Author: rockinghamcountyltcnews

October 20, 2020

As you are all aware, New Hampshire continues to have a significant nursing and LNA staffing crisis. To provide the best care for our residents, the decision has been made to close a unit. This was done early last year and did reopen a few months later. Residents and responsible parties are being notified this morning. After examination and review, B1B has been selected as the unit to close. It is important to note NO ONE is losing their job! This closure will provide us the opportunity to move staff around in a way that is consistent with our high quality of care, which is and always should be our priority. This will start to occur later next week, with many moving parts and hoped will be completed within a 2-3-week timeframe. This gives us the opportunity to move some LNAs and nurses to other areas to best care for our residents. Residents and families are being notified this am. Department Heads, managers, and supervisors were notified as well, and will be sharing this information with staff.

Covid Update: we continue with surveillance testing, as directed by Department of Health and Human Services. This includes testing 10% of our staff each of 3-weeks/month and 100% of staff the 4th week/month. In the event a positive result is reported, we will revert to mandatory testing each week, as determined but the Department of Health and Human Services. We continue to be n Phase 1-reopenig. Phases are driven by % of positivity within a county. Based on this, the state may move us up or down in the reopening process. This is always subject to change.

New Hampshire continues to have a 14-day quarantine travel requirement so be mindful of your travel, especially with holidays fast approaching.

Our new pharmacy, Partner’s Pharmacy, was implemented October 1st.This was extremely successful. This included acquisition of new medication carts, an automated dispensing machine, and associated lap top technology.

Dress down (ok to wear jeans) Wednesday’s in October if fall colors accompany jeans.

Infection prevention: Residents and staff have started to receive their influenza vaccines. As a reminder, while we can’t mandate anyone to wear a mask when they are not working, we strongly encourage all to follow the CDC and state guidelines. We have started to see an increased number of cases in New Hampshire and Rockingham County. We ask that everyone take extra precautions to maintain social distance, wear a mask, good hand washing. This protects you and our residents.

This is a challenging time and we have an amazing team who has risen to the challenge. We thank them and you for your understanding as we continue to move through this pandemic ad all it brings with it.

October 13, 2020

Dear Residents/Family Members/Responsible Parties:

We are writing to provide you an update about the current state of Coronavirus Disease (COVID- 19) at Rockingham County Nursing Rehabilitation and Nursing Center. We are extremely happy to report that National Guard testing last week yielded no positive results. After discussion with the state this morning, they have agreed to take us out of outbreak status.  

Being out of outbreak means we can reopen to prescheduled visits. These visits will be coordinated through Social Services. With infection control measures in place such as mask wearing, social distancing, hand hygiene, and increased cleaning and disinfection, residents are free to move above the building on their home level. The snack bar will reopen, and communal limited dining can resume. We hope to resume other services, as we move forward as we work through the guidelines to determine what is best for our residents, based on these guidelines.  This may include hairdressing, dermatology, and podiatry.

We continue to screen anyone who enter the buildings. Regardless of where we are in the Covid-19 crisis, we follow all state, federal and Center for Disease Control guidelines regarding precautions and disinfection. In the event, we do have a positive, during our continued testing, we have the possibility of returning to outbreak status; of course, we are hoping that doesn’t happen!

It is because of our dedicated staff, who work hard every day to safeguard your loved ones and your unwavering support in keeping your loved ones safe, that we have managed to only have one resident test positive, very early on in this pandemic. We appreciate and thank you for your understanding of these inconveniences caused by Covid-19. Protecting your loved one continues to be our ultimate responsibility.

Finally, as a reminder, additional information please visit our Blog which is updated every couple of weeks, or so.  It is located at: www.RockinghamCountyLTCnews.org

Sincerely,

Donna Roe, DNP, APRN-BC, CEN, RN-BC

October 12, 2020

Update: As a reminder, subject to change based on current CDC/state guidelines.

