COVID-19 Advisory

Heritage Health Care Preparedness & Response Plan

Heritage Health Care is using this website to provide information about our plan for preparation and response to the Coronavirus, or COVID 19. We have based our plan on CDC and related government health agencies. A pandemic is an epidemic of infectious disease that spreads through human populations across a large region, such as a continent or worldwide. Please note that pandemic’s exclude seasonal flu. 

The virus that causes COVID-19 seems to spread easily and sustainably in the community (community spread) in some affected geographic areas. 

Purpose of our Planning 

We have established key components for pandemic preparedness and continuously updating our readiness efforts. We are also continually identifying additional steps to take upon presumed and positive cases of the virus within our healthcare and community settings.

Transmission of Coronavirus

The COVID-19 virus is thought to spread mainly from person-to-person and especially between people who are in close contact with one another (within about six feet). This happens through the respiratory droplets produced when an infected person coughs or sneezes. It is also possible that a person can become infected with COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or eyes. 

Coronavirus Symptoms

Symptoms of coronavirus may appear within 2 to 14 days after exposure and include: fever, cough, sore throat, and shortness of breath.

Designated Coordinator

Each Americare community has a Pandemic Coronavirus/Influenza Response Coordinator to coordinate pandemic preparedness planning and to monitor public health advisories, information, and updates on a routine basis (or more often, if indicated).

Each Americare community has a Pandemic Influenza Response Coordinator, (administrative professional or director of nursing) to aid in pandemic preparedness planning, execution of preparedness plans at their local community, and distribute/inform/educate their employees, residents, and families on a routine basis. We have instructed each Americare Response Coordinator to establish contact with their local public health and emergency planning partners to understand current community response plans prior to outbreak in that specific area.

Updated 05/14/20

Heritage Health Care – New Communications Protocols

Who is allowed in the community?

Unfortunately, at this time no visitors are permitted in any Americare Senior Living community. The only persons allowed entry are essential staff and healthcare providers, and family members visiting a resident when end of life is imminent.    

Why is Heritage Health Care taking this restrictive action?

We understand the virus is most dangerous to seniors and, as we continue to monitor the spread of COVID-19 around the country, we feel that restricting all visitors is a necessary step to keep everyone safe. 

How long will this last?

The COVID-19 pandemic is an ever-evolving situation. We will release these restrictions when we feel it is safe to do so and base our decisions on recommendations from agencies such as the CDC and state departments of health.

Will my private duty caregiver be allowed to enter the community?

Yes, if they are deemed essential healthcare providers by the community’s executive director, outside healthcare providers, including home health, private duty, nursing services, physicians, physical therapy, and hospice staff. Your private duty caregiver will be granted access to the community once they have completed our entry screening procedures.  

What are your screening procedures for people entering the community?

Everyone entering the community will be asked questions about possible cold-like symptoms, shortness of breath, if they have been exposed to a known or suspected case of COVID-19, and if they have recently travelled. We also take everyone’s temperature to ensure they do not have a fever.

What if there is an emergency?

Emergency medical/fire services personnel are able to enter the community if needed.

Can I visit with my loved ones outdoors on the community grounds?

Because outside guests pose a risk of exposure to residents, we ask that you do not have or schedule in-person visits, either indoor or outdoor. Our residents may enjoy a walk around the community with essential healthcare personnel.

Are there other ways I can visit or see my loved ones?

We are offering virtual visits through various video conferencing services. Our staff will make every effort to keep you informed of the residents and connect you as opportunities present themselves.

What if my loved one is on Hospice, can I visit then?

Hospice services can be accessed for weeks or months at a time and every person’s prognosis is different. We certainly want to allow for compassionate care and ask that families only visit when end of life is imminent.  

Resident Exit & Re-Entry 

Are residents allowed to leave?

We ask that all residents remain on the community grounds unless they need medical care. 

Why are residents not allowed to leave?

COVID-19 is most dangerous for seniors, and every trip outside the community opens the risk of a resident being exposed and bringing the virus back to the community. 

What if I accept the liability of leaving the community?

We understand that you may be willing to put yourself at risk of exposure to the virus. However, this also puts others in our community at risk, and we cannot allow that. 

Why are residents who live in cottages or freestanding homes not allowed into the building?

We are not monitoring the health or symptoms of residents who live in cottages or freestanding homes and we are not following their comings and goings. Therefore, we cannot allow residents of cottages and freestanding homes to enter the main community building.

Am I allowed to temporarily move out of the community?

