COVID-19 (Coronavirus) Update

hands holing a heart shape object March 20, 2020 Letter

No Visitors PosterMarch 20, 2020

Dear Health Care Provider, Legal Representative or Family Member:

As one would expect, we are busy at our RPHF facilities keeping current on COVID-19 directives from the regulatory agencies and implementing and evaluating our plans in conjunction with the ever changing directives. RPHF is committed to providing our healthcare providers, family members, legal representatives, residents and employees with up-to-date information regarding the facilities and how we are dealing with the challenges presented by COVID-19. The following is a summary of highlights from the past week.

In the last few days we placed orders for additional personal protective equipment (i.e., gowns, gloves, masks, shoe covers, face shields, goggles, hand sanitizer, etc.) that is now available from our suppliers. While these supplies are still limited, we are working diligently to expand our inventory to meet the needs of our residents and protect our staff. In addition, we also placed orders for supplies from the national stockpile, though we are told what will actually be delivered from this source is questionable.

We have placed orders for additional respiratory equipment such as oxygen concentrators and nebulizer machines, and additional thermometers. While our oxygen companies normally supply the respiratory equipment, we want to be prepared in case the need is greater than the supply they have available.

Our staff has been vigilant in monitoring all residents twice daily during the morning and evening shifts. We are screening our resident’s temperatures and assessing them for any respiratory symptoms. If a resident develops a symptom of concern, the resident is placed in a private room, if they are not already in one, with the appropriate precautions in place, including assessment and monitoring every two hours. We notify the resident’s attending physician, along with the local public health department when needed. To date our facilities have not had any COVID-19 diagnosis.

We now provide food and beverages to staff during their work shifts. This allows staff to remain in the facility for the entire shift, reducing the risk of exposure while in the public. We continue to educate our employees on the importance of abiding by the national directive to stay in quarantine at home outside of work hours in an effort to keep themselves, their families and our residents healthy.

There are a few things we are asking families, friends and legal representatives to do to assist us at this time.

  • If you intend to visit a resident by looking through your loved one’s window, we are asking that you please call the facility ahead of time to arrange this. Some families are unsure about which window belongs to their loved one and have been walking around the perimeter of the facility to locate it. Some of our residents have been startled. A heads up from you would be helpful.
  • We know many organizations and social media outlets are asking you to send messages to your loved ones. We encourage you send these messages in an electronic format such as text, email, FaceTime or Skype. We are concerned about COVID-19 surviving on paper or cardboard for any period of time and have to handle any item that comes inside our nursing home with care.
  • We are so thankful for your words of appreciation and support. It can be overwhelming at times for our staff. Your kind words mean more to them than you know.

Your continued patience and understanding are critical in facing the challenges before us. Thank you for your cooperation.

Sincerely,

Dr. Shellie M. Sonnentag, DNP, AGPCNP-C, CD
Vice President of Clinical Services
Real Property Health Facilities Corp.
435 Village Walk Lane Suite B
Johnson Creek, WI 53038

Click for March 14, 2020 Letter

March 14, 2020

Dear Residents, Employees, Health Care Providers, Legal Representatives or Family Members:

On the evening of March 13th, the Centers for Medicare and Medicaid Services (“CMS”) issued updated guidance regarding COVID-19 to all nursing home providers nationwide. At this time, the facilities have been instructed to cease communal dining and all group activities.

Our staff members have been informed of this directive and will be speaking with our residents today and assisting the residents in adjusting to these changes. Our teams have devised temporary care plans for every resident to meet their psychosocial needs during this timeframe.

Once again, we are appreciative of your understanding and patience.

Sincerely,

Dr. Shellie M. Sonnentag, DNP, AGPCNP-C, CD
Vice President of Clinical Services
Real Property Health Facilities Corp.
435 Village Walk Lane Suite B
Johnson Creek, WI 53038

Click for March 11, 2020 Letter

March 11, 2020

Dear Health Care Provider, Legal Representative or Family Member:

The current COVID-19 outbreak situation means that it is critical we take every precaution possible. We must prevent this virus from entering our facility. Protecting our residents’ health and safety is our top priority.

The CDC has done a careful review of the death rate in the elderly, especially those with dementia or chronic diseases. Experts are recommending we take action to limit individuals from entering our building and to ensure sick employees stay home.

Early data shows that:

  • The mortality rate for people over 80 in the general population is 15% in China.
  • The World Health Organization report estimates the mortality rate at 21.9% for those over 80.
  • At the nursing home in Washington state, there have been 50 residents who have tested positive for the COVID-19 virus. As of March 9, 2020, 19 of those have died. This is a high death rate.

There is a risk that people who appear healthy will enter nursing homes and infect residents. Studies of past viral epidemics, where recommending prevention was delayed, were not effective. These studies show that the sooner we limit interactions with each other and wash your hands frequently, the virus spreads more slowly.

These facts have led many to recommend severe limitations on visitors. This describes why we have taken this action now.