Covid: We continue to be in outbreak status as identified by state/DPH guidelines. This means 100% of staff and residents continue to be tested weekly. Our last round of outbreak testing was held Wednesday 10/07/2020 and completed by the National Guard. If you see a Guardperson, please thank them for their continued service! We are waiting on results. If all negative, which includes tests off site, we can continue a phased reopening again. Off-site results do take longer to get results back.

Sentinel Covid surveillance testing will start up again once out of outbreak stats and staff are not required but highly encouraged to be tested at that time. This typically is 10 % of residents and staff.

New Hampshire remains a 14-day quarantine state so be mindful of the travel policy. This impacts staff and potential visitors. Once visitation is opened again, Social Services will reach out to coordinate visits, with the understanding that in the event of a positive case again, things will change. For the safety of our residents and staff, please take every precaution including wearing a mask, social distancing, and good/frequent hand washing when not in the building.

Dress down Wednesday’s in October; wear fall colors and jeans!

Influenza vaccine: Please make every effort to get your vaccine. Staff can please reach out to Occupational Health to set-up a time for your vaccine. If you opt to have at your local pharmacy, please provide a copy of your vaccine to Occupational Health so we can best track staff testing- this will help in the event of an outbreak. All visitors, please help keep our residents and staff safe by getting an influenza vaccine.

This continues to be a challenging time. I cannot thank our team enough. Everyone, in every department, continues to go above and beyond to keep each other and our residents healthy, physically and emotionally.

September 22, 2020

Thank you for your continued work and dedication to our residents!

Important updates but as a reminder, all are subject to change in a moment’s notice and based on current CDC/state guidelines.

Covid: We continue to be in outbreak status as identified by state/DPH guidelines. We will be having 2nd round of outbreak testing of resident and staff testing this Thursday 10am—2pm.Once we have no positives for a period of 2-rounds of testing, the state will let us know when we are out of outbreak status.

CMS (our federal governing body) has now mandated testing for 100% staff and residents when in outbreak status. There is a brand-new policy approved regarding mandatory testing and sequel to those who refuse to be tests. Please see the new policy and memos posted. It is the hope of CMS this new mandate will better safeguard our residents.

Sentinel Covid surveillance testing will start up again once out of outbreak stats and staff are not required but highly encouraged to be tested at that time.

New Hampshire remains a 14-day quarantine state so be mindful of the travel policy.

Dress down (ok to wear jeans) Wednesday’s in September 9/23 (welcome fall); 9/30 (Rockingham Pride Day- wear your shirt)

Flu Clinics start this week- please make every effort to get your vaccine. If you can not make a influenza clinic please reach out to Occupational health to set-up a time for your vaccine. If you opt to have at at your local pharmacy, please provide a copy of your vaccine to Occupational health so we can best track staff testing- this will help in the event of an outbreak.

While we can’t mandate wearing a mask when staff are not working, we strongly encourage you to follow the CDC and state guidelines. We have seen an uptick in cases with schools opening so please take extra precautions to maintain social distance, wear a mask, good hand washing. This protects you and our residents.

This is a challenging time and you are an amazing team. We have risen to the challenge and will continue to do so, together! Thank you for everything you do!

September 14, 2020

Thank you for your continued work and dedication to our residents!

Updates follow but as a reminder, all are subject to change in a moment’s notice and based on current CDC/state guidelines.

Covid: Unfortunately, as a result of surveillance testing, we became of aware of a staff ‘cluster’ of Covid positives and have had to put these on hold. We still have one test outstanding, but from what has been reported to us, five staff members tested positive. This moves us back into a lower ‘phase’ of reopening and have had to stop many things, such as outdoor visits, communal dining, communal activities’ Letter have been sent to all resident responsible parties (be that the resident, or a DPOA/Guardian) and mailed to staff.

Sentinel Covid surveillance testing we believe will NOT take place next Sunday, but we will be required to now do outbreak testing, via the National Guard. We will have more on that today.

New Hampshire remains a 14-day quarantine state so be mindful of the travel policy.

