Reopening Implementation Plan for Reopening in Accordance with the Pennsylvania Department of Human Services Interim Guidance for Personal Care Homes during COVID-19-Mental Health Association of Washington County (MHA)-Enhanced Personal Care Home (EPC)

FACILITY INFORMATION This section contains the name and location of the facility along with contact information for an individual designated by the facility. That individual does not have to be the Administrator but should be someone available to respond to questions regarding the Implementation Plan. 1. FACILITY NAME MHA-Enhanced Personal Care Home 2. STREET ADDRESS 200 Spring Street 3. CITY Bentleyville 4. ZIP CODE 15314 5. NAME OF FACILITY CONTACT PERSON Lianne Danko 6. PHONE NUMBER OF CONTACT PERSON 724-239-3775 x105 DATE AND STEP OF REOPENING The facility will identify the date upon which all prerequisites will be met to begin the reopening process and the Step at which the facility will enter reopening. Those facilities that experienced a significant COVID-19 outbreak will identify the date the Department of Health survey was conducted (that is required prior to reopening). 7. DATE THE FACILITY WILL ENTER THE REOPENING PROCESS 9/4/2020 8. SELECT THE STEP AT WHICH THE FACILITY WILL ENTER THE REOPENING PROCESS – EITHER STEP 1 OR STEP 2 (CHECK ONLY ONE) ☐ Step 1 The facility must meet all the Prerequisites included in the Interim Guidance for Personal Care Homes, Assisted Living Residences and private Intermediate Care Facilities During COVID-19 ☒ Step 2 The facility must meet all the Prerequisites, including the baseline universal test for COVID-19 administered to staff and residents (in accordance with the June 26, 2020, Order of the Secretary of Health) AND Have the absence of any new facility onset of COVID-19 cases for 14 consecutive days since baseline COVID-19 testing 9. HAS THE FACILITY EXPERIENCED A SIGNIFICANT COVID-19 OUTBREAK? (IF NO, SKIP TO #11) No STRATEGY FOR TESTING, COHORTING, PERSONAL PROTECTIVE EQUIPMENT, AND STAFFING To ensure the facility has taken appropriate measures to protect residents and staff, descriptions of those strategies are required in this section (prerequisites to enter the reopening process). 10. DATE RANGE FOR THE BASELINE UNIVERSAL TEST ADMINISTERED TO STAFF AND RESIDENTS (BETWEEN JUNE 14, 2020 AND AUGUST 31, 2020) IN ACCORDANCE WITH THE JUNE 26, 2020, ORDER OF THE SECRETARY OF HEALTH Click or tap to enter a date. to Click or tap to enter a date. 11. DESCRIBE THE ABILITY TO HAVE COVID-19 DIAGNOSTIC TESTS ADMINISTERED TO ALL RESIDENTS SHOWING SYMPTOMS OF COVID-19 AND TO DO SO WITHIN 24 HOURS The facility will utilize Centerville clinics in order to test upon onset of symptoms or suspected exposure within 24 hours. 12. DESCRIBE THE ABILITY TO HAVE COVID-19 DIAGNOSTIC TESTS ADMINSTERED TO ALL RESIDENTS AND STAFF IF THE FACILITY EXPERIENCES AN OUTBREAK, INCLUDING ASYMPTOMATIC STAFF The facility will utilize Centerville clinics to test all residents and staff if the facility would experience an outbreak. 13. DESCRIBE THE PROCEDURE FOR TESTING OF NON-ESSENTIAL STAFF AND VOLUNTEERS The facility has the ability to test all staff, as needed, through Centerville clinics. 14. DESCRIBE THE PROCEDURE FOR ADDRESSING RESIDENTS OR STAFF THAT DECLINE OR ARE UNABLE TO BE TESTED Residents that are not able to be tested will be quarantined. The agency policy requires all staff to submit to testing as needed to continue employment. Staff who refuse testing will no longer be permitted to work. 15. DESCRIBE THE PLAN TO COHORT OR ISOLATE RESIDENTS DIAGNOSED WITH COVID-19 IN ACCORDANCE WITH PA-HAN-509 PURSUANT TO SECITON 1 OF THE INTERIM GUIDANCE FOR Personal Care Homes, Assisted Living Residences and Intermediate Care Facilitiess DURING COVID-19. The facility has a contract with a local hotel and will cohort residents according to test results and symptoms within the building. All residents that test negative will be taken to the hotel. 