Yes. If you desire, you can temporarily move out of the community to stay with family members. However, you are not able to return to the community until we are able to lift these restrictions. Please note that rent will continue to be due per the resident services agreement.  

What happens if someone goes to the hospital and is ready to return to the community?

Residents who are returning from the hospital will be screened just like others who enter the community.  Our assisted living communities and skilled nursing communities differ in the acuity levels they accept upon admission which also pertain to re-admissions. (see Prospective Residents and Families Tab)  Rest assured we want to bring your loved one “home” when it is safe to do so.    We are working closely with all of our hospital partners to understand how they are properly screening discharging patients to ensure we have accurate information when considering each admission.  Hospitals too have enhanced infection control procedures in place to mitigate the risk of Coronavirus infection in their facilities.  

What if I have recently returned from vacation or a cruise?

If a resident decides to leave the community, when unrelated to health care needs, they will not be able to return until visitor restrictions are lifted.

Will new residents still be able to move into the community?

The admitting facility will assess the prospective resident’s symptoms of respiratory infection upon admission to the healthcare setting.    

• The prospect is to have COVID19 test prior to admission preferably within 2 days of admission to allow for timely results related to the move in period.
•  If the COVID test is negative prospect will be allowed to move into the community and will quarantine to room. 
• On the 6^th day of admission, a second COVID19 test will be performed. 
  • If the result of this test is negative and the resident is not displaying symptoms the quarantine for the resident will be lifted. 
• If the result is positive, the protocols for positive residents will be followed. 
• All new admissions should be admitted to a room without a roommate for the initial quarantine period. 
  • If occupancy levels do not allow for a resident to quarantine in a private area the community should consult with the regional director of operations for guidance. 
• In the event pre-admission testing is not available or if unable to be performed the new resident will be required to quarantine to room for 14 days.

Will we allow Daylight (adult day care) and temporary respite stays?

We have suspended our Daylight (adult day care) and temporary respite stay program at this time. Clients using these programs are welcome to admit to our community full-time providing they meet our revised admission criteria. Please contact your community’s administrator for further information.

Outside Deliveries

How will outside deliveries work?

Deliveries, when possible, will be made outside the building. A Heritage Health Care staff member will accept packages and distribute them to residents.

Can I bring something to a resident?

Yes. Similarly, we are following our delivery procedure by having a staff member meet you or pick the item up at the entrance of the community. We will then take the delivered item to the resident. To assure a staff member is promptly available to meet you, we suggest calling ahead. 

Personal Needs

How do I get any personal items I may need?

We recommend that a family member bring your items to the front door of the community building and a staff member will accept the package and/or items. To assure a staff member is promptly available to meet you, we suggest calling ahead.

For those residents who do not have family in the immediate area, we will ensure they receive the items they need.   

Will the salon remain open?

We have decided to close our in-house salons at this time. We know personal appearance still matters and are committed to keeping our residents feeling and looking their best. Our care staff will help residents with hair care needs that do not require a licensed beautician, such as shampooing and styling. We will not be able to accommodate perms, hair coloring or cutting.   

Medical Needs

How will I get to my doctors’ appointments?

When possible we will work with physicians’ offices to utilize technology to replace offsite doctor visits. At this time residents can still leave the community for necessary medical visits, including emergencies and essential doctor appointments. Transportation to these types of offsite appointments will be arranged by our staff members.  

How do I get other pharmacy items, such as over the counter medicines?

If you are using Pegasus Pharmacy, deliveries will continue as normal. If other pharmacy or over the counter items are needed, we recommend a family member pick up these items for you to drop them off at the front door. To assure a staff member is promptly available to meet someone dropping off items at the front door, we suggest calling ahead. 

What if I need outside home health or hospice care?

To add an extra layer of protection around our residents at this time, beginning March 30 we are suspending services of outside home health agencies and private sitting services unless those providing the services do not provide services at any other health care setting or patient home.  Our nursing staff will accommodate the needs of these residents through normal care protocols.  The exception would be the hospice nurse when the death of the patient is imminent or a change of condition evaluation needs to be completed.  The hospice nurse would be required to wear personal protective equipment during their visit and would only be allowed in rooms of patients on service.  

Will the in-community therapy provider still see residents?

Residents receiving therapy by our in-house therapy staff (staff that is not shared with other health care settings) will continue to receive those services.  

Will therapy provided by outside therapists/agencies continue?

Beginning March 30th, residents in our assisted living setting whose therapy is provided by therapists who provide services in other healthcare settings will have their therapy suspended for 30 days once a coordinated care hand-off takes place between the therapist and our facility nursing personnel.