Staff Development: CPR – Staff Development is looking at adjusting these classes due to the outbreak. If you are registered, and things change, someone will contact you.

The new pharmacy starting October 1st ‘Partner’s Pharmacy’.

Dress down (ok to wear jeans) Wednesday’s in September 9/16 (end of summer), 9/23 (welcome fall); 9/30 (Rockingham Pride Day- wear your shirt)

Flu Clinics start this week- please make every effort to get your vaccine. As a reminder, while we can’t mandate anyone to wear a mask when they are not working, we strongly encourage you to follow the CDC and state guidelines. We expected an uptick in cases with schools opening so please take extra precautions to maintain social distance, wear a mask, good hand washing, This protects you and our residents.

This is a challenging time and you are an amazing team. We have risen to the challenge and will continue to do so, together! Thank you for everything you do!

September 4, 2020

Lots to share this week

WOOHOOO- no more quarantine at this point in time! Thank you to D2 and all the departments that helped to get RCNC through the 2-week periods. All residents tested negative in this past round of testing. We continue to get staff results in, all negative thus far. If your test does result in a positive, you will be called and you will then need to follow-up with Occupation Health,

Updates follow but as a reminder, all are subject to change in a moment’s notice and based on current CDC/state guidelines.

  • Resident visits will resume Tuesday 9/8. These will remain outdoors only. It is the hope that we can continue outdoor visits through Columbus Day (aka Indigenous People Day). Social Services is working with Infection Prevention/Control and leadership to determine how to start inside visits, per state and CDC guidelines, once cold weather sets in. Once we know more, we will share information.
  • As part of resident visits, Universal Workers will be used to supplement Activities and Social Services staff. UWs play a vital role with outdoor visits. While they cannot sit in with a visit, due to privacy concerns. They monitor the clock, the surroundings, and are the eyes and ears when Activities/SS can’t be near a resident. Please make sure your residents are ready to go. At least 15-minutes prior to their scheduled family visit time.
  • Sentinel Covid surveillance testing will take place on Thursday 9/10/2020. Please help spread the word so that staff show up and get tested!!  When you see a tester on Thursday, let’s thank them for helping to keep us and our residents safe.
  • As a reminder, while we cannot enforce or monitor mask usage outside of the facility, we encourage all to wear masks when in public and to practice good hand hygiene.  With schools starting up, there is an uptick in cases. We wear masks to protect others, the vulnerable population we serve, our staff, and the community at large. 
  • Hairdressing will be started soon.
  • Podiatry and Dermatology visits start in September. The dentist is still on emergency basis only.
  • We are in the talking stages of the gym opening up and will have more information on this, as available.
  • Unit doors are now open and the snack bare reopening next week-with continued masks and social distancing.
  • Soup is coming back to the cafeteria. Unable to open back the salad bar at this time r/t cleaning process between utensil uses.

Staff Development: There are CPR courses coming up. Mandatory education starts next week for nurses/MNAs on our controlled substance. This will be one of our QAPI projects we are required to have, and they are good to have. QAPI is the merger of two approaches to quality management [(Quality Assurance (QA) and Performance Improvement (PI)].

  • If there is a QA/PI idea you have or education need in general, please let us know.

Fun:

  • Dress down (ok to wear jeans) Wednesday’s in September- 9/9 (tie-dye); 9/16 (Summer); 9/23 (welcome fall); 9/30 (Rockingham Pride Day- wear your shirt)
  • Start thinking abut your Pumpkin decorating skills…….

Finally…. Everyone is doing an amazing job during this challenging time – what a team we have!

August 28, 2020

 

THANK YOU cannot be said or shouted loud or often enough. Over the past 2-weeks, amidst of our Covid quarantine, we have witnessed amazing care and compassion. What stories we will have for our grandchildren and great grandchildren “I remember the great pandemic of 2020!” They will roll their eyes and say “not again….we have heard that story so many times before grammy/grandpa.” I am sure we can play that scenario over and over in our heads. When you do this reminiscing, remember fondly all the times you truly made a difference in someone’s life and of your work partners who were there with you ~ I feel privileged to be one of them!