16. DESCRIBE THE CURRENT CACHE OF PERSONAL PROTECTIVE EQUIPMENT (PPE) AND THE PLAN TO ENSURE AN ADEQUATE SUPPLY OF PPE FOR STAFF (BASED ON THE TYPE OF CARE EXPECTED TO BE PROVIDED) The facility maintains a supply of PPE adequate for quarantining precautions and caring for individuals diagnosed with COVID-19. The Program Administrator keeps an inventory of all PPE and reports to the Executive Director, in order to make more purchases as needed. 17. DESCRIBE THE CURRENT STAFFING STATUS AND THE PLAN TO ENSURE NO STAFFING SHORTAGES The facility is currently staffed well above the state requirement and maintains staffing above state requirement on a daily basis. In the event of an outbreak, the facility will provide coverage by converting to 12 hour shifts in order to reduce the number of staff required to operate in a 24 hour period. The facility has sufficient staff at this time. 18. DESCRIBE THE PLAN TO HALT ALL REOPENING FACILITIES AND RETURN TO STEP 1 IF THE FACILITY HAS ANY NEW ONSET OF POSITIVE COVID-19 CASES The facility will halt all reopening plans and resume restrictions if Washington County should revert to red. SCREENING PROTOCOLS In each block below, describe the screening protocol to be used including where screening occurs, method of determining symptoms and possible exposure, and action taken if screening reveals possible virus. Include how the data will be submitted to the Department. 19. RESIDENTS Residents are screened for signs and symptoms of COVID-19, twice a day, in the morning and evening when medications are administered. Screening also occurs upon return to the facility from any appointment or home visit. All screening will take place in the med. room. If screening reveals possible virus, resident physician will be contacted and resident will be scheduled to test for COVID within 24 hours. The data will be submitted to the appropriate entities via the COVId-19 tracker. 20. STAFF All staff are screened at the beginning and end of their shift, for signs and symptoms of illness, temperature, and potential exposure. All staff that vacation at one of the “hotspot” states are required to test prior to coming back to work. Screening takes place in the staff office, located directly near side entrance of the building. The data will be submitted to the appropriate entities via the COVID-19 tracker. 21. HEALTHCARE PERSONNEL WHO ARE NOT STAFF All Healthcare Personnel are screened before entry for signs and symptoms of illness, temperature, and potential exposure. All Healthcare Personnel are screened in the front lobby, prior to entering the facility. If they do not pass the screening, they are not permitted in the facility. 22. NON-ESSENTIAL PERSONNEL All non-essential personnel wil be screened before entry for signs and symptoms of illness, temperature, and potential exposure. All non-essential personnel are screened in the front lobby, prior to entering the facility. If they do not pass screening, they are not permitted in the facility. 23. VISITORS All visitors will be screened prior to entry to the facility or outside visitation area, for signs and symptoms of illness, temperature and potential exposure. All visitors are required to sign in and out after each visit. If visitors do not pass screening, they are not permitted in the facility or to visit outside. 24. VOLUNTEERS This facility does not currently utilize volunteers but if we would choose to during the reopening, all volunteers would be screened utilizing the same process as our staff. COMMUNAL DINING FOR RESIDENTS UNEXPOSED TO COVID-19 Communal dining is the same for all steps of reopening so there is no need to differentiate among the three steps. 25. DESCRIBE COMMUNAL DINING MEAL SCHEDULE, INCLUDING STAGGERED HOURS (IF ANY) Residents are scheduled in the dining room to ensure social distancing can be achieved. Dining times have been extended in order to accommodate social distancing. 26. DESCRIBE ARRANGEMENT OF TABLES AND CHAIRS TO ALLOW FOR SOCIAL DISTANCING Tables and chairs are spaced to allow for six feet of social distancing. 27. DESCRIBE INFECTION CONTROL MEASURES, INCLUDING USE OF PPE BY STAFF All high-touch point surfaces are sanitized before and after uses. Residents are encouraged to sanitize hands before and after meals and to wear masks when in common areas. Staff utilize masks when providing direct care, in common areas and in the med. room, kitchen and dining areas. 