Covid-19 FAQs

Concepts in Community Living is proud to manage the following communities.

Following is a list of Frequently Asked Questions. Please contact the Director at your community if you have additional questions.

As the situation with Covid-19 (Novel Coronavirus) is rapidly changing and ever evolving, it may be difficult to ensure timely updates to the following frequently asked questions. However, we know there are a lot of questions and we wanted to be able to provide a central location to post answers to some of the questions we’ve been receiving.

Please stay tuned to our websites for regular Covid-19 updates and, as always, please contact the Director at your community should you have any questions. In addition, any member of the CCL management team would be happy to answer your questions and hear your concerns. You may reach us at (503) 255-4647 or info@ccliving.com.

We could not keep our residents and employees safe, without each and every one of you helping to make it happen.

Whose direction are you following in developing your precautionary measures?

Concepts In Community Living, Inc., the management agent responsible for the operations of the community, is issuing policy and procedure that is informed by the direction of the Centers for Disease Control and Prevention (CDC) and Centers for Medicare and Medicaid Services (CMS) at the federal level, Oregon Health Authority, Washington Department of Health, state Governor’s orders and state industry associations. We are also involved in, and following, the guidelines promulgated by our local counties.

What are the guidelines issued by the Centers for Disease Control and Preventions for Long Term Care facilities?

https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html

Where can I find more information about Covid-19 response and prevention efforts?

Washington Department of Health Frequently Asked Questions
https://www.doh.wa.gov/Emergencies/NovelCoronavirusOutbreak2020COVID19/FrequentlyAskedQuestions

Washington Visitor Restrictions for Assisted Living Communities
https://www.dshs.wa.gov/sites/default/files/ALTSA/covid-19/Restrictions%20Assisted%20Living%20Facilities.pdf

Oregon Health Authority Covid-19 Page
https://govstatus.egov.com/OR-OHA-COVID-19

What precautions are you taking to mitigate the spread of the virus?

In addition to maintaining the 6 ft of physical distance and not gathering in groups, we perform symptom screening on all staff, visitors and residents daily. Symptom screening includes temperature checks and symptom checks. We are requiring universal masking of our staff. Essential visitors are required to wash hands and wear face mask while in the building. Staff and essential health care providers at higher risk may be required to wear additional PPE (Personal Protective Equipment). Staff members showing any signs or symptoms are told to stay home and may be asked to obtain a Covid-19 test for diagnostic reasons. Residents who show signs and symptoms are assisted to wear a mask, isolate in their apartment, and shall be closely monitored and facilitated to see their physician for an evaluation. Daily disinfecting of all high-touch surfaces, and more frequent cleaning of all common areas, is a priority.

What are residents advised to do to protect themselves?

Residents are encouraged to remain vigilant for, and immediately report, fever or symptoms consistent with Covid-19 (e.g., sore throat, new or worsening cough, shortness of breath, muscle aches). Residents shall be reminded that Public Health Authorities have urged older adults to stay home and limit their interactions with others. Residents are encouraged to remain in their rooms as much as possible, practice physical distancing, and not allow outside visitors into the community. If residents leave their apartment, or are around others, they should wear a cloth face mask, if tolerated, regardless of symptoms.

What happens if I or my loved one develops signs or symptoms of Covid-19?

If a resident exhibits signs and symptoms consistent with Covid-19, the resident’s physician will be contacted for a virtual or in-person evaluation. Based on the evaluation, the resident may be transferred to an urgent care setting for further monitoring and testing. If a resident requires a higher level of care, or the facility cannot fully implement all recommended infection control precautions, the resident may be temporarily relocated to another facility that is better able to manage the care and precaution needs required of the resident. The state has contracted with several providers for the care of Covid-19 positive residents. State licensing and public health authorities shall be involved in finding appropriate care setting in this situation.

How do I protect myself and what do I do if I am sick?

https://www.cdc.gov/coronavirus/2019-ncov/index.html

Who is permitted to visit the community?