Here some weekly updates:

  • Kudos to staff and to all the support staff who helped them through this challenging week.
  • Kudos to all the other units/support staff for helping across all units. You have managed to keep things running smoothly, almost without skipping a beat.

Resident visits (all) remain on hold, pending the second round of testing on 8/31/2020. Once results are available, discussion will ensure as to the next step of our phased reopening. Staff sentinel Covid surveillance testing will take place on Monday 8/31/2020. Please help spread the word so that staff show up and get tested!! 

While we cannot enforce or monitor mask usage outside of the facility, we encourage all to wear masks when in public and to practice good hand hygiene.  This is to protect the vulnerable population we serve, our staff, and the community at large. 

Staff Development: There are 2-CPR courses coming up. Please reach out if you have expired or soon to be expired. Education coming up on controlled substance process (aka narcotic count). If there is something you would like for education, please let us know.

Everyone is doing an amazing job working together during this challenging time and we are proud to be on this team with you! 

Thursday August 20, 2020

First, let’s start by saying THANK YOU! During this challenging time, the dedication and commitment you show to RCNC, your residents, and to our/your county is commendable.

We wanted to send an update on the current COVID-19 status. As many of you are aware, we were informed that one individual who had been in our facility tested positive for COVID-19.  Upon gaining the necessary information, we immedicably reached out to the NH DHHS for further guidance.  We were informed this is not considered a cluster or outbreak at this time, and they commended our efforts for on-going, good source control, stating that this entire scenario, based on the information provided, is of low-risk, though does still bear watching.  Thank you!

Any individuals who have been exposed or potentially exposed have already been contacted and the unit has been quarantined.  Please be mindful of the additional work placed on this unit and the need to provide additional resources, as able. We will do our best to limit staff (same staff). Staff have been educated on donning and doffing PPE. If at any time, you feel additional education is needed, please reach out to your assigned leadership member.

Food services has met with the manager and Covid team and has a plan and process in place for meal deliveries. Environmental Serves / Housekeeping has met as well with the manager and team and has a plan and process in place for enhanced cleaning, trash removal, and disinfection.

Activities have been altered to ensure the safety of all residents. Units not impacted directly will continue with activates on their units. Doors between units will return to closed status. Snack bar will be suspended at this time. Activities on all other units may continue, with the following guidelines: 

  • No mixing of residents from different units during communal activities
    • Residents must don masks and socially distance at least 6’ during activities
  • Communal dining may resume tomorrow (was halted today until all info was obtained and a plan was made) under the following conditions:
    • Residents must don a mask coming out to the dining room
    • Mask removed and placed on clean paper towel during eating.  Once done eating, resident must don mask again.
    • Tables MUST, MUST, MUST be disinfected after each resident is finished eating.  This is very important!
    • Staff dining – only 1 person per table

Resident visits (all) are placed on hold, through 8/31 (anticipated), in the best interest of all of those in our care. This is never an easy decision, but we have an obligation to all our resident’s safety and feel it is in their best interest at this time.  In light of this, the parking spots for resident visits may be temperately be used by staff.

Regular Sentinel Surveillance testing will continue as normal on Friday, 8/21/20.  It will be with anterior nares swabs, NOT the deep nasopharyngeal swabs.  Please help spread the word so that staff show up and get tested!!  Thanks to Sarah, Tamara and Stacy for helping to test on Friday! The entire resident population, on the unit potential directly impacted, will be tested with nasopharyngeal swabs by a mobile testing service that should be contacting me very soon.  Hoping for a Friday testing date.  From there, the CDC guidance is that the D2 residents will be tested every 7 days until they determine this is no longer needed. In addition, we continue with 10% of the remaining residents in the facility will still be tested Friday.