Dining

Are there changes to the dining schedule?

We will offer residents the opportunity to eat in their room with meal delivery services. We will have scheduled dining hours and allow for alternating meal times so that during dining community members may still practice social distancing. 

If I live in a cottage or freestanding home, how will I get my meals?

We will deliver your meals to your front door. 

Activities

Will social activities and events still be offered?

We’re committed to keeping our residents engaged and active during this time. Additional training and resources have been provided to our Lifestyle Coordinators so that they can support one-on-one activities, technology avenues to provide family interactions, and limited participant activities that embrace social distancing. Our daily activity calendar will reflect these changes.

How is social wellness being addressed?

In addition to one-on-one activities, we are encouraging letters and correspondence from families, kids, and college students. We are also enhancing resident-accessible technology that will support connection and interaction with family and friends via FaceTime, Skype, and other platforms.   

Heritage Health Care Staff

How are staff being screened?

All staff members are required to complete a wellness check at the beginning of each shift. This check includes taking their temperature, monitoring for cold-like symptoms, and discussing recent travel and possible exposure to someone with COVID19. 

Does staff get paid when they miss work?

Full-time and part-time staff have a paid time off (PTO) bank that allows them to be paid when missing work due to illness. However, revisions to this policy may occur based on governmental guidance or Heritage Health Care policy updates.

What are you doing to help staff?

We are temporarily waiving the 90-day wait period for PTO access for our new employees. Our free EAP program provides mental health and wellness assistance to employees and we are also helping to support eligible Heritage Health Care employees (on a case-by-case basis) through the Americare Relief fund.  

Is Heritage Health Care still hiring and how are job applications handled?

Yes, we are still hiring for select positions. In addition to current openings, we are ramping up our temporary workforce to free up our clinical staff of non-clinical duties like housekeeping, laundry, meal delivery, and activities. 

We accept online job applications at Heritage Health Care jobs. This link will take you to a site where you can look at job openings in your area. We will hold interviews over the phone or at an off-site location. 

Resident Illness

How are you checking residents?

In our healthcare setting, we are proactively monitoring the temperatures and symptoms of all residents, as well as checking for any changes. 

What happens if a resident has symptoms?

Residents with cold-like or flu-like symptoms, including fever, coughing, or shortness of breath will be asked to stay in their rooms until they are symptom-free or unless directed otherwise by our local health department. We will coordinate their care with their physician and other providers as needed. We will also deliver their meals and provide all necessary services in their rooms.

What happens if there is a case of COVID-19 in our community?

While we hope that no confirmed cases of COVID-19 appear in any of our communities, if there is a suspected or confirmed case, we will follow all CDC guidelines and work closely with the state and local departments of health. Family and employee notification will also occur. 

Comments & Concerns

Who do I call if I have a comment, concern, or complaint?

We encourage you to call or email your community’s executive director or director of nursing with your concerns and comments. 

Heritage Health Care Restricted Visitation Policy

Update 6.24.20

Please refer to the “Our Community and COVID-19” page on your community’s website for our new visitation program.

 

Update 4.29.20

The states in which we operate are beginning to relax their stay-at-home orders and to re-open businesses.  Each state has its own criteria and timeline for doing so. 

Nonetheless we have received clear guidance from each state’s health department, the Centers for Medicare and Medicaid Services (CMS) and the American Health Care Association that until further notice all of our assisted living, memory care assisted living and skilled nursing communities should remain closed to visitors.   

 

Our communities are adhering to a restricted visitation policy to protect the health and safety of our residents and our staff. Currently, we have limited visitation to follow the policy set out below:

• Family member visitors over 12 years of age visiting a resident when end of life is imminent – limited to two family members at a time
• Outside healthcare professional and providers serving current residents
• Resident ombudsman
• Essential vendors and delivery personnel

All visitors must sign in and complete a wellness check upon entering the building, as well as adhere to infection control and personal protective equipment instructions. For example, all allowed visitors must answer NO to the following questions before entering the building: 

• Do you have a fever of 100.4 F or greater? 
• Do you have a dry cough, sore throat, or are experiencing difficulty breathing?   
• Have you traveled to an area where COVID-19 has been present or been in contact with a presumptive or known case of COVID-19?

Americare has always been a vital part of the healthcare continuum in the communities we serve. And that hasn’t changed.

In an effort to balance the health and safety of our current residents in light of Coronavirus while helping your family determine if our Americare community is the right choice, we have put revised guidelines in place regarding our admission criteria and processes.

