The interim guidance is based on what is currently known about the coronavirus. We are encouraging all staff members and clients to have a general knowledge of Coronavirus (COVID-19) and the recommended protocols.
GENERAL INFORMATION
The Center for Disease Control (CDC) is working across the Department of Health and Human Services and across the U.S. government in the public health response to COVID-19. Much is unknown about how the virus that causes COVID-19 spreads. Current knowledge is largely based on what is known about similar coronaviruses. Coronaviruses are a large family of viruses that are common in humans and many different species of animals, including camels, cattle, cats, and bats. Rarely, animal coronaviruses can infect people and then spread between people, such as with MERS-CoV and SARS-CoV. The virus that causes COVID-19 is spreading from person-to-person in China and some limited person-to-person transmission has been reported in countries outside China, including the United States. However, respiratory illnesses like seasonal influenza, are currently widespread in many US communities.
HEALTHCARE FACILITY GUIDELINES
The following protocols have been established by the CDC and effective at Ascend Healthcare 03/20/20-Present:
- All Staff are required to wear a mask in the facility
- Sick employees are required to stay home
- Separate sick employee’s or client’s immediately upon the onset of any symptoms
- Emphasize staying home when sick, respiratory etiquette and hand hygiene by all employees and clients
- Increase routine environmental cleanings
- Advise employees and potential clients before traveling to take certain steps
- Avoid congregate settings
GENERAL PRACTICE
- All employees will wear a mask inside the facility
- All employees are committed to following CDC guidelines outside of work
- Ascend will temporarily have more flexible protocols regarding sick leave. Should a staff member feel ill, a doctor’s note will not be required to excuse sick time.
- Staff members showing signs of illness will immediately be sent home. Ascend will identify on-call staff members to best be prepared for any staff illness.
- Ascend has dedicated quarantine rooms in each facility should any client appear to be sick or demonstrating acute respiratory illness in order to support symptom isolation.
- Ascend will post additional hand washing and respiratory etiquette signs in common areas and bedrooms.
- Ascend will increase routine cleaning measures, including using sanitation wipes to down common areas two times per shift.
- All employees and clients will be required to routinely monitor their temperature throughout shift.
- All employees using air travel are encouraged to wear the highest level PPE while on the plane and in congregate spaces
- All employees who travel must immediately inform their supervisor if while traveling they were knowingly exposed to COVID- 19. These employees must complete a 10 day shelter in place and have a clean bill of health from their doctor prior to returning to work.
- Ascend will temporarily stop attending in-person AA, NA, and emotions anonymous meetings to avoid possible congregate settings where illness may be easily spread and instead will attend these sessions over Zoom.
- Ascend will be mindful in outing identification to ensure congregate areas are avoided.
- Clients will not be allowed offsite for non-emergent medical, dental, or other services
CLINICAL PROCEDURES
- Ascend will make every effort to maintain clinical standards and provide consistent group, individual, and family therapy sessions as regularly scheduled.
- Ascend is encouraging all contract group facilitators to run their groups via Zoom. This will enable our clients to continue to receive the best possible care in the safest setting.
- Ascend is requiring all family therapy sessions to be conducted via the telephone and Zoom.
- Ascend is not allowing on-site visits from family members at this time.
- Ascend will temporarily suspend all upcoming in-person family day programming and facilitate via Zoom.
- Ascend will not allow offsite visits. It is our responsibility to put the health of the overall group above all else. If an offsite visit is determined clinically necessary Ascend requires all congregate spaces be avoided to avoid potential exposure to COVID-19. Violation of this rule could result in early termination from the program.
CLIENT ILLNESS PROCEDURE
- Due to increased concern over potential client illness, Ascend will adopt the following procedures as advised by our medical director.
- All clients will have their temperatures taken and documented 2x daily regardless of
symptom display - Any clients exhibiting any symptoms of COVID will be immediately quarantined and provided with COVID-19 testing (both rapid and PCR).