All non-essential visitors are prohibited from visiting inside the assisted living, residential care, or memory care community. While each state defines essential visitors a little differently, in general, all visitation is restricted at this time except for in certain compassionate care situations, such as end-of-life, bereavement due to the loss of a loved one, and for essential health care providers providing essential services. These visits require regulatory approval and are not intended to be routine but instead are intending to provide comfort during challenging times and help offer the resident critical emotional and social supports during their time of need. In these approved situations, the visit shall be by appointment only, and limited to two visitors per resident at any one time. The intention of visitor restrictions is to keep Covid-19 out of our community. Given the significant and grave risk this virus poses to our vulnerable residents, the Centers for Disease Control and Prevention, advised this restriction as a necessary safeguard in long-term care settings.

Oregon:
Essential individual includes the following; however, a discussion must be had with serious consideration given to delay or postponement of any non-essential services. Consideration must be given to the essential nature of the visit and alternatives for visiting, in addition to the need to maintain strict adherences to visitor protocol and screening.

Facility staff and prospective staff seeking employment
Outside medical personnel such as doctors, hospice staff, therapist, mental health therapists, or other facility staff assessing a resident prior to admission
Emergency responders including EMS, Fire, and Police
Vendors, but only when access to facility is required
Adult protective services staff engaged in an active adult abuse investigation
Licensing/Survey staff
Long term care ombudsman and deputies (not volunteers)
Legal guardians; and friends and family members visiting during end -of-life stages.

Washington:
No one is permitted to enter the community to visit a resident. As per the Governor’s proclamation, “This prohibition does not apply to end-of-life situations or to visits by attorneys, administrative law judges, advocates, or similar persons who represent a resident. Does not apply to vendors or volunteers who supply or work in a facility.”

How do I visit with my loved one?

In Oregon, for counties that are beginning to open, CMS have issued recent guidance allowing for the possibility of limited structured outdoor visitation utilizing best practices for physical distancing. Check with the director at your community to find out if your county is at the phase to offer limited structured outdoor visitation and if the community has an approved plan and protocol for outdoor visitation. If the community has suspected or confirmed Covid-19 cases, outdoor visitation will not be permitted. Where outdoor visitation has been approved, in addition to other community specific protocol, which may include specified visiting hours, strict adherence shall be paid to logging all visitors, symptom and risk screening, face masking, hand washing, and 6-foot physical distance, and no food shall be consumed. In addition, visits are limited to two visitors per resident at any one time, shall be by appointment only, and shall be monitored to ensure protocol is being followed.

In Washington, the Governors proclamation restricting visitation remains in place.

In addition, we encourage our family and friends to stay connected thru phone calls, sending e-mail, sending letter mail and packages, we are happy to facilitate a virtual connection with your loved one. Using Skype, Face Time, Zoom, or Google Hangouts we can connect you with your loved one through live video so that you can see your loved one and stay in close contact. Call our Life Enrichment Coordinator to arrange your virtual video visit. If your loved one does not yet have a tablet, iPad, iPhone or laptop, we can facilitate access to one. However, if your loved one does not yet own their own personal device, we highly recommend purchasing one for them. In addition to keeping in touch through video, email, or phone calls, residents enjoy connecting to online enrichment and exercise classes, too.

Are we allowed window visits?

Please contact the Director to inquire about the safety and feasibility of a window visit with your loved one. This could potentially be permitted; however, it will depend on the safety of the area surrounding the window. If permitted, window visits must occur with the window closed. The family member would call the resident and speak with them while standing outside their closed window.

Can families drop off items for residents?

Yes, families are encouraged to drop off items in the front foyer area for later retrieval by staff. Families should call the staff and let them know they are dropping something off. It is recommended that items be dropped off in a paper bag with the resident’s name on it. Staff will later retrieve the items to disinfect prior to bringing them to the resident. Anything the resident may enjoy doing in their apartment such as books, puzzles, crafts, personal devices and other sources of meaningful engagement, are highly recommended.

