Lantern restricts all visitation except certain compassionate care situations, such as end of life situations. Decisions about visitation during an end of life situation are made on a case by case basis. Potential visitors are screened prior to entry for fever or respiratory symptoms. Those with symptoms are not permitted to enter the community. Visitors that are permitted inside, must wear a facemask while in the building and restrict their visit to the resident’s room or other location designated by the community.  They are also reminded to frequently perform hand hygiene.

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• Non-essential personnel including volunteers and non-essential consultant personnel (e.g., barbers) are restricted from entering the building.

• Lantern provides alternative methods for visitation (e.g., video conferencing) for residents.

• Visitor restrictions are implemented, Lantern has a process to allow for remote communication between the resident and visitor (e.g., video-call applications on cell phones or tablets) and has policies addressing when visitor restrictions will be lifted (e.g., end of life situation).

• Health care professionals such as lab technicians, mobile x-ray technicians that travel to and visit other communities are not permitted beyond a certain area in the Lantern community. The specimens will be brought to the lab techs by the Lantern staff to the designated area. A health assessment will be completed on the lab techs before entry into the designated space.  After the lab tech leaves, the space will be disinfected. The lab tech will only be permitted into the community and the designated space after wearing a mask.

• Health care professionals such as mobile x-ray technicians will be permitted up to the designated space inside the community. The x ray tech will only be permitted into the community and the designated space after wearing a mask. The elderly senior wearing a mask will be transported to the designated area.  A health assessment will be completed on the x-ray techs before entry into the designated space.  After the x ray tech leaves, the space will be disinfected.  If the elderly senior is unable to be transported to the designated area, the x-ray technician will be guided to the elderly resident’s room through the shortest possible route/path to the elderly resident’s unit. The path the X-ray tech took will be disinfected and sanitized.

• The name of the nursing homes and assisted living communities that have COVID-19 positive cases will be displayed by the front door of the community. Health care professionals that have been in the community will not be permitted into the Lantern community until they have been quarantined for 21 days.

• The name of the nursing homes and assisted living communities that have COVID-19 positive cases will be displayed by the employee entrance and in employee break room. Health care professionals that do PRN/Part-time work in those communities will not be permitted to work in the Lantern community.

• New hire that had worked in any of the nursing homes/assisted living/group homes that had positive COVID-19 cases will not be hired until they have self-quarantined for 21 days and are free of symptoms. A clean bill of health from a physician is preferred.

• When family visitations are permitted, Lantern will limit visitation to one family member per senior for 30 minutes. The visitation will be scheduled. A total of 9 family visits will be permitted per day.  The visitation schedule will be as follows- 9:00 AM- 9:30 AM, 9:45-10:15 AM, 10:30 AM- 11:00 AM, 11:15 AM- 11:45 AM, 1:30- 2:00 PM, 2:15 PM- 2:45 PM, 3:00- 3:30 PM, 3:45 PM- 4:15 PM, 4:40 PM-5:00 PM. The visitation schedule will be honored 7 days a week. The visitation will be allowed in an assigned space. A 6 ft social distance will be maintained between the elderly senior and the family member. A health assessment will be completed for the family member before permitting them into the community. The family member must wear a mask and wash their hands and sanitize their hands before the visitation. The elderly senior will wear a mask during the entire visit. After the visitation, the entire space will be sanitized.

• When testing is available and accessible, all the existing staff and our elderly seniors will be tested for COVID-19. All the new hire will be tested for COVID-19.  Any new hire that test positive for COVID-19 will be required to quarantine for 21 days and submit a clean bill of health from a physician.

• Family care conferences will happen as scheduled. The care conferences will be conducted using Skype technology. Each community will have dedicated space to conduct family care conference.

