The Maplewood’s Response to COVID-19
The Maplewood has been and continues to be guided by recommendations from the New York State Department of Health and CMS regarding COVID-19 precautions and procedures to protect and maintain the health and safety of our residents and staff.
As COVID-19 began to escalate in this area, we jumped into action evaluating just about every aspect of operations. Our team carefully reviewed all infection control protocols, enhancing policies and procedures if needed. We built-up supply inventory early, especially personal protective equipment (PPE), finding alternative suppliers if necessary. An alternative staffing plan was created to ensure shifts would be covered if employees became ill. All of the services and amenities provided to residents were reviewed to determine which could continue and how they might need to be altered. Everyone and everything that comes into the facility each day were considered and new policies and procedures were quickly put in place.
In addition to our infection control measures, the layout of our facility has served us well. All resident rooms are private and have private bathrooms. Back when this design was created, the goal was to enhance dignity and privacy while providing lovely, spacious living areas for everyone. We never dreamed that someday this kind of setup would be needed for the strict protocols that have been implemented over the past several months. It sure has worked well for us, eliminating the worry about resident to resident contact from shared living quarters. And, if someone needs to be restricted to their room for medical reasons, they continue living in a beautiful, comfortable space, much like a hotel suite.
As you could guess, the restrictions that have kept everyone safe, have also created a new challenge in regard to social engagement. We immediately went to work planning meaningful social experiences in addition to making sure residents continue to be connected with their families and Maplewood community during this time.
We feel confident in our preparedness efforts and ability to handle the virus. While COVID is a new virus, our staff is well trained and prepared to treat infectious diseases. We are accustomed to dealing with influenza, which is also a respiratory illness and requires similar practices for preventing the spread to other residents and staff.
The following are highlights of precautions, protocols and updates regarding how The Maplewood is responding to COVID-19:
February 27, 2020
- Begin PPE conservation and supply building initiatives. Placed orders hoping to receive supplies of masks and other needed equipment. The first shipment was finally received on June 2.
March 6, 2020
- Letter to families with update about COVID-19, reminder to refrain from visiting if ill, and request to follow a provided list of habits to help prevent the spread of respiratory viruses such as hand hygiene, cough etiquette, avoid touching eye, nose and mouth, etc.
- Implement more stringent cleaning of high touch areas
- Additional staff education and retraining for infection prevention
March 12, 2020 – Visitor Restrictions and Screening
- Announce new visitation restrictions including limited visiting hours of 10-4 daily, allowing only resident family members and powers of attorney, exposure screening questions required upon entering, entry through the main door only and discontinuation of guest dining services
- Notify family members via email, hard copy letters and phone calls
March 13, 2020 – DOH Mandate to Immediately Cease Entry to Visitors
- End all family visits and all access to the facility for family, companions, visitors, volunteers and non-essential personnel (see our current Visitation Policy)
- Notify family members via email and phone calls
- Hang signs on entry doors announcing no visitors are allowed
- Cancel all resident outside appointments and handle needs in-house with nursing staff and medical director
- Purchase Chromebooks and iPads and begin setting up a program for video chats with residents and loved ones
- Begin providing family news updates regarding COVID-19 at least once a week
March 16-20, 2020
By Monday morning, the following items were in place:
- Mandatory protocols for all staff each time they enter the facility, including masking, temperature screening, exposure and illness screening and enhanced handwashing practices, remaining in the building for the entirety of their scheduled shift and social distancing during meal breaks
- Cease in-facility visits from medical consultants/specialists – Medical providers such as the medical director, wound care specialist, xray technician and lab technician continue to be admitted into the facility as essential personnel
- Cease resident communal dining
- Switch from traditional group activities and events to one-on-one visits and activities
- Switch from group exercise and wellness classes to one-one-one sessions
- Deliver one-on-one physical and occupational therapy in resident rooms and in limited capacity in therapy gym
- Begin submitting mandatory daily reports to the DOH regarding PPE supplies, number of staff in the building each day and number of staff and residents testing positive each day
More protocols and activities were added throughout the week:
- Begin facilitating video chats between residents and loved ones
- In addition to the nursing and therapy departments, staff from activities, administration, housekeeping and social services begin spending extra one-on-one time residents visiting, sharing a quiet activity or simply keeping them company for a while
- Window visits with loved ones begin
- Cancel mail delivery and begin daily pick up at the Post Office with delivery to residents after a required holding time
- Laundry for all residents now done in the Maplewood, even for those families who have previously elected to do this themselves
March 25, 2020 – DOH Mandate
All nursing home administrators received a letter from the NYS Department of Health announcing an emergency regulation that had just been issued, giving orders to all facilities in New York as follows:
“No resident shall be denied re-admission or admission to the NH solely based on a confirmed or suspected diagnosis of COVID-19. NHs are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or re-admission.”
