December 11, 2020
Dear Family Member/Designated Representative,
As the holiday season and the new year approaches, we are pleased to inform you of some developments that we are anticipating in the upcoming weeks. We know how difficult this period has been for the residents, family members and the community at large. We thank you for entrusting us to care for your loved one and for your ongoing support and understanding.
As you may be aware, the FDA has been working with pharmaceutical companies on approving an emergency use of COVID-19 vaccinations. Through a partnership of various Federal and State programs, once the vaccination is approved, nursing home residents and staff are earmarked for the first phase of vaccine distribution.
The NYS Department of Health will be overseeing the implementation of this program through a contract with Walgreens and CVS pharmacies. The facility is expecting that we will be begin having vaccinations available for us within the next few weeks. The exact dates are unknown at this time. We anticipate that we will be receiving the Pfizer vaccine which is currently in phase 3 clinical trials. This vaccination uses two shots administered approximately 21 days apart. The vaccination will not give a person COVID-19. The first shot primes the immune system to recognize the virus, and the second shot strengthens the immune response.
We will be following all the recommendations from the CDC, FDA and the NYS Department of Health as we prepare for and provide immunizations for the residents. Please read the Fact Sheet: Understanding the COVID- 19 Vaccine which was compiled by leading experts in the field.
As in all vaccinations, the medical and nursing staff will be monitoring the residents for any signs and symptoms of adverse effects and any concerns will be immediately addressed. For a day or two after the vaccination the resident may experience short-term discomfort: fatigue, headache, muscle pain, chills, fever and pain at injection site after vaccination. These are normal reactions.
Even after the vaccine program begins, the facility will remain vigilant in taking the same proactive measures to prevent the spread of COVID-19. The staff will continue to wear appropriate protective equipment and the facility will continue with the increased cleaning and disinfection processes.
We would like to take this opportunity to wish you a joyous and healthy holiday season and look forward to a brighter 2021. If you have any further questions please contact us at 718-869-8000.
Beach Gardens Rehab and Nursing Center (BGRNC) will maintain an effective Pandemic Emergency Plan. BGRNC will comply with all directives and guidelines by New York State Department of Health, Centers for Communicable Diseases and any other Regulatory Agencies. The Plan will include the Facility’s response and recovery from a natural and/or manmade disaster/hazard. All required and recommended elements by the NYS DOH, have been addressed and incorporated into the Pandemic Emergency Plan. BGRNC recognizes the risk associated with a pandemic and will utilize all available resources to meet the resident and staff needs.
The circumstances of infectious disease emergencies, including ones that rise to the level of a pandemic, vary due to multiple factors, including type of biological agent, scale of exposure, mode of transmission and intentionality. Infectious disease emergencies can include outbreaks, epidemics and pandemics. A pandemic is an outbreak of an infectious disease that affects people or animals over an extensive geographical area. The impact of a novel virus, to which the general population would have little or no immunity, is not possible to predict as we have learned during the COVID-19 pandemic. We have also learned that the SNF population can be at increased risk of severe illness and mortality due to comorbidities and chronic illness. During a pandemic, nursing homes may need to implement restricted visitation or manage a shortage of personal protective equipment and more difficult issues that may threaten the facility’s ability to remain operational.
Preparedness Tasks for all Infectious Disease Events
1. Staff Education on Infectious Diseases
BGRNC’s Infection Preventionist (IP), in conjunction with the Facility’s In-service Coordinator/Designee, provide education on Infection Prevention and Management upon hire, annually and as needed for any identified infection prevention and control concerns, updates on an ongoing basis.
BGRNC’s IP, in conjunction with the In-service Coordinator, will in-service all staff on Infection Prevention policies and procedures as needed in the event of an infectious outbreak including all CDC and State updates/guidance.
See Infection Control-In-service Education Program in IP Manual
2. Develop/Review/Revise and Enforce Existing Infection Prevention Control, and Reporting Policies
BGRNC will continue to review/revise and enforce existing infection prevention control and reporting policies. As needed, BGRNC will communicate with local Epidemiologists to ensure that any new regulations and/or areas of concern as related to Infection Prevention and Control are incorporated into the Facility’s Infection Control Prevention Plans. The Emergency Preparedness Plan and Procedure will be reviewed and attested annually and as needed by the Administrator/designee.