Initial Inquiry/Community Tours

We are suspending on-site visits by prospective residents and families. Our admission coordinator will work with prospects via telephone, web-conference, off-site in-person visits to provide initial information, share images of the community. Admission staff will be prepared to share pictures of the prospective resident’s room via text or email.

Admissions to our Assisted Living, Memory Care Assisted Living and Independent Living Communities

Pre-admission screening/admission paperwork

• Prior to admission, a nurse from the community will go onsite to provide a pre-admission screen to determine if the prospective resident is exhibiting symptoms of any respiratory infection (cough, sore throat, runny nose and is running a temperature of 100.4F.)
• Prospective resident exhibiting the symptoms above will be not be considered for admission at this time.
• Once resident is accepted for admission, designated community personnel will complete the necessary admission paperwork with the family and resident via email or off-site prior to admission.
• We are suspending all day-care and short-term respite stays at this time. These clients would be eligible for full-time admission to our community if they meet the above criteria.

• The prospect is to have COVID19 test prior to admission preferably within 2 days of admission to allow for timely results related to the move in period. 
• If the COVID test is negative prospect will be allowed to move into the community and will quarantine to room.  
• On the 6th day of admission, a second COVID19 test will be performed.  
• If the result of this test is negative and the resident is not displaying symptoms the quarantine for the resident will be lifted.  
• If the result is positive, the protocols for positive residents will be followed.  
• All new admissions should be admitted to a room without a roommate for the initial quarantine period.  
• If occupancy levels do not allow for a resident to quarantine in a private area the community should consult with the regional director of operations for guidance.  
• In the event pre-admission testing is not available or if unable to be performed the new resident will be required to quarantine to room for 14 days.

Admissions to our Skilled Nursing Communities

Pre-admission screening:

• Prior to admission, a member of our nursing staff will conduct a pre-admission screen based on communication with the patient’s current medical provider to determine if the prospective resident is exhibiting symptoms of any respiratory infection (mild or acute), is running a temperature of 100.4F.

The admitting facility will assess the prospective resident’s symptoms of respiratory infection upon admission to the healthcare setting.    

• The prospect is to have COVID19 test prior to admission preferably within 2 days of admission to allow for timely results related to the move in period.
•  If the COVID test is negative prospect will be allowed to move into the community and will quarantine to room. 
• On the 6^th day of admission, a second COVID19 test will be performed. 
  • If the result of this test is negative and the resident is not displaying symptoms the quarantine for the resident will be lifted. 
• If the result is positive, the protocols for positive residents will be followed. 
• All new admissions should be admitted to a room without a roommate for the initial quarantine period. 
  • If occupancy levels do not allow for a resident to quarantine in a private area the community should consult with the regional director of operations for guidance. 
• In the event pre-admission testing is not available or if unable to be performed the new resident will be required to quarantine to room for 14 days.

Our eldercare advisors, administrators and nurses are committed to ensuring you receive the best information possible as you consider your choices for senior care. We realize that some of these measures may seem restrictive. Rest-assured, once you have decided to move in to one of our communities we will do everything we can to keep you and your family connected. You will also be part of a coordinated communication loop to keep you informed.

Heritage Health Care Guidelines for COVID-19

We’ve put together a pamphlet to help you and your family members navigate and understand the coronavirus illness. It is available here.

We are committed to giving our local media partners the most accurate information possible. We will publish a current press release on this page and update as needed. It is important that we keep our local leadership team focused on caring for our residents and staff.

We ask journalists requesting further information or comment to email our Senior Vice President, Patricia Cokingtin at pcokingtin@americareusa.net.

Press Release 

Contact:  Patricia Cokingtin, Senior Vice President
Email:  pcokingtin@americareusa.net
Date:  March 30, 2020

FOR IMMEDIATE RELEASE

Americare Communities Update Their Plan to Prevent and Respond to COVID-19

Americare Senior Living has put an official plan in place to prevent and respond to possible cases of COVID-19 in their communities. Based on information from the American Health Care Association, the Centers for Disease Control and Prevention and the National Institutes of Health, to date the company have instructed its communities to do the following:

Beginning 3.5.20:

• Re-educate all staff on proper infection control procedures. This was accomplished through their online learning platform
• Implement enhanced workplace cleaning procedures and have ensured adequate supplies of personal protective equipment.
• Posting an entrance poster in each community that asks visitors to refrain from entering the building if they are experiencing a temperature of greater than 100.4 degrees F, runny nose, cough or sore throat.
• Asking all staff and volunteers to complete a daily self-check including temperature when they enter the building.
• Residents will also be screened daily.
• Restricting volunteer groups from the buildings in the immediate future
• Distributing a letter along with instructions on what to do if you contract COVID-19 to all employees, residents, and family members
• Community and regional staff will follow local health department protocols to report any known cases of residents or staff.