Unfortunately, as everyone discovered, this led to a very bad situation downstate where hospitals were over capacity and the nursing homes in and around NYC accepted many people who had the virus. These patients brought COVID it into those facilities, resulting in a devastating number of deaths. Many of these facilities did not, and still do not, have the PPE they need to care for these patients properly.
Thankfully, it did not come to this in the Rochester area, and this order has since been completely reversed. Currently anyone coming from the hospital to a nursing home is first tested for COVID.
March 26, 2020
- Receive first shipment of PPE supplies from NYS Office of Emergency Management
April 3 – 17, 2020
- Purchase additional exercise equipment for the therapy department to offer more options for individual exercise. The new Sci-Fit Recumbent Stepper has been very popular and provides both cardiovascular and physical benefits. It allows individuals to move their arms and legs simultaneously while seated in the reclining seat of in their own wheelchair.
- Telemedicine begins with medical team and medical consultants
- Modify process for new admissions/returning residents, putting all on 2 weeks of isolation and precautions
- Host an ice cream room service delivery day
- Begin weekly room-to-room happy hours on Friday afternoons
May 10 – 15, 2020 – Mandatory staff testing
- On May 10, 2020, Governor Cuomo signed an executive order requiring twice a week testing of all personnel in nursing homes and adult care facilities. Facilities were given until May 15th to determine how they were going to attempt compliance.
- Maplewood staff began testing on May 15th and all were tested by May 22nd. This has since been changed to once a week testing.
May 18, 2020
- New thermal and image technology installed to improve on and document staff screening for temperature and wearing masks.
May 22, 2020 – DOH Infection Control COVID-19 Survey
- The Department of Health arrived for a surprise visit to conduct an Infection Control COVID-19 Focus Survey to determine if our facility was in compliance with Federal and State requirements. The surveyors found The Maplewood to be in substantial compliance with zero deficiencies, and they made no new recommendations.
June 3, 2020
- Resident testing by DOH – no positive results
June 20, 2020
- Two additional imaging and thermal screening devices were installed at each of the public entrances in anticipation of being able to bring back visitors and some service providers. These devices capture temperature and check for a mask on each person entering the building.
July 10 – 28, 2020
- The DOH released a multi-page directive announcing the terms under which limited visitation in nursing homes could take place. Among the many rules, this included the stipulation that a facility must be free of COVID positive cases among both residents and staff for 28 days before visitors could enter. Any occurrence of a case would start the 28-day clock over again. The 28-day rule (as it became known), created a hurdle for the majority of nursing homes to meet the visitation criteria. Our state nursing home association, NYSHFA, began working on getting the governor to reduce the 28-day waiting period to a far more reasonable 14 days. Thanks to those efforts and the countless letters from families, the 28-day rule was changed to 14 days in September.
- Maplewood immediately got to work reviewing the state’s extensive list of requirements and carefully planning for safe visitation options that meet all the criteria.
- A new Visitor Screening and Management technology was implemented, called Visitly, in anticipation of visitors being allowed into the facility. This system makes the screening process safer and easier for visitors, while automating the tracking documentation that Maplewood is required to maintain.
August 27, 2020
- Maplewood hosted an uplifting family parade event with picnic lunches to go. Residents’ families decorated their cars and drove past Maplewood as residents and staff, who were outside waiting, cheered and waved at their loved ones. For many, this was the first time residents and families were able to see each other for many months. Webster First Responders joined us, leading the line of cars through the route. Read more and watch a parade video on our blog.
August 28, 2020
- Family visitation began inside the facility, in accordance with the guidelines from the state health department. It was wonderful to see how happy residents and families were to be together, even with many safety protocols in place and spacing between each other.
September 25 – October 25, 2020
- The annual flu vaccine program for residents and staff took place at Maplewood.
November 8, 2020 – Increase in Cases in Monroe County
- Cases in Monroe County hit record highs for the area and spread continued to increase throughout the month, reaching yellow and orange zone status.
- Maplewood joined the Echo Program, which was created by the Agency for Healthcare Research and Quality (AHRQ) to help nursing homes across the nation collaborate with each other in responding to COVID-19. By participating in this program, Maplewood has gained access to useful information and resources regarding safety practices, infection control, quality improvement and nursing home operations. In addition, the program has connected us with a virtual learning community of specialists and peers to ask and answer immediate challenges.
November 17, 2020 – Clearview Visiting
- A new option for family visits was created at The Maplewood. Clearview visiting makes use of a large vestibule with plenty of comfortable seating. This climate-controlled space offers heat and air conditioning for year-round visiting in any weather. An amplification system makes it easy to hear each other, while a plexiglass panel provides totally clear viewing, protection, and the ability to get close enough to interact and even show residents photos on your phone. We’ve had residents play Yahtzee with family members, sing songs together, and simply enjoy sitting and talking for a while.
November 26 – December 11, 2020 – Enhanced Protocols
- Maplewood worked to proactively positioned itself to respond as community spread increased. The facility moved to more enhanced levels of protective measures, operations protocols and preparedness.