Which outside health care service providers are considered essential health care providers?

The determination of essential health care providers is determined on a case-by-case basis. The goal of restricting all visitors in long-term care settings is to limit exposure given the high mortality rate for seniors and those with complicating conditions. A risk-benefit analysis should consider whether the health care service is necessary, and/or related to compassionate care at end of life. Typically, hospice, home health, and labs may be considered essential depending on whether the services are considered essential for that particular resident.

What restrictions apply to visitors that are considered essential?

All visitors, except Emergency Medical Services (EMS), shall be screened for symptoms including temperature, upon entry. Visitors will be asked to wash their hands and are required to wear a face mask prior to entry. Additional PPE may be required upon request based on screening responses. While on site, visitors will be required to physically distance, practice respiratory hygiene and cough etiquette, and demonstrate frequent hand hygiene. Visitors are restricted to the resident room or may be assigned to another location identified by staff. Any visitor demonstrating symptoms, or suspected of posing a risk to residents or staff, shall not be permitted to enter the community, even in compassionate care situations. In addition, in Washington, residents are permitted 1 essential visitor per day. In Oregon, the resident is permitted no more than 2 essential visitors at any one time. As the situation with COVID-19 is rapidly changing, this direction may change as well.

Are you accepting new resident move-ins?

The community may consider moving in a new resident with extreme care and caution. Certain requirements will need to be met in addition to our typical screening and evaluation process, including presenting a negative Covid-19 test, dated not more than 7 days’ prior, obtaining a physician attestation that the resident is appropriate for moving into an assisted living community, providing 7 days of symptom screening at home prior to move-in, and symptom and risk screening immediately before move-in.

Modified move-in procedures may be offered from virtual tours to virtual move-in consultations. Restrictions will remain in place in terms of visitor restrictions; however, staff will work together to ease the transition as much as possible. Personal belongings and furniture being brought in shall be limited and items will need to be disinfected prior to locating in the resident’s room. New residents may be subject to a 7 to 14-day quarantine after move-in, as individuals may be asymptomatic for a time before testing positive.

Are residents permitted to dine in the dining room?

At this time, the CDC recommends that long-term care settings cancel community dining and group activities and outings. Residents who require feeding assistance, residents at risk for choking, or residents who require monitoring, may be served in the dining room while observing the restrictions of 6 foot of physical distance. As restrictions begin to loosen, residents may be permitted in small groups to dine in the dining room while observing 6 foot of physical distance upon entering, exiting, and while dining. Residents are receiving their hot meals via tray service 3x a day, snack and hydration carts at least 2x a day, and grab-and-go options are also routinely available.

Are residents permitted to participate in activities and outings?

The guidance from the Centers for Disease Control and Prevention for Long-Term Care facilities calls for cancellation of all communal dining and group activities. https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html For this reason, residents are not to congregate in places like the art and craft spaces, the library, lounge, or dining room. Ask the Life Enrichment Coordinator for a calendar of virtual programs and modified activities that may be available.
Can a resident go outside for a walk?

Yes, residents are permitted to sit and enjoy the courtyard and other walking paths on campus as long as he/she maintains physical distance of 6 feet from others at all times. Family and friends however are not permitted at this time to visit with residents outside on our grounds.

Can residents leave the community?

While we cannot stop a resident from leaving the community, as he/she always has the right to leave, we will strongly urge the resident not to leave due to the possible risks of exposing oneself, and upon their return, exposing other residents and staff to the virus. Residents who insist on leaving the community shall be subject to a 14-day quarantine in their apartment upon their return.

What kinds of precautions apply if a resident is gone for an overnight stay or longer?

Out of an abundance of caution, residents will be asked to quarantine in their apartment for 14 days following an overnight or longer absence, regardless of whether he/she is showing any symptoms. Residents will receive in-room tray service and in-room one-on-one socialization, in addition to their regular care and housekeeping services. Alternatively, residents who receive a negative Covid-19 test may expedite the quarantine requirements.