Update 3.13.20:

• Implement a revised visitor policy that limits visitors to family a loved one at end of life or on hospice services, outside healthcare providers, and essential vendors and delivery personnel.
• Allowed visitors will be prohibited from entering the building if they are experiencing a temperature of greater than 100.4 degrees F, runny nose, cough or sore throat.
• Require all staff and allowed visitors to complete a daily self-check including temperature when they enter the building.
• Residents will also be screened daily.
• Review of Pandemic – COVID-19 and Contact Isolation policy with all staff
• Distributing a letter along with instructions on what to do if you contract COVID-19 to all employees, residents, and family members
• Community and regional staff will follow local health department protocols to report any known cases of residents or staff.

Update 3.20.20:

• Suspend Daylight (adult day care) and temporary respite care admissions. Residents using these programs are allowed to admit to the community providing they meet our revised admission criteria.
• Eliminate large group activities. We are allowing small group activities that allow for proper social distancing between residents
• Americare hosted a webinar on 3.19.20 for our lifestyle coordinators giving them direction and ideas on continuing life enrichment activities for our residents.
• Limit communal dining. We have implemented staggered dining times to provide for proper social distancing (one person per table). We are offering in-room dining to any resident who can eat unassisted. Our caregivers continue to assist residents who need extra help with dining.
• Shipped Wi-Fi -enabled portable devices to all of our communities to ensure we can connect our residents face-to-face or voice-to-voice with their loved ones. We also continue to assist residents with their own devices to do the same.
• We are putting processes in place to accommodate telemedicine visits from our residents’ physicians and nurse practitioners.
• We are beginning an effort to recruit and train up a temporary workforce of Hospitality Assistants in our communities that need them.
  • The Hospitality Assistant will be trained to perform non-direct patient care tasks such as meal delivery, light housekeeping and laundry, assistance with activities and telephone reception.
  • This workforce is designed to allow our certified and licensed caregivers to concentrate on direct resident care.
  • Hospitality Assistants will receive the same infection control training and will be subject to the same daily screenings as other personnel.
• Have developed an internal system to monitor key data points both daily and weekly from each Americare community to allow timely response to material or manpower shortages and other information requested by the CDC.​

Update 4.1.20

•  In order to add an extra layer of protection for your family member during this time, we are suspending outside therapy and home health services for the next 30 days in our ALF and memory care communities.  An exception will be made if the therapy company or home health agency is able to assign one therapist or care provider to the building.  Our directors of nursing are working our treating therapists and home health agencies to ensure a coordinated hand-off of care is completed by April 3.   Our skilled nursing communities have therapists  assigned to only one building and they will continue to treat our skilled nursing residents on service.
• New residents admitting to the assisted living setting will be placed on in-room quarantine for 7 days and monitored for symptoms daily like all community residents.  Residents admitting to our memory care setting will be monitored every shift for symptoms for the first 72 hours and daily thereafter.

Update 4.8.20

• As of 3.31.20 all new admissions in our skilled nursing communities were placed on a 14-day in-room quarantine. Residents are checked each shift for symptoms for 72 hours and daily thereafter. 
• As of 4.6.20 all new admissions to our assisted living communities are placed on a 14-day in-room quarantine.  Residents are checked each shift for symptoms for 72 hours and daily thereafter.  Residents admitted in our memory care settings will be checked for symptoms every shift for the first 72 hours then daily thereafter. 

Update 4.29.20

• The states in which we operate, Tennessee, Mississippi, Missouri, Kansas and Illinois are planning or beginning to relax their stay-at-home orders and to re-open businesses.  Each state has its own criteria and timeline for doing so. 
• Nonetheless we have received clear guidance from each state’s health department, the Centers for Medicare and Medicaid Services (CMS) and the American Health Care Association that until further notice all of our assisted living, memory care assisted living and skilled nursing communities should remain closed to visitors except in cases where end of life in imminent. 
• We understand how difficult it is for our residents to be separated from loved ones.   Each of our communities is doing its best to help residents stay connected.  We have equipped each building with one or more smart devices to make face-to-face visits possible.  Our staff is also helping residents with their own phones and tablets more easily make those connections. 
• We will update our families and residents on the visitor policy at least monthly or more often if guidance changes.