- Any client that tests positive will be quarantined and temporarily discharged from the facility back home until a medical clearance can be provided
Any client whose symptoms escalate to include cough, fever, and difficulty breathing will be taken to the emergency room and will subsequently need to be temporarily discharged from the facility until a medical clearance can be provided - All clients and staff who came in to contact with any person suspected of having COVID will be provided with testing
Please note Ascend is not able to guarantee on-site COVID-19 testing.
NEW ADMISSION PROCEDURES
- All potential clients will be required to complete a COVID-19 comprehensive questionnaire prior to approval to admit.
- All potential clients will require medical approval (by Dr. Ross or Dr. Acosta) prior to approval to admit.
- All potential clients must have a negative serological COVID test (within 72 hours) prior to admission.
- All family members or persons living inside the home of the potential client will be screened for symptoms and be required to provide a negative COVID test prior to admission
- All clients will be required to wear a mask for the initial 5 days of treatment until an additional test can be administered and the result is determined
- All new clients will be required to room alone for the initial 5 days of treatment until a negative COVID test is confirmed.
- All new admissions will be immediately evaluated by the nurse upon admission to assess for any COVID-19 symptomology, complete a comprehensive nursing assessment, and be provided with a hygiene orientation.
- All new admissions will be provided with Ascend supplied clothing and their own personal garments will be immediately laundered.
RE-ADMISSION or PREVIOUSLY INFECTED PERSON ADMISSION
Ascend has consulted with a pediatric infectious disease specialist regarding best protocols on admissions for previously infected persons and has identified the following protocols:
- Ascend recognizes that based on what is currently known about COVID-19, persons may test positive past when they are considered contagious
- Current data suggests that persons are no longer contagious 10 days following their initial positive result in asymptomatic or mildly symptomatic persons IF there has been no medications given AND the person has not had a fever for at least 24 hours
- Ascend will require previously infected persons to provide proof of initial positive test (if within 90 days of admission) and screen each person on an individual basis to determine eligibility to enter the program and when.
STAFF PROCEDURES
- Ascend is requiring all staff take and document their temperatures at the start and end of their shift.
- Ascend is encouraging all staff to follow all CDC guidelines around social distancing outside of work.
- Ascend is encouraging all staff to follow ‘Stay Safe’ quarantine procedures as outlined by California government agencies
- Ascend is requiring all staff inform their supervisor if they have violated ‘Stay Safe’ quarantine procedures and have attended congregate meetings or designated high risk zones
- Ascend is requiring staff to follow Los Angeles County orders regarding essential workers including providing masks to all staff members
- All staff are required to be masked in the facility at all times
- All employees who travel must immediately inform their supervisor if while traveling they were knowingly exposed to COVID- 19. These employees must complete a 10 day shelter in place and have a clean bill of health from their doctor prior to returning to work.
- Ascend is requesting all staff who are considered high risk to postpone non-essential excursions outside their homes in order to reduce the risk of contracting COVID-19. This includes anyone over the age of 60 and anyone who is immunocompromised.
POSITIVE COVID-19 TEST PROTOCOLS
- All staff and clients are required to follow all of the above protocols outlined in this document
- Should a staff member or client test positive for COVID-19 Ascend will implement the following:
- Shift partners will be informed of a potential exposure and provided with testing options
- All other staff whom have been exposed will require negative test prior to coming back to work.
- If a staff member or client begins demonstrating symptoms Ascend will follow all protocols outlined in this document (see Client and Staff Illness)
- All admissions will seize for at least 10 days until it can be determined persons in the house (both staff and clients) are asymptomatic
- The employee will require medical clearance prior to returning to work. Per the CDC there are persons who may continue to test positive beyond their point of contagion.
- These persons will be evaluated on an individual basis and will require medical clearance from their primary care doctor and Ascends medical director or psychiatrist before returning to work.
ALL EMPLOYEE’S MUST NOTIFY A SUPERVISOR IF
- They are sick OR have a sick family member
- If they feel any type of acute respiratory illness
- If they OR a family member are confirmed to have COVID-19 (coronavirus)