28. DESCRIBE ANY OTHER ASPECTS OF COMMUNAL DINING DURING REOPENING We make every effort to honor resident requests for dining in their room or dining area but must maintain social distancing requirements. ACTIVITIES AND OUTINGS In each block below, describe the types of activities that will be planned at each step and the outings that will be planned at Step 3 (an all-inclusive list is not necessary). Include where they will be held and approximately how many residents will be involved. Describe how social distancing, hand hygiene, and universal masking will be ensured. Also include precautions that will be taken to prevent multiple touching of items such as game pieces. 29. DESCRIBE ACTIVITIES PLANNED FOR STEP 1 (FIVE OR LESS RESIDENTS UNEXPOSED TO COVID-19) Residents will participate in small group activities, 5 or less, with residents maintaining 6 feet of distance. Masking and hand hygiene will be encouraged. All activities will be those that can be sanitized after each use and will be ones that items are not shared during the activity. Crafts, trivia games, word games, coloring, bingo, current events, coping skills groups, and activities similar will be offered. 30. DESCRIBE ACTIVITIES PLANNED FOR STEP 2 (TEN OR LESS RESIDENTS UNEXPOSED TO COVID-19) Residents will participate in group activities of 10 or less, with residents maintaining 6 feet of distance. Masking and hand hygiene will be encouraged. All activities offered will be those that can be sanitized after each use and will be ones that items are not shared during the activity. All activities offered in Step 1 will be offered in Step 2. Any requests for activities that are provided, we will attempt to conduct if we are able to maintain distance and sanitize or dispose of items needed. 31. DESCRIBE ACTIVITIES PLANNED FOR STEP 3 Residents will participate in small group activities, focusing on activities of resident interest and preference, while maintaining 6 feet of distance. Masking and hand hygiene will be encouraged. In addition to activities being offered in Steps 1 and 2, we will also schedule in-house movies, have picnics and conduct chair exercises. 32. DESCRIBE OUTINGS PLANNED FOR STEP 3 Residents will be offered outdoor outings in groups of 4 or less in order to maintain social distancing within the vehicles. Masking and hand hygiene will be strongly encouraged and all high-touch point surfaces will be sanitized before and after each trip. Hand sanitizer will be taken to go, in order to ensure that all residents and staff can continue to sanitize their hands while out in the community. Scenic rides, picnics, walks in the community, ice cream trips, and fast food runs will be incorporated. All residents’ suggestions will be taken into consideration if we are able to maintain all precautions necessary during the proposed outing. NON-ESSENTIAL PERSONNEL In Step 2, non-essential personnel deemed necessary by the facility are allowed (in addition to those already permitted in Section 4 of Interim Guidance for Personal Care Homes, Assisted Living Residences and Intermediate Care Faciilties During COVID-19). In Step 3, all non-essential personnel are allowed. Screening and additional precautions including social distancing, hand hygiene, and universal masking are required for non-essential personnel. 33. DESCRIBE THE LIMITED NUMBER AND TYPES OF NON-ESSENTIAL PERSONNEL THAT HAVE BEEN DETERMINED NECESSARY AT STEP 2 Podiatry services, Case Managers and Peer Mentors have been deemed necessary at this step. Only one professional of any type is permitted to enter, after appropriate screening has been completed, at a time. 34. DESCRIBE HOW SOCIAL DISTANCING, HAND HYGIENE, AND UNIVERSAL MASKING WILL BE ENSURED FOR NON-ESSENTIAL PERSONNEL AT STEPS 2 AND 3 Providers will be required to enter our front door and begin the screening process in the lobby, prior to enetering the facility. All providers will be provided appropriate PPE if they do not have their own. Masking and hand hygene are required. Services will be provided in the med. room or office area, with one resident at a time. Sanitation between each resident is required. 