Who should be tested for Covid?

Testing at this time is focused on people with Covid-like symptoms such as those with fever, cough, or shortness of breath. Residents in long-term care settings and staff working in these settings are generally prioritized for testing. Testing is provided at the physician’s discretion and at this time a physician order is required for testing. Nurses in our communities, and in some cases trained and delegated staff, may perform Covid-19 specimen collection for testing in-house. We will utilize our local Public Health Authorities/ Department of Health to secure testing; however, if access is prohibitive, we may use our in-house capacity to perform a Covid-19 test.

Where can I get tested?

For our staff and residents, we will work with county health departments, resident/staff physicians, and our contracted laboratory partners to secure testing as needed for our existing residents and staff. For all others, you might refer to the following resources to locate Covid-19 testing resources.

Oregon
Oregon Health Authority has published a COVID-19 test site locator to help Oregonians across the state find testing sites in their community. The interactive map is available in both English and Spanish and can be toggled into multiple other languages:
healthoregon.org/covid19testing or healthoregon.org/pruebasdecovid19 (Spanish)

Washington

You can make an appointment for Covid testing, contact your medical provider. Or, check with your local health department or district.

Testing Sites by Health Jurisdiction:

https://www.doh.wa.gov/Portals/1/Documents/1600/coronavirus/TestingSiteOnlineResources-LHJ.pdf

Will I find out if someone is being tested or is positive for the virus at the community?

Yes, as soon as a symptomatic staff member or resident is referred to take a Covid-19 test, you will be notified. We will also notify you as soon as the test results come back. If you have concerns about receiving our notifications, please contact the Director at your earliest convenience to verify the contact information we have on file. In the case of asymptomatic testing, strictly as a precautionary measure (not due to Covid-like symptoms), we will not issue notification.

Please note that turnaround time on test results vary greatly from 5-7 hours and in some cases, 5-7 days. During this time, we will be following the guidance of the local Public Health Authorities and local Health Department for contact tracing and precautionary measures we should be taking. If the situation involves a staff member, they will be sent home until test results come back negative, or until either the CDC time-based, test-based, or symptom-based method for determining return-to-work, has been met. If the situation involves a resident, they will remain in isolation or be moved to an appropriate acute care setting better able to safely accommodate their needs, until two negative Covid-19 test results 24-hours apart can be obtained.

Is state licensing agency involved when a resident or staff tests positive for Covid?

Yes, in the state of Oregon, as soon as a symptomatic staff or resident is referred to take a Covid-19 test, the state issues an Executive Order which restricts new admissions, restricts re-admissions, requires additional staff training, restricts visitors, and cancels communal dining and group activities. The state will be heavily involved should any resident or staff member test positive for Covid-19. In Washington, we provide notification to the state, who in turn provides guidance and oversight of the preventative efforts, along with the local Public Health Authority/ Department of Health.

What is your plan for lifting the restrictions and reopening the community?

As states begin to roll out their phased approaches to reopening, we are aware that our long-term care communities will lag far behind the opening plans of all other sectors. As you know, our elderly residents are at the highest risk for complications and mortality from Coronavirus, and as such, we will be under heightened precautions and restrictions for quite some time to come.

Further, CCL has its own criteria for lifting restrictions which must be met separate from any state and local plans which may be issued. We respect and acknowledge how hard the continued restrictions will be, but we ask that all directives as put forth by the Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), and state and local government continue to be adhered to fully.

Where can I voice my concerns?

At any time, you are encouraged to contact the Director of your community by calling the main phone number or by sending an email. If you are not satisfied with the support you receive or you would like to share your concern as well with the management company, please contact Concepts In Community Living, Inc. at (503) 255-4647 or info@ccliving.com. (Link to our website)

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Covid-19 FAQs