See Infection and Prevention Program in IP Manual
3. Conduct Routine/Ongoing, Infectious Disease Surveillance
At daily Morning Meetings, the IDT team will identify any issues regarding infection control and prevention.
Resident infections as well as the usage of antibiotics will be reviewed on a monthly basis to identify any trends.
All staff are educated annually and as needed to report any change in resident condition to supervisory staff.
Rates of infectious diseases and detection of significant increases above those rates will be identified and addressed.
Infection surveillance will be an ongoing systematic, collection, analysis interpretation and dissemination of data to identify infections and to monitor adherence to recommended IPC practices
See PP Infection Control surveillance in IP Manual
4. Develop/Review/Revise Plan for Staff Testing/Laboratory Services
BGRNC will conduct staff testing, if indicated, in accordance with NYS regulations and Epidemiology recommendations for a given infectious agent.
BGRNC shall have prearranged agreements with laboratory services to accommodate any testing of residents and staff, including consultants and agency staff.
Administrator/ DNS/Designee will check daily for staff and resident testing results and take action in accordance with State and federal guidance.
Refer to vendor list in Emergency Management Plan (EMP)
5. Staff Access to Communicable Disease Reporting Tools
Designated staff are assigned to access and report to Health Commerce System (HCS), National Occupational Research Agenda (NORA) and National Healthcare Safety Network (NHSN). All roles are assigned and updated, as needed, for reporting to NYSDOH.
See Annex K Section 1 Communicable Disease Reporting
See guidelines for Infectious Outbreak Investigation
6. Develop/Review/Revise Internal Policies and Procedures for Stocking Needed Supplies
The Medical Director, Director of Nursing, Infection Control Practitioner, Safety Officer, and other appropriate personnel will review the Policies for stocking needed supplies.
The facility has contracted with Pharmacy Vendor to arrange for 4-6 weeks supply of resident medications to be delivered should there be a Pandemic Emergency.
The facility has established par Levels for Environmental Protection Agency (EPA) approved environmental cleaning agents based on pandemic usage.
The facility has established par Levels for PPE.
See Vendor Contracts in EMP
See Policy on Par Levels for resident medication, cleaning agents, and PPE
7. Develop/Review/Revise Administrative Controls with regards to Visitation and Staff Wellness
All sick calls will be monitored by Department Directors to identify any staff pattern or cluster of symptoms associated with infectious agent. Each Department Director will keep a list of sick calls and report any issues to IP/DNS/ Designee.
Staff members will be screened, on entrance to the facility, to include symptom check as per DOH and CDC guidance.
Visitors will be informed of any visitation restriction related to an Infection Pandemic. Any visitation restriction will be enforced/lifted as allowed by NYSDOH.
A contingency staffing plan is in place that identifies the minimum staffing needs and prioritizes critical and non-essential services, based on residents’ needs and essential facility operations. The staffing plan includes collaboration with local
and regional planning and to address widespread healthcare staffing shortages during a crisis.
See PP on Visitation Guidelines during Pandemic
See Policy on Staff Screening and Monitoring During a Pandemic
See Policy on Emergency Preparedness/Hazard Staffing Guidelines
8. Develop/Review/Revise Environmental Controls related to Contaminated Waste
Areas for contaminated waste are clearly identified as per NYSDOH guidelines
BGRNC’s Environmental Coordinator shall follow all Department of Environmental Conservation (DEC) and DOH rules for the handling of contaminated waste. The onsite storage of waste shall be labeled and in accordance with all regulations. The handling policies are available in the Environmental Services Manual. Any staff involved in handling of contaminated product shall be trained in procedures prior to performing tasks and shall be given proper PPE.
BGRNC will follow cleaning for standard terminal enhanced cleaning and Disinfection
See Policy on Control Methods in IP Manual
See Policy on Handling of Biohazardous Waste Material
9. Develop/Review/Revise Vendor Supply Plan for food, water, sanitizing agents medication, and other supplies
BGRNC has vendor agreements in place for any/all supplies.
BGRNC maintains a minimum supply of 96 hours of food and water. This is monitored on a quarterly basis to ensure that it is intact and safely stored
BGRNC has adequate supply and access to medication from the Pharmacy and other related vendors.