• Alcohol-based hand sanitizer for hand hygiene is available in every resident room and other resident care and common areas (e.g., outside dining hall, in therapy gym).
• Sinks are well-stocked with soap and paper towels for hand washing.
• Signs are posted immediately outside of resident rooms indicating appropriate IPC precautions and required personal protective equipment (PPE).
• Lantern will provide tissues and facemasks for coughing people near entrances and in common areas with no-touch receptacles for disposal.
• Lantern have supplies of facemasks, gowns, gloves, and eye protection.
• COVID-19 has been incorporated into emergency management planning for the Lantern communities.
• A multidisciplinary planning committee/ team has been created to specifically address COVID-19 preparedness planning.
• Various leadership assigned responsibility for coordinating preparedness planning.
• Lantern COVID-19 response coordinator contacted local or regional planning groups to obtain information on coordinating the community’s plan with other COVID-19 plans.
• A copy of the COVID-19 preparedness plan is available at all the Lantern communities and accessible    by staff.
• Relevant sections of federal, state, regional, or local plans for COVID-19 or pandemic influenza are reviewed for incorporation into the Lantern’s plan.
• A plan is in place for protecting residents, healthcare personnel, and visitors from respiratory infections, including COVID-19.
• A member from the leadership and the CEO has been assigned responsibility for monitoring public health advisories (federal and state) and updating the COVID-19 response coordinator and members of the COVID-19 planning committee when COVID-19 is in the geographic area.
• Lantern has a process for inter-community transfers that includes notifying transport personnel and receiving communities about a resident’s suspected or confirmed diagnosis (e.g., presence of respiratory symptoms or known COVID-19) prior to transfer.
• Lantern has a system to monitor for, and internally review, development of COVID-19 among residents and healthcare personnel (HCP) in the community. Information from this monitoring system is used to implement prevention interventions (e.g., isolation, cohorting).
• Lantern has infection control policies that outline the recommended transmission-based precautions that should be used when caring for residents with respiratory infection. (In general, for undiagnosed respiratory infection, Standard, Contact, and Droplet Precautions with eye protection are recommended unless the suspected diagnosis requires Airborne Precautions.
• An individual from the leadership team has been assigned responsibility for communications with public health authorities during a COVID-19 outbreak.
• A list has been created of other healthcare entities and their points of contact (e.g., other long-term care and residential communities, local hospitals and hospital emergency medical services, relevant community organizations—including those involved with disaster preparedness) with whom it will be necessary to maintain communication during an outbreak.
• Lantern ensures HCP have access to EPA-registered hospital-grade disinfectants to allow for frequent cleaning of high-touch surfaces and shared resident care equipment.
• Lantern has a process to monitor supply levels.
• Lantern has a contingency plan, that includes engaging their health department and healthcare coalition when they experience (or anticipate experiencing) supply shortages.
• Lantern has a process to identify and manage residents with symptoms of respiratory infection (e.g., cough, fever, sore throat) upon admission and daily during their stay in the community, which include implementation of appropriate transmission-Based Precautions.
• Lantern has criteria and a protocol for initiating active surveillance for respiratory infection among residents and healthcare personnel. CDC has resources for performing respiratory surveillance in long-term care communities during an outbreak.
• Lantern has plans developed on how to immediately notify the health department for clusters of respiratory infections, severe respiratory infections, or suspected COVID-19.
• Lantern has criteria and a protocol for: limiting symptomatic and exposed residents to their room, halting group activities and communal dining, and closing units or the entire community to new admissions.
• Lantern has plans and material developed to post signs at the entrances to the community instructing visitors not to visit if they have fever or symptoms of a respiratory infection.
• Lantern has criteria and protocol for when visitors will be limited or restricted from the community.
• The community instructs Health care personnel (including consultant personnel) to regularly monitor themselves for fever and symptoms of respiratory infection, as a part of routine practice.
• Lantern has a process to actively screen health care professionals for fever and symptoms when they report to work.
• Lantern has a process to identify and manage health care professionals with fever and symptoms of respiratory infection.
• Lantern has a plan for monitoring and assigning work restrictions for ill and exposed health care professionals.
• Lantern has plans to provide education and training to health care professionals, residents, and family members of residents to help them understand the implications of, and basic prevention and control measures for, COVID-19.
• Plans and material developed for education and job-specific training of health care professionals which includes information on recommended infection control measures to prevent the spread of COVID-19, including:
  • Signs and symptoms of respiratory illness, including COVID-19.
  • How to monitor residents for signs and symptoms of respiratory illness.
  • How to keep residents, visitors, and staff safe by using correct infection control practices including proper hand hygiene and selection and use of PPE. Training include return demonstrations to document competency.
  • Staying home when ill.

• Lantern has informational materials (e.g., brochures, posters) on COVID-19 and relevant policies for residents and their families.

• Lantern for the time being has taken action to stop group activities inside the community and field trips outside of the community.

• Lantern for the time being has taken action to stop communal dining on the assisted living neighborhoods.

• Residents are encouraged to remain in their room.  If there are cases in the community, residents are restricted (to the extent possible) to their rooms except for medically necessary purposes.  If residents leave their room, they wear a facemask, perform hand hygiene, limit movement in the community and perform social distancing.

• Lantern has implemented universal use of facemasks for staff while in the community. If facemasks are in short supply, they are prioritized to use re- usable/washable cloth mask.

• Staff perform hand hygiene in the following situations: Before resident contact, even if PPE is worn.  After contact with the resident. After contact with blood, body fluids or contaminated surfaces or equipment. Before performing sterile procedure. After removing PPE