This morning the World Health Organization declared the outbreak of Coronavirus (COVID-19), a global pandemic. While the CDC still considers it to be a low threat to the general public, our facility has issued new safeguards aimed at limiting the exposure risk for the most susceptible populations – our residents. These residents are predominantly older and have many complex health conditions making them particularly vulnerable to this infection. To minimize the risk of exposure, effective today, March 11th, and until further notice, we are taking the following actions:

  • Our facility has adopted a NO VISITORS stance, meaning no outside visitors will be permitted to visit residents in the facility. The only exceptions will be in compassionate care cases when a resident is in his or her last stage of life or on hospice care. In those cases, visitors will be limited and specifically allowed in the resident’s room only.
  • Our staff will continue to be screened daily before working their scheduled shift.

While the COVID-19 risk to the average American remains low, these common sense measures will help protect our most vulnerable residents. We are making every effort to minimize the impact of these policies on our residents while continuing to put their safety first.

During this time, our staff will work with families and friends to maintain contact with their loved ones via phone, Skype or FaceTime.

We understand how difficult this will be and appreciate your understanding and patience.

Sincerely,

Dr. Shellie M. Sonnentag, DNP, AGPCNP-C, CD
Vice President of Clinical Services
Real Property Health Facilities Corp.
435 Village Walk Lane Suite B
Johnson Creek, WI 53038

Click for March 10, 2020 Letter

March 10, 2020

Dear Health Care Provider, Legal Representative or Family Member:

Real Property Health Facilities Corp. (“RPHF”) manages and oversees the operations of several skilled nursing homes and assisted living facilities located in Wisconsin, Indiana, Kansas and Montana, including Willow Ridge Healthcare in Amery, WI. RPHF has no higher priority than the safety and health of its residents and employees and is working diligently to ensure our facilities receive the highest quality health care services. While there are currently no cases of Coronavirus (“COVID-19”) identified in any of our facilities, RPHF is taking necessary steps to mitigate the risk of the virus spreading within our facilities.

We have established a robust infection prevention and control program, which we routinely follow for seasonal viruses such as respiratory flu and norovirus. These viruses present significant health concerns to our facilities and serve as regular reminders of the importance of effective infection control. Utilizing our infection control protocols provide us with a strong foundation in dealing with this new virus.

What are the symptoms of COVID-19? According to the Centers for Disease Control (“CDC”), those affected generally exhibit cold-like symptoms including fever, cough, and shortness of breath. It spreads through contact with another infected person, such as being too close during a cough or sneeze. This general route for this virus spreading mimics that of the typical cold or flu.

Earlier this week, based on the recommendations of the CDC and other state and local health departments, we have been working with our directors of nursing and facility administrators to execute and elevate our standard protocol.

Such steps include:

  • On-site health care professionals who continually monitor the current guidance to ensure the steps taken follow information received from reputable sources and monitoring employees, contractors, residents and visitors for symptoms, and utilizing potential action plans if symptoms should present themselves. Our paid leave policy for employees who are symptomatic is being reviewed, to encourage ill staff to remain home to minimize risk of resident exposure;
  • Education and training on infection control provided regularly to all employees and residents, including re-educating our teams and our residents of our existing infection control protocols – and how they should be observing it;
  • Connection to national, state, and county and local health departments to remain informed;
  • Emergency management station status that provides primary response from federal and local emergency services, prioritized over other general public environments;
  • Culinary teams who adhere to rigid guidelines from the Food and Drug Administration for food sourcing and processing. We intentionally engage in safer storage techniques and stricter sanitation standards than most private homes. We are adjusting our culinary services, such that we will temporarily eliminate high risk touchpoints (for example: salad bar, shared lobby coffee services, pre-set utensils on tables within our dining rooms, etc.);
  • Housekeeping services on site with enhanced cleaning schedules of all surfaces, utilizing robust cleaning procedures with appropriate disinfectants to keep high resident traffic/touch areas sanitized;
  • Responsive measures to quickly intervene should anyone with symptoms need support. Signage is being displayed at community entrances, discouraging visitors with symptoms from entering.

You may be asking how you can help aid us, in minimizing the spread of any illness. Here are some requests we would make of you:

  • Wash your hands frequently and use good hygiene behaviors;
  • Maintain social distancing – 6 feet distance between yourself and anyone who is coughing or sneezing;
  • Use a tissue or your bent elbow for a cough or sneeze. Then dispose of the tissue and wash your hands immediately;
  • If you have a fever, cough and difficulty breathing, please isolate yourself from others and notify our team immediately or seek medical care;
  • If you have been exposed to someone with fever, cough and difficulty breathing, please isolate yourself from others and notify our team immediately;
  • Encourage your friends and loved ones to visit after the greater community risk has diminished. Visits by those potentially exposed – whether they are aware of exposure or not – raises our risk of spreading the virus.

We thank you for your assistance, support and understanding of the policies and procedures we are enforcing to keep your loved ones safe in this evolving situation.

Sincerely,

Dr. Shellie M. Sonnentag, DNP, AGPCNP-C, CD
Vice President of Clinical Services
Real Property Health Facilities Corp.
435 Village Walk Lane Suite B
Johnson Creek, WI 53038

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