BGRNC has access to supplies of cleaning/sanitizing agents.
Supply Logs will be kept by the Department Head who will be responsible for monitoring the supply and reporting to the Administrator/designee any shortages or needs.
Refer to EMP and the PP on Food Subsistence, Water
10. Develop Plans to Ensure Residents are Cohorted based on their Infectious Status
Facility will cohort residents together who are colonized or infected with the same pathogen to confine their care to one area as well as to minimize contact and to prevent spread.
Facility will revise cohorting based on NYSDOH, CDC, and Local Epidemiologists as guidance becomes available and necessary.
See Policy on Cohorting
11. Develop a Plan for Cohorting Residents using a part of a unit, dedicated floor or wing, or group of rooms
BGRNC will dedicate a wing or group of rooms at the end of a unit in order to Cohort residents. This area will be clearly demarcated as isolation area.
Appropriate transmission-based precautions will be adhered to for each of the Cohort Groups as stipulated by NYSDOH.
Residents will be transferred based on their infection status in accordance with applicable NYSDOH and CDC guidance.
All attempts will be made to have dedicated caregivers assigned to each Cohort group and to minimize the number of different caregivers assigned.
BGRNC will revise cohorting based on DOH and CDC guidance which becomes necessary.
See Policy on Cohorting in IP Manual
12. Develop/Review/Revise a Plan to Ensure Social Distancing Measures
BGRNC will follow the procedure on social distancing measures in accordance with State and CDC guidance to help control and prevent the spread of infections during outbreaks, including recreational activities and dining.
BGRNC will post signage indicating directives for social distancing as per NYSDOH and CMS guidance.
Residents and staff will be educated and monitored to maintain social distancing between peers.
13. Develop/Review/Revise a Plan to Recover/Return to Normal Operations
Recovery services will focus on the needs of the residents and staff and help to restore the facility’s pre-disaster physical, mental social and economic conditions.
BGRNC will adhere to directives as specified by, State and CDC guidance at the time of each specific infectious disease or pandemic event e.g., regarding how, when, which activities/procedures/restrictions may be eliminated, restored and the timing of when those changes may be executed.
BGRNC will maintain communication with the local NYSDOH and CMS and follow guidelines for returning to normal operations. During the recovery period residents and staff will continue to be monitored daily in order to identify any symptoms that could be related to the infectious agent.
Refer to Emergency Preparedness Manual Section on Recovery
Additional Preparedness Planning Tasks for Pandemic Events
1. Develop/Review/Revise a Pandemic Communication Plan
The Administrator in conjunction with the Social Service Director will ensure that there is an accurate list of each Resident’s Representative, and preference for type of communication.
Communication of a pandemic includes utilizing established Staff Contact List to notify all staff members in all departments.
Facility will update website and provide family notification on the identification of any infectious disease outbreak of potential pandemic.
See PP on Communication during a pandemic
Refer to list of resident representatives/contacts information
Refer to Staff Contact List located in EMP
2. Develop/Review/Revise Plans for Protection of Staff, Residents, and Families Against Infection
Education of staff, residents, and representatives
Screening of residents
Screening of staff
Visitor Restriction as indicated and in accordance with NYSDOH and CDC
Proper use of PPE
Cohorting of Residents and Staff
See infection Prevention and Control Policy in IP Manual
Response Tasks for All Infectious Disease Events
1. Guidance, Signage, Advisories
BGRNC will obtain and maintain current guidance, signage advisories from the NYSDOH and the U.S. Centers for Disease Control and Prevention (CDC) on disease-specific response actions.
The Infection Preventionist/Designee will ensure that appropriate signage is visible in designated areas for newly emergent infectious agents
The Infection Preventionist/Designee will ensure that appropriate signage is visible in designated areas to heighten awareness on cough etiquette, hand hygiene and other hygiene measures in high visible areas.
Refer to CDC website for Signage Download
2. Reporting Requirements
BGRNC will assure it meets all reporting requirements for suspected or confirmed communicable diseases as mandated under the New York State Sanitary Code (10 NYCRR 2.10 Part 2), as well as by 10 NYCRR 415.19 (see Annex K of the CEMP toolkit for reporting requirements).