We will need to increase our COVID screening of all facility residents to every shift.  This is starting effective today, 3-11 shift and the supervisor has been made aware. BPs are only one needed time a day.  All other VS should be Q-shift.

Please help remind your staff that while we cannot enforce or monitor mask usage outside of the facility, we encourage all to wear masks when in public and to practice good hand hygiene.  This is to protect the vulnerable population we serve, our staff, and the community at large.

All residents/responsible parties will be receiving letters and Human Resources is working on another letter to staff.

If you have any concerns about your own health, as a reminder, to not come in if sick and reach out to Occupational Health early for guidance. Ext 9118.

Everyone is doing an amazing job working together on this for the well-being of the residents and staff.  We are proud to be on this team with you all! 

8/14/2020

Another big week here at RCRNC! Outdoor visits are going wonderfully. Residents are enjoying seeing loved ones and staff are excited to see residents with smiles on their faces. Special thank you to social services, activities for their ongoing coordination, and for all the staff helping to make this happen This is not an easy task! Also, there are some reserved spaces for family members visiting, when you first enter the parking lot. Please be mindful and do not park in these spots during the day/evening shifts.

Residential dining areas have opened, with limited capacity are we are pleased to say it is going well. Residents are remaining socially distanced, we have opted, for the most part, not to use tablecloths due to the nature of the cleaning required, given the Covid environment. Important reminder that residents will don a mask while in transport to the dining area and upon completion of their meals. Residents are required to wash their hands, either by soap and water or antibacterial hand rub (ABHR), prior to the start of their meals and again at the completion of their meals. Staff must their own wash hands, in the same matter previously mentioned, in between each resident meal tray passed and also in-between each meal tray collected.

Regarding staff dining. We anticipate opening the back-dining area in the Water Tower Café, most likely mid next week. The same guideline holds true to the front area, 1-per table with cleaning in between.

Residents are now attending small group activities, on their individual units, and in the chapel. Residents cannot go between units to an activity not on their home unit. These activities must allow for at least 6 ft of social distance between residents and staff and all residents must be wearing a mask. If the resident removes the mask, it is the responsibility of staff to remind the resident to reapply the mask or assist the resident with reapplying.

Resident Snack Bar has reopened. Max capacity is six residents at a time and at least a 6ft social distance must be maintained at all time.

Doors between units have reopened and B2 Sunroom and the B1 Main Entrance seating areas have been re-opened to residents. Max capacity in the B2 sunroom is three residents and the max capacity of the B1 Main Entrance seating area is two residents. Housekeeping provides frequent disinfection of these two areas.

Next Covid testing date is 8/21 from 7a-3p in the Hilton Auditorium and everyone is encouraged to take part. We continue to test a percentage of residents routinely as well as symptomatic residents.  The state is fine-tuning its labs process which has created a backlog in getting test results. There are six test results remaining from last weeks.

Occupational Health will be preforming N95 fit testing on the units again on Monday (8/24) and Tuesday (8/25). She will be circulating around from 2pm-4pm. All clinical nursing staff are encouraged to be fit tested, however this is not mandatory. If you would like to be fit-tested and can not make one of these dates/times, please reach out to her to set-up a time ext 9118. As always, in any situation where a N95 mask is required, staff is and will continue to be provided one.

Given our current Phase 2 in reopening, services will continue to be gradual to return. We will be developing polices and process to help make sure we do this in a safe and thoughtful manner. We will not be starting indoor visits at this time or having the dentist come in, except in emergency situations. School is starting back up, and most likely there will a community/state uptick. Please continue to be diligent and wear masks when in a public setting and take part in our Covid testing. We continue to move forward as dictated by state and CDC guidelines and will update as we receive information.

You are all doing an amazing job during this challenging period, in light of staff vacations and Covid. This is a challenging environment and location for hiring of staff and we continue to actively look for new staff. If any of you have anyone to recommend, please send them our way!

Stay Well and please reach out to Human Resource or Donna Roe with any concerns.