy for staff to discard PPE after removal, prior to exiting the room, or before providing care for another resident in the same room when there are units with separate cohort spaces for both COVID-19 positive and negative residents.
 If there are COVID-19 cases identified in the community, health care professionals are provided and are wearing recommended PPE for care of all residents, in line with the most recent CDC guidance.
 Residents are wearing a facemask (as they are able to tolerate) whenever they leave their room or are around others, including whenever they leave the community for essential medical appointments.
 All community personnel are required to wear a facemask while in the facility, unless in a staff allowable area for eating and drinking. Must maintain social distance while utilizing staff break areas.
 The community adheres to our policy & procedure to determine what PPE is necessary and when. A burn rate calculation of PPE is utilized and reviewed by the ED to ensure adequate provision of PPE. The established par levels are stored at the local corporate office and the community orders additional PPE as needed to maintain a 2 month emergency supply. During past outbreaks the community has utilized the local Health department for emergency supplies as needed.
4. STAFFING SHORTAGES
 The community has policies in place to address staffing shortages including contingency and crisis capacity strategies.
 The community can demonstrate that there has been advanced planning, in alignment with its emergency preparedness plans, for backup staffing using all resources (e.g., corporate resources, temporary staffing agencies, , or other resources) to be able to cover shifts based on potential staff quarantines.
 The community has a plan for expediting training of new health care professional staff brought in from other locations to provide resident care in the event that the facility reaches a staffing crisis.
 A designated person has been assigned responsibility for conducting a daily assessment of staffing status and needs and has implemented or is ready to implement backup plans as needed.
 If a staffing need is identified, the Executive Director will work collaboratively with the DON and ADON. The community will initially ask PRN staff to work a designated schedule as available. Nursing Management personnel will be utilized as needed providing medication administration and direct patient care. All potential staff in the hiring process will be expedited. Agency staff will be used as needed in the event of a high number of positive staff test results based on proactive testing initiatives. Agency contracts are in place with Town Nursing and Five Star Staffing Agency and were utilized during our initial outbreak.
 The ADON & ED will conduct a modified training and orientation in the case of outside staff being used. Outside staff will be supported by nursing management and current experienced nursing staff.
 The community utilizes an App to offer up open shifts, incentives and cover call outs when needed and the app sends out notifications to all nursing team members.
 The community sick leave policies are non-punitive (i.e., they do not result in disciplinary actions or job performance reviews, and they do not require provider notes), flexible, and consistent with public health policies that do not dissuade health care professionals from staying home when they are sick.
5. COMMUNICATION
 The community has a plan for communicating with staff, residents, and their families regarding the status and impact of COVID-19 in the community, including the prevalence of confirmed cases of COVID-19 in staff and residents as directed by CMS guidance.
 The ED is responsible for communication with team members, residents, and families regarding the status and impact of COVID-19 within the community as changes develop during an active outbreak. This communication may be provided by hand delivered community updates at mealtimes to residents without email and will be in the form of an email communication to families, resident representatives and residents who have requested email communication. Staff Members will be communicated to using an App and also
through signage posted in staff only areas. The communication includes the prevalence of confirmed cases of COVID-19 of residents and team members (not to include personally identifiable information), information on actions implemented to prevent or reduce the risk of transmission, including whether normal operations of the facility will be altered.
 Residents, their representatives and families will be notified by 5 p.m. the next calendar day each time a confirmed infection of COVID-19 is identified, or whenever three or more residents or staff with new onset of respiratory symptoms occurs within 72 hours of each other.
 Communication includes local, state, and federal reporting of infectious outbreaks in accordance with regulation.
 The Executive Director’s email address is posted on the community’s web page to allow residents and families to communicate urgent concerns or complaints.
6. VIRTUAL COMMUNICATION
 Virtual Communication either by phone or video-conferencing between residents, their representative, loved ones or anyone else of the residents choosing that is non-medically related, can be arranged through the Activities Department, by dialing 732-905-9222 X2120 by phone or emailing DawnC@SpringOak.net. A Tablet can be brought to the resident’s room or a quiet common area to allow for privacy, by appointment, for video-conferencing.
 Virtual Communication for Wellness needs, Doctor Appointments and TeleMed can be arranged through the Wellness Department at 732-905-9222 X2102 or by emailing our ADON at LQuijano@SpringOak.net. These virtual appointments will take place in a designated private area in one of the Wellness Offices
 Families are encouraged to check our website for updates and follow our Facebook page for community happenings.
7. DINING & ACTIVITIES
 Currently all residents are experiencing In-Room Dining. As we progress through the Phases of reopening as outlined in Executive Directive No. 20-026 we will be able to allow for dining in our dining room with social distances and strict cleaning procedures in place. Residents and Families will be notified as we progress to that point.
 Currently we are not able to bring groups together for activities. We continue to offer residents a selection of in-room crafts, puzzles, word problems, brain teasers, books, mobile library and other activity supplies in order to keep them occupied. As we move through the Phases of reopening as outlined in Executive Directive No. 20-026 we do have a plan in place for socially distanced activities and small group outings. Residents and Families will be notified as we progress to that point.
In the event that any Resident or Power-of-Attorney should have a pressing concern related to COVID-19, please contact the Facility Executive Director at the facility phone number (732) 905-9222, or email ksabo@springoak.net