35. DESCRIBE MEASURES PLANNED TO ENSURE NON-ESSENTIAL PERSONNEL DO NOT COME INTO CONTACT WITH RESIDENTS EXPOSED TO COVID-19 If the facility has a resident that has been exposed to COVID-19, non-essential services would not be permitted in the facility. If appropriate to the service being provided, all contact with unexposed residents would be held outdoors in the visitng area or in the covered gazebo area, dependent on weather. VISITATION PLAN For visitation to be permitted in Steps 2 and 3 of reopening (as described in Section 6 of Interim Guidance for Personal Care Homes, Assisted Living Facilities and Intermediate Care Facilites During COVID-19), the following requirements are established. Screening and additional precautions including social distancing, hand hygiene, and universal masking are required for visitors. 36. DESCRIBE THE SCHEDULE OF VISITATION HOURS AND THE LENGTH OF EACH VISIT Visitation can be scheduled through any staff member on-site for the hours of 9:00am to 8:00pm, seven days a week. Visits are limited to 30 minutes at a time but can be adjusted if deemed necessary. There will be no limit to the number of visits per week but staff will make sure that all requests to visit can be accommodated to ensure that each resident can have at least one visit a week for all residents that have family involvement. No more than two adult visitors plus one child visitor are permitted at a time, outdoors. All children, under the age of 18 must have a parent or guardian with them and all children older than two must have a mask. 37. DESCRIBE HOW SCHEDULING VISITORS WILL OCCUR Families may call the facility between 8:00am and 9:00pm, any day of the week, in order to schedule a visit. Visitors will be advised of the screening process and will be encouraged to visit outdoors if weather permits. 38. DESCRIBE HOW VISITATION AREA(S) WILL BE SANITIZED BETWEEN EACH VISIT All visitation areas will be wiped down and sanitized, by facility staff, before and after each visit. 39. WHAT IS THE ALLOWABLE NUMBER OF VISITORS PER RESIDENT BASED ON THE CAPABILITY TO MAINTAIN SOCIAL DISTANCING AND INFECTION CONTROL? Residents will be permitted two adult visitors plus one child visitor at a time, per visit, if outdoors. If residents are visiting with family indoors, only one visitor is permitted inside at a time. 40. DESCRIBE THE ORDER IN WHICH SCHEDULED VISITS WILL BE PRIORITIZED Scheduled visits will be on a first-come, first-serve basis, unless a resident is expressing feelings of loneliness. In that case, those resident visitors will be scheduled ASAP. Because our facility is enhanced, we track mood and behavior consistently. STEP 2 41. DESCRIBE HOW THE FACILITY WILL DETERMINE THOSE RESIDENTS WHO CAN SAFELY ACCEPT VISITORS AT STEP 2 (CONSIDERING SUCH SAFETY FACTORS AS EXPOSURE TO OUTDOOR WEATHER AND TRANSPORTING RESIDENT TO VISITOR LOCATION) Residents that have passed screening can safely receive visitors. No transportation will be required to any of our visiting areas. Any resident with a health need that warrants no exposure to outdoor weather will visit with family at the indoor visitng room. 42. DESCRIBE THE OUTDOOR VISITATION SPACE FOR STEP 2 TO INCLUDE THE COVERAGE FOR SEVERE WEATHER, THE ENTRANCE, AND THE ROUTE TO ACCESS THE SPACE We have two outdoor visiting areas, designated for safe and socially distanced visits. One of the visitation areas has coverage from weather. Both areas are located in places that allow visitor access without having to enter the facility. Visitation areas are located near facility entrances and are easily accessible. 43. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING OUTDOOR VISITS Seating for visitors and residents are clearly marked with signage to ensure a minimum of 6 feet is maintained. Staff will remind families and residents throughout the visit, if necessary. 