COVID-19 (Coronavirus) Update

hands holing a heart shape object April 4, 2020 Letter

No Visitors PosterDear Residents, Employees, Health Care Providers, Legal Representatives and Family Members:

Another week has passed and we are grateful to report we have no suspected or active COVID-19 cases amongst our residents.

Earlier this week, prior to President Trump’s request, the management team started on plans to create a COVID-19 isolation unit for each of our skilled nursing locations.  An area at each home will be designated for this purpose. This area will be separated from the main living areas of the facility by an antechamber, which is a separated space created by two temporary walls. The antechamber creates the necessary barrier between the isolation unit and the rest of the home.  Staff will use the antechamber to sanitize their hands and apply and remove their personal protective equipment (PPE).  Staff treating residents in the isolation unit will be dedicated to that unit and will not access any other areas of the facility.  They will wear full PPE, including a fit-tested N-95 mask, a full face-shield, gown, gloves and hair protection. The isolation units will have Honeywell HEPA Air Filtration units.

Our plan is to use the isolation units to care for our current residents in the event they become symptomatic, have suspected COVID-19 infection or test positive for COVID-19. The CDC has instructed us to assume that any resident our facilities now receive from a hospital or the community is infected with COVID-19, unless the resident has tested negative for COVID-19.  For this reason, any resident that returns to us from the hospital or is admitted from the community, untested, will spend at least 14 days of quarantine in the isolation unit for the protection of our other residents and staff.

In addition to our staff wearing masks at all times, we are now requiring any staff with resident contact to wear a full face shield.  This provides the staff with additional protection from coughs, sneezes and splashes.  Please don’t be alarmed if you look through your loved one’s window and see a staff member with a mask and a full face shield.  This is part of our new “normal” in an effort to keep everyone as safe as possible.

We want to thank the local K-12 schools, the technical colleges and the universities in our areas for donating unused supplies to some of our nursing homes.  So far, they have donated thermometer probe covers, Clorox bleach wipes, and gloves.   We also want to thank our volunteer sewing crews for the fabric masks and reusable/washable isolation gowns.  We are greatly indebted to you.

In appreciation for our employees’ dedication, the company has implemented a bonus program effective April 1st through May 31st.   The resilience, strength and commitment demonstrated by our staff has proven critical in getting us through this crisis.  Most importantly though, the staff’s efforts to put a smile on a resident’s face at every opportunity is inspiring.

Please do your part and abide by the “Safer at Home” orders.  If you must go out, please consider wearing a mask.  If we all do our part, the faster we will get through these challenging times.

We thank you for your continued patience and understanding.

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 30, 2020 Letter

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

We hope this update finds you all well. Currently, we have no suspected or active COVID-19 cases in any of our nursing home or assisted living locations. We did have three residents with symptoms, but fortunately, each of their tests were negative.

We have been working diligently to obtain more personal protective equipment (PPE) for our staff and residents. The following list summarizes our successes:

  • The order we placed for our reusable full face shields have been delivered to each of our locations. The face shields will be worn with a mask when we have a resident on isolation precautions due to fever or symptoms.
  • We are expecting our new infrared thermometers to be delivered this week. The new thermometers will make it easier and faster to screen our employees and residents for fever.
  • We have contacted local distilleries that have turned to production of hand sanitizers. Many of our locations have received a bulk supply of this alcohol-based hand sanitizer that will allow us to refill our dispensers and bottles for resident and staff use.
  • We have been overwhelmed by the generosity of the sewers/quilters in our local communities. They have come to our aid by sewing fabric surgical masks for our staff to wear during their shifts. Our residents also wear these masks when they leave their facilities for medically-necessary appointments.
  • We continue to educate and reinforce with our staff about the national and local “Safer at Home” orders.
  • We are turning to technology for health care provider visits by working towards telehealth appointments instead of having physicians, nurse practitioners and physician assistants make in-person visits.
  • Some of our locations are now receiving a limited supply of the strategic national stockpile PPE.

We are still faced with some challenges, namely trying to get more disposable or reusable isolation gowns, N-95 masks and extra oxygen concentrators. We will continue our efforts to obtain these needed supplies in the event of a surge in the number of COVID-19 cases. Many of our sewers/quilters have committed to continue to make fabric masks, and now, some reusable isolation gowns.

At this time, we ask that you please continue to follow our updates on each of our nursing home and assisted living websites, as well as each facility’s Facebook page. If a positive COVID-19 case does occur at one of our locations, the facility management team will notify all interested parties directly. Also, our residents get so excited to FaceTime/Skype family members and to receive your videos. Please keep them coming.

We thank you for your continued patience and understanding.

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 20, 2020 Letter

March 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 Oakbrook Health & Rehabilitation in Thorp, 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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