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Two nursing homes in Lebanon County managed to keep COVID-19 infections among staff and residents to a minimum for months into the pandemic.
As of June 8, Londonderry Village in Palmyra has reported zero cases. The facility was visited by the PA National Guard last week and tests were administered to close to 300 residents and staff – results are expected to be reported next week.
“Our main concern would be whether or not we have folks on the campus who might be infected but are asymptomatic,” said Londonderry Village president Jeff Shireman in a statement posted to the facility’s website.
Cedar Haven in Lebanon reported its first COVID-19 case — a staff member who tested positive — on June 3. Since then, two other Cedar Haven staff members have tested positive, as well as two residents, both of whom lived on the same floor. The diagnosed residents have been further isolated, with tests for several other residents pending.
“Our administrative team created an isolation wing ahead of time so that we could swiftly implement this measure for the safety of our residents and team should we see confirmed cases among our resident population,” said Cedar Haven in a statement posted to its website.
Meg Farrington, director of marketing and communications for Stone Barn Management, Cedar Haven’s parent company, said the staff members are self-isolating at home and will be required to take a second test before they are allowed to return to work. Farrington said the staff members were exposed to infected persons outside of the facility.
“We hoped that we would never have a case of COVID-19, but now that we do, we are following protocols put in place by our head of infection control and administration. We’re confident of our clinical team’s response and desire to put resident safety first,” she explained in an interview that was conducted prior to the resident cases being confirmed.
Farrington said some of the protocols were already in place in mid-March, including restricting visitation and staff use of Personal Protective Equipment (PPE) such as face coverings, gloves and gowns. Additionally, new arrivals and anyone who was symptomatic were placed in an area of the facility for isolation for two weeks. The area was served by a dedicated staff using PPE.
“Our administrator, Steven Zablocki, and staff were proactive,” she said.
Other measures include taking staff temperatures twice a day — once upon arrival to work and again as they finish their shift — and a heightened housekeeping protocol. To reduce cross-contamination, staff members who work at other facilities were asked to dedicate themselves to one facility.
“It’s pretty common in this industry for staff to work at one facility full-time and then at another part-time. That’s usually not a concern, but with COVID-19, we wanted to ensure that our residents stay healthy,” Farrington said. “Our staff has worked so hard to put these measures in place to ensure the safety of residents and staff.”
Cedar Haven uses its website as a tool to share updates about COVID-19. Farrington said with visitation restricted, Cedar Haven launched a video conference option for family visits and telemedicine physician visits. At the end of May, Cedar Haven celebrated its 400th video call.
For 38 years, Londonderry Village was known as Lebanon Valley Brethren Home. The name was changed about two years ago. Jeff Shireman, president, said the retirement community has about 600 residents on its campus, and about 100 of those residents are in one of two levels of healthcare. There are 28 residents in personal care, and 72 in skilled care. Londonderry Village employs a staff of 270.
Regarding nursing homes that had cases of COVID-19, Shireman said, “It’s not that they did anything wrong – this virus was challenging. At the beginning not a lot was known about it, and we’ve learned more as we went along.”
Like Cedar Haven, Londonderry Village put protocols in place in March, including restricting visitations. Shireman said the facility’s director of security, who has a military background, closed all entrances but one and established a checkpoint for those entering the facility.
“We locked down earlier and more severely than most other facilities,” Shireman said.
At the checkpoint, visitors (including those making deliveries) undergo a short three- or four-question survey and a temperature screening. Anyone with a temperature of 100 degrees or above is denied entrance. Initially, one of the survey questions was whether or not the person had recently visited one of the COVID-19 “hot spots,” such as New York City.
Family visitations are only allowed for end-of-life situations.
“It was difficult for our residents, so we brought in tablets and computers for virtual visits with families,” Shireman said.
Other visitors are only allowed for independent living residents if they’re caregivers or delivering groceries, as well as a few other essential reasons. Visitors are restricted to one person per vehicle. Communal dining areas closed mid-March, but meals can be delivered by staff. The community’s convenience store has also been closed since March, but residents can place grocery orders that will be delivered by staff.
Additional protocols are in place for skilled care, where residents have heightened medical needs, such as the use of PPE and preventing cross-contamination from other facilities by requiring that staff only work at Londonderry Village. Residents who have been hospitalized and come back to skilled care are placed in an isolation area with a dedicated staff for 14 days.
“Our residents and staff have been great at accepting the restrictions. Its part of our culture at Londonderry Village that everyone is responsible for the safety of everyone else,” Shireman said. Like Cedar Haven, Londonderry Village uses its website to post COVID-19 updates.
He added that Londonderry Village’s skilled care unit has a few structural advantages. A few years ago during a flu outbreak, UV lights were installed in HVAC ducts in the unit. The installed UV lights were augmented by portable UV lights. He said the UV lights clean the air as it circulates around the facility.
In addition to a skilled care unit, residents requiring skilled care can opt to live in one of the village’s “Green Houses,” a stand-alone unit that can accommodate up to 10 residents. Shireman said that there are 300 such houses nationwide, and Londonderry Village is the only retirement community in the state to offer this skilled care alternative.
“We’re trying to de-institutionalize skilled care and make it more like home than an institution. Skilled care residents don’t often have many choices with their life, by living in a home-like setting they can make choices like when to get up in the morning,” Shireman explained.
Shireman said the benefit of a Green House, particularly in a situation like COVID-19, is that people are living in smaller groups and are being cared for by dedicated staff that works only in that particular Green House, helping to limit exposure while providing more personalize care.
“One of the advantages we have is that in skilled care we’re taking care of people from The Greatest Generation,” Shireman said. “They lived through World War II, and they know what sacrifice is.”
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