The DON/Infection Preventionist will be responsible to report communicable diseases via the NORA reporting system on the HCS on NHSN as directed by CMS.
3. Limit Exposure
BGRNC will Cohort residents according to their infection status
BGRNC will monitor all residents to identify symptoms associated with infectious agent.
Units will be quarantined in accordance with NYSDOH and CDC guidance and every effort will be made to cohort staff.
BGRNC will follow all guidance from NYSDOH regarding visitation, communal dining, and activities and update policy and procedure and educate all staff.
Hand sanitizer will be available on entrance to BGRNC, exit from elevators, according to NYSDOH and CDC guidance
See Policy on Cohorting
4. Separate Staffing
BGRNC will implement procedures to ensure that as much as is possible, separate staffing is provided to care for each infection status cohort, including surge staffing strategies.
5. Conduct Cleaning/Decontamination
BGRNC will conduct cleaning/decontamination in response to the infectious disease utilizing cleaning and disinfection product/agent specific to infectious disease/organism in accordance with any applicable NYSDOH, EPA, and CDC guidance.
See Policy on Terminal Cleaning in OP Manual
See Policy on Environmental Cleaning in OP Manual
6. Educate Residents, Relatives, and Friends About the Disease and the Facility’s Response
BGRNC will provide updates to residents, relatives, and friends with education about the disease and the facility’s response strategy at a level appropriate to their interests and need for information. Method of communication will be via telephone calls, mailings, Robo-calls, or facility website.
Refer to the BGRNC Policy and Procedure on Communication during a Pandemic*
7. Procedure on Advising Vendors, Staff, and other stakeholders on facility policies to minimize exposure risks to residents
Subject to any superseding New York State Executive Orders and/or NYSDOH guidance that may otherwise temporarily prohibit visitors, the facility will advise visitors and vendors to limit/discontinue visits to reduce exposure risk to residents and staff.
Vendors and Consultants will be notified, in writing, by the Administrator/ designee of pandemic practices and limitations to entry into the facility.
Emergency staff including EMS will be informed of required PPE to enter facility
Vendors will be directed to drop off needed supplies and deliveries in a designated area to avoid entering the building.
BGRNC will implement closing the facility to new admissions in accordance with any NYSDOH directives relating to disease transmission
See PP on Visitation during a Pandemic
Refer to Vendor contract list in Emergency Manual
8. Limiting and Restriction of Visitation
BGRNC will limit and/or restrict visitors as per the guidelines from the NYSDOH
Residents and Representatives will be notified as to visitation restrictions and/or limitations as regulatory changes are made.
See PP on Visitation during a Pandemic
Additional Response Tasks for Pandemic Events
1. Ensure Staff Are Using PPE Properly
Appropriate signage shall be posted at all entry points, and on each resident’s door indicating the type of transmission-based precautions that are needed.
Staff members will receive re-education and have competency done on the donning and doffing of PPE.
Infection Control rounds will be made to monitor for compliance with proper use of PPE
See Policy on Surveillance in the IP Manual
See Policy on PPE in IP Manual
2. Post a Copy of the Facility’s PEP
BGRNC will post a copy of the facility’s PEP in a form acceptable to the commissioner on the facility’s public website and make available immediately upon request.
A “hard copy” of document will remain available in BGRNC’s lobby, accessible by residents, families and staff. Additional copies can be provided, upon request.
3. BGRNC Will Update Family Members and Guardians
The Nursing Department will provide telephone updates, to authorized family members and guardians for residents infected with the pandemic infectious disease, daily, and upon changes to a resident’s condition.
BGRNC will provide weekly updates to all residents detailing the number of infections and deaths at the facility;
Robo Calls and/or mail correspondence and/or phone calls will be provided updates to authorized family members and guardians, once per week, detailing the number of infections and deaths at the facility;
Staff will offer residents the use of cell phones, tablets etc. to communicate, with authorized family members and/or guardian
BGRNC will communicate with Residents, Representatives as per their preference via, calls/robocalls and document all communication preference in the CCP/medical record.
