07/25/2020 Essential Care Giver Policy

July 25, 2020

Pioneer Memorial Care Center – The Country Place - Crossroads

Policy on Essential Caregivers

July 25, 2020

PMCC recognizes the importance of social distancing and physical separation to help keep residents safe from exposure to COVID-19. PMCC also acknowledges the unintended consequences of prolonged social distancing and isolation on a resident’s overall health and well-being, particularly with residents who have had friends, family, or caregivers participate actively in their care prior to the pandemic. Though this is not a requirement by the state of Minnesota, we feel that some need to be met as safely as possible.  There is risk for each new individual that enters the building, the possibility for exposure rises, so access request will be heavily examined and requires EC to do training. The following protocols will be utilized to address the desire for essential caregivers effective July 25th, 2020.

Note:  if at any time there is a concern about community exposures to COVID-19, or exposures of staff, residents or families to COVID-19 within our facility, we will be suspending this policy until further notice.

1. Essential Caregiver (EC) Eligibility:

Residents/Resident Representatives requesting an essential caregiver need to meet these qualifications:

1. An essential caregiver could be a family member, outside caregiver, friend or volunteer, who has provided regular care and support to the resident before or during the pandemic. Residents can have more than one essential caregiver for providing emotional support and individualized, person-centered care.
2. The resident had an EC in past care giving roles like feeding.
3. EC is identified in resident plan of care or resident has an identified need for an EC due to failure to thrive or exacerbated signs of depression identified by medical staff.
4. Needs identified by weight loss, PHQ9 change, staff report, depression / psychological need, feeding support, and behavioral support.
5. Complete infection control training, and signing that prescribed requirements will be adhered.

2. Requesting Essential Caregivers

Qualifying residents/resident representatives can request an essential caregiver using the following process:

1. Submit request through staff who will present it to clinical meeting for review.
2. Submission through email at pmcc@gvtel.com.
3. Each review will be vetted through inter-disciplinary team based on each individuals needs.

3. Personal Protective Equipment (PPE)

a. ECs must wear the same level of PPE for the resident visit that staff are required to wear. (MDH PPE grid can be foundhere:

https://www.careproviders.org/members/2020/COVID_ppegrid.pdf) At minimum, this includes a face mask and protective eyewear (eyewear must cover the front and sides of the eye area). PPE will be worn by EC at all times during visit.

b. The facility will not provide PPE to ECs. Required PPE consists of 3 layer mask, and

goggles with side shields.

c. Staff will train ECs on the proper method of donning and doffing required PPE.

d. ECs failing to properly utilize PPE will not be eligible for future visits.

4. Facility Essential Caregiver Screening/Check in Process

a. Essential Caregivers (EC) must go through our essential caregiver orientation training, which includes review of proper infection control, screening, use of personal protective equipment, visitation terms, and triggers for pausing EC visits, prior to their first visit.

b. All EC must enter the building through designated door, and immediately check in with staff for your screening prior to each visit. 

• • Pioneer Memorial Care Center – Employee Entrance located on the North side of the building.
  • The Country Place – The front office entrance.
  • Crossroads – The front office entrance.

c. All ECs must perform hand hygiene before proceeding to visitation, and as directed with needed care tasks.

d. All ECs will be screened by staff for temperature and other signs and symptoms of COVID-19.

e. At each visit, ECs will sign and date a visit form indicating their understanding of the EC requirements and rules.

f. EC will immediately contact the facility if they develop a fever or symptoms consistent with COVID-19 before or after a visit with a resident.

g. EC visits will be prohibited if a resident in our facility is COVID positive, unless defined as a compassionate care visit for end of life.

h.If EC has had contact with a person who has had exposure, which resulted in the need for a COVID test they will let us know.

5. Essential Caregiver Visits

            a. All visits by ECs must be scheduled. “Walk-ins” will not be permitted.

b. Scheduling visits:  The following system will be utilized for ECs to schedule visits:       

• Call and schedule with neighborhood staff

b. After screening, ECs must wear the appropriate PPE and go directly to either resident room or other designated area that fits need, ie. Activity Room, Conference Room.  Visits can only be between the resident requesting the EC and the EC, and not include other residents or staff in the facility.

            c. Visits shall be limited to no more than 3 hours per day in duration or incremental visits.

d. No more than one EC can visit a resident at a time, but a resident can have more than one EC scheduled visit in a day (maximum 3 hours per day )

e. EC will maintain 6 foot social distance from individuals in the building at all times, unless delivering cares to resident.

f. EC will not take the resident out into the community except for essential medical appointments coordinated by nursing staff.

g. The maximum number of EC visits in a day for each building is 2 individuals at any one time.

6.  Triggers for Pausing Caregiver Visits

a.EC visits will be prohibited during a resident 14-day quarantine – exceptions will be made for compassionate care visits

b. EC visits will be prohibited if a resident is COVID-19 positive or symptomatic – exceptions will be made for compassionate care visits.

c. Visiting rights may be restricted or revoked for individual ECs if communicated safety measures are not followed.

d. Visiting rights will be revoked for the EC if they are COVID-19 positive or are exhibiting signs or symptoms of COVID-19, until one of the following criteria are met.

e. In the event of an unforeseen emergent circumstance, we may need to reschedule in the best interest of the residents.

Symptom-based strategy. Exclude from visits until:

• • At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); and,
  • At least 10 days have passed since symptoms first appeared

Test-based strategy. Exclude from visits until:

• • Resolution of fever without the use of fever-reducing medications and
  • Improvement in respiratory symptoms (e.g., cough, shortness of breath), and
  • Negative results of an FDA Emergency Use Authorized COVID-19 molecular assay for detection of SARS-CoV-2 RNA from at least two consecutive respiratory specimens collected ≥24 hours apart (total of two negative specimens).

7. Concerns with Essential Caregiver Policy can be directed to: 

a. Lisa Frey, Administrator at 218-687-2365 ext. 223 or Melissa Bergman, Director of Nursing at 218-687-2365 ext. 227

b. Office of Ombudsman for Long-Term Care at 651-431-2555 or 1-800-657-3591 to request advocacy services.