44. DESCRIBE THE INDOOR VISITATION SPACE THAT WILL BE USED IN THE EVENT OF EXCESSIVELY SEVERE WEATHER TO INCLUDE THE ENTRANCE AND THE ROUTE TO ACCESS THE SPACE An indoor visitation space is located directly near our side building entrance. Once a family member is screened and approved for entrance in the main lobby, family member will be directed to the side entrance to limit exposre in the building. In the visitor room, seating is clearly marked with signage in order to ensure proper social distancing throughout the visit. Staff will remind families and residents, if necessary. 45. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING INDOOR VISITS There is clear signange on seating and staff will monitor as needed to ensure that 6 feet of social distancing is being maintained throughout the visit. STEP 3 46. DESCRIBE HOW THE FACILITY WILL DETERMINE THOSE RESIDENTS WHO CAN SAFELY ACCEPT VISITORS AT STEP 3 (CONSIDERING SUCH SAFETY FACTORS AS TRANSPORTING RESIDENT TO VISITOR LOCATION) Residents that have passed screening can safely receive visitors. No transportation will be required to ay of our visiting areas. Any resident with a health need that warrants no exposure to outdoor weather will visit with family at the indoor visitng room. 47. WILL OUTDOOR VISITATION BE UTILIZED AT STEP 3? IF NO, SKIP TO QUESTION #52 Outdoor visitation will continue to be strongly encouraged in step 3. 48. DESCRIBE THE OUTDOOR VISITATION SPACE FOR STEP 3 TO INCLUDE THE COVERAGE FOR SEVERE WEATHER, THE ENTRANCE, AND THE ROUTE TO ACCESS THE SPACE (IF THE SAME AS STEP 2, ENTER “SAME”) Same. 49. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING OUTDOOR VISITS (IF THE SAME AS STEP 2, ENTER “SAME”) Same. 50. DESCRIBE THE INDOOR VISITATION SPACE THAT WILL BE USED TO INCLUDE THE ENTRANCE AND THE ROUTE TO ACCESS THE SPACE (IF THE SAME AS STEP 2, ENTER “SAME”) Same. 51. DESCRIBE HOW A CLEARLY DEFINED SIX-FOOT DISTANCE WILL BE MAINTAINED BETWEEN THE RESIDENT AND THE VISITOR(S) DURING INDOOR VISITS (IF THE SAME AS STEP 2, ENTER “SAME”) Same. 52. FOR THOSE RESIDENTS UNABLE TO BE TRANSPORTED TO THE DESIGNATED VISITATION AREA, DESCRIBE THE INFECTION CONTROL PRECAUTIONS THAT WILL BE PUT IN PLACE TO ALLOW VISITATION IN THE RESIDENT’S ROOM Ony one visitor will be permitted in a resident’s room at a time, if a resident permits, in order to maintain social distancing. The visitor will be screened in the lobby and must wear a mask and use hand sanitizer prior to entering and being escorted to the resident bedroom. A nonporous chair will be provided, 6 feet from the resident and will be sanitized before and after use, by facility staff. VOLUNTEERS In Step 2, volunteers are allowed only for the purpose of assisting with outdoor visitation protocols and may only conduct volunteer duties with residents unexposed to COVID-19. In Step 3, all volunteer duties may be conducted, but only with residents unexposed to COVID-19. Screening, social distancing, and additional precautions including hand hygiene and universal masking are required for volunteers. 53. DESCRIBE INFECTION CONTROL PRECAUTIONS ESTABLISHED FOR VOLUNTEERS, INCLUDING MEASURES PLANNED TO ENSURE VOLUNTEERS DO NOT COME INTO CONTACT WITH RESIDENTS EXPOSED TO COVID-19 This facility does not currently utilize volunteers, however; if we were to begin using volunteers during the reopening phases, all volunteers will receive COVID-19 education and training, prior to assisting with outdoor visits or entering the facility. Education and training would include prevention, social distancing, proper use of PPE and how to remove PPE and discard, hand hygiene, sanitation and review of emergency preparedness as well as this plan. Volunteers would only be permitted to assist with residents that have passed screening. 54. DESCRIBE THE DUTIES TO BE PERFORMED BY VOLUNTEERS DURING STEP 2 If volunteers would be utilized by this facility in step 2, they would only be permitted to assist with outdoor visitation. Such as, screening of visitors, social distancing reminders and ensuring the use of masks and hand hygiene. ____________________________________________ _____________________________ SIGNATURE OF ADMINISTRATOR DATE