Residents will be notified with regards to the number of cases and deaths in the facility unless they verbalize that they not wish to be notified. This will be
4. BGRNC Will Update Families and Guardians Once a Week – See Section 3 Above)
5. Implement Mechanisms for Videoconferencing
The facility will provide residents with no cost, daily access to remote videoconference or equivalent communication methods with Representatives
Refer BGRNC ‘s Policy and Procedure on Communication during a Pandemic
6. Implement Process/Procedures for Hospitalized Residents
BGRNC will implement the following process/procedures to assure hospitalized residents will be admitted or readmitted to such residential health care facility or alternate care site after treatment, in accordance with all applicable laws and regulations including but not limited to 10 NYCRR 415.3(i)(3)(iii), 415.19, and 415(i); and 42 CFR 483.15(e).
Prior to Admission/readmission the DNS/designee will review hospital records to determine resident needs and facility’s ability to provide care including cohorting and treatment needs.
See Policy on Admissions/Readmissions during a Pandemic
See Policy on Bed Hold Policy
7. Preserving a Resident’s Place
BGRNC will implement processes to preserve a resident’s place in a residential health care facility if such resident is hospitalized, in accordance with all applicable laws and regulations including but not limited to 18 NYCRR 505.9(d)(6) and 42 CFR 483.15(e).
See Policy on Admissions/Readmissions during a Pandemic
See Policy on Bed Hold Policy
8. BGRNC’s Plan to Maintain at least a two-month supply of Personal Protective Equipment (PPE)
BGRNC has implemented procedures to maintain at least a two-month (60 day) supply of PPE sufficient to protect health care personnel and residents. The PPE will be stored in a safe and secure environment and will be audited to ensure the integrity of the 60 day PPE stockpile.
The facility will maintain contracts with vendors to secure PPE, as needed
PPE stockpile will be stored both on and off site
Supplies to be included, but not limited to, in the 60-day stockpile
Sanitizer and disinfectants (meeting EPA Guidance current at the time of the pandemic)
See Policy and Procedure on Securing PPE
See Policy on Standard Precaution
Recovery of all Infectious Disease Events
1. Activities/Procedures/Restrictions to be Eliminated or Restored
BGRNC will focus on recovery services based on the needs of the residents and staff to restore the facility’s pre-disaster physical mental, social and economic conditions.
See Emergency Preparedness Manual
2. Recovery/Return to Normal Operations
BGRNC will communicate any relevant activities regarding recovery/return to normal operations, with staff, families/guardians and other relevant stakeholders.
BGRNC will ensure that during the recovery phase all residents and staff will be monitored and tested to identify any developing symptoms related to the infectious agent in accordance with State and CDC guidance.
BGRNC will screen and test outside consultants that re-enter the facility, as per the NYS DOH guidelines during the recovery phase.
See Emergency Prep Manual
Thank you for entrusting us to care for your loved one. Due to COVID-19, many of our facility policies have temporarily changed and are continuously being revised based on current state and federal guidelines.
We know how much your loved one means to you and how important it is for you to stay in touch with them. Based on current federal and state guidelines, we are continuously adjusting our visitation protocols. We have multiple opportunities for visitations, both virtual and in-person. Please call Ramon Welsh, Director of Social Services at x 8005 to discuss these options and to schedule an appointment.
When scheduling an in-person visit, please be aware of the following guidelines that are in place to ensure the safety our residents, staff and visitors.
In-person visitation generally occurs every day at pre-scheduled times. Visitors will be screened for COVID-like symptoms prior to entering the facility. Visitors under 18 years of age must be accompanied by an adult 18 years or older. A demographic questionnaire must be completed upon your arrival in case the NYS Department of Health needs to reach out to you for contact tracing purposes. There is a designated visiting area that is large enough to allow for appropriate social distancing. It is set up with a hand sanitizing station and it has designated staff to regularly sanitize the area. Visitors must wear a facemask/face covering at all times while on facility premises.
Please be aware that we will continue to offer window visits during the times when visitation is not allowed in the building. Please contact Maria Moya, Director of Recreation at x 8022 to arrange those visits. We also will continue to offer facetime, Whatsapp, and/or video calls. Please contact Maria Moya, Director of Recreation at x8022 to arrange a time for those calls.
Thank you for your cooperation and please reach out to any of our staff members if you have any questions or concerns.
Gina Solomita LNHA MHA RD CON