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Shared-Living Facilities COVID-19 Checklist

COVID-19 Checklist for Special Populations in Shared-Living Facilities

Protecting Against COVID-19

COVID-19 has specific challenges for congregate or shared living facilities for people with mental illness, addiction, and alcoholism. Providers need to monitor for signs of coronavirus disease 2019, and also must support residents in managing their mental health and addiction recovery.

As of Monday, March 23, 2020, Ohioans are living under a Stay at Home Order issued by Amy Acton, MD, MPH, Director of the Ohio Department of Health (ODH). This order limits the movement in communities to essential needs and functions so that we can stop the spread of COVID-19. 

Governor Mike DeWine and Amy Acton, MD, MPH, Director of the Ohio Department of Health (ODH) continue to recommend that people limit time outside their homes, especially people who are at higher risk of developing severe symptoms from COVID-19.

Options include use of telehealth services for behavioral health care. Residents should call providers to see how to best receive their scheduled care, including medication management.

Symptoms of COVID-19 may appear two to 14 days after exposure to the virus. Symptoms to watch out for are cough, shortness of breath or difficulty breathing, fever, chills, muscle pain, sore throat, and loss of taste or smell.

In order to minimize exposure and outbreak of COVID-19 in shared living environments, ODH and the Centers for Disease Control and Prevention (CDC) recommend the following protocols in adult care facilities and recovery residences.

Prevention and Screening

Current Residents

  • Screen each resident daily for fever and respiratory symptoms.
  1. Ask the following questions:
    • Are you experiencing fever, dry cough, sore throat, or shortness of breath?
    • Have you been exposed to or tested positive for COVID-19?
      • If someone answers “yes” to these questions, your facility should isolate/quarantine the resident in a single room the best you can.
      • If the person is experiencing symptoms, call that resident’s primary care provider (PCP) for direction. If the person does not have a PCP, call the local health department.
      • Follow the directions that the PCP or health department provide on whether the resident needs to be seen in person at an office, urgent care, or hospital. If the resident needs to be seen, call ahead to notify the facility that the resident is coming and is exhibiting symptoms of COVID-19.
      • If the resident is told to recover at home, then talk with the resident throughout the day to check on needs and monitor symptoms. Call or support the resident in calling the PCP or health department again if symptoms change or worsen.
  • Ask residents to immediately report if they feel feverish or have symptoms of respiratory infection.
     
  • If a thermometer is available, refer to manufacturer’s instructions for cleaning and disinfecting. 

New Residents

  • Monitor all residents upon move in and at least daily for 14 days for fever and symptoms of respiratory illness (shortness of breath, new or change in cough, and/or sore throat).
    • If a new resident has a fever, cough, or other symptoms of COVID-19 when arriving to move in, provide them with a surgical mask (you may have to use a scarf or bandana if surgical masks are not available), and have them contact a healthcare provider to be screened before moving into the residence. 
       
  • Ask the referral source to help with the screening of potential residents before they move in.

Environment

  • Remind all staff and residents each day to:
    1. Immediately report symptoms.
    2. Stay 6 feet from one another when in the same room.
    3. Cough and sneeze into tissues or their elbows, not their hands.
    4. Wash their hands frequently with soap and water for at least 20 seconds each time.
    5. Avoid touching their faces.  
       
  • Provide protection supplies such as soap and water, hand sanitizer, tissues, paper towels, and no-touch garbage cans for use by all residents and staff.
     
  • Frequently clean commonly touched surfaces such as countertops, railings, light-switches, door handles, and doorknobs, and all frequently touched bathroom surfaces. Antiviral sprays and wipes work, but so does soap and water.

Employees

  • Employees should monitor their own health, watching for signs of cough and fever.
     
  • Employees who appear to have symptoms upon arrival at work or who become sick during the day should immediately be separated from others and sent home.
     
  • Sick employees with suspected or confirmed COVID-19 are to stay at home until they recover.
    • As of May 4, guidelines from the Centers for Disease Control and Prevention are as follows:
      • Employees who are not tested should remain in isolation until at least three full days (72 hours) have passed since recovery (no fever without use of fever-reducing medications and improvement in symptoms) AND at least 10 days have passed since the onset of symptoms.
      • Residents who are tested should remain in isolation until there is no fever without use of fever-reducing medications AND improvement in symptoms AND there are negative results (showing no COVID-19) on at least two consecutive lab tests of respiratory specimens collected at least 24 hours apart.   

Quarantine and Isolation Guidance

Quarantine means separating and restricting the movement of people who were exposed to a contagious disease to see if they become sick.

Isolation means separating sick people with a contagious disease from people who are not sick.

  • While it is ideal to isolate or quarantine residents of congregate settings with confirmed cases of COVID-19 outside of the home, this may not be possible. The following special considerations should be made for group homes and congregate settings with confirmed cases when outside isolation is not possible.

Group 1: Residents who report no symptoms or exposure and have no observable symptoms of COVID-19. 

  • Continue advising on preventative measures such as social distancing, washing hands, avoiding touching face, and covering coughs/sneezes with napkins or inner elbow.
     
  • Complete daily check in with residents regarding common symptoms (fever, dry cough and shortness of breath).

Group 2: Residents who report exposure to someone with confirmed COVID-19 but have no symptoms.

  • If possible, immediately quarantine resident(s) in a single room, with their own bathroom if possible.
    • If a bathroom is not accessible for only the resident with exposure to COVID-19, provide the resident with proper cleaning supplies to clean commonly touched areas after use. This would include the sink area, toilet and toilet handle, light switches, doorknobs, soap dispensers, and shower/bathtub.
  • Set protocols for resident communication, such as calling staff when help is needed. 
  • Deliver meals to the resident’s room. If staffing does not allow for meals to be delivered, arrange an alternative schedule for the isolated resident to eat.
    • Used non-disposable food service items should be handled with gloves and washed with soap and hot water or in a dishwasher. 
  • Monitor for symptoms (fever, cough, and/or shortness of breath) twice per day.
  • If symptoms develop, follow guidance for Group 3.

Group 3: Resident reports mild symptoms. Test results may be pending or confirm COVID-19. 

  • Contact the resident’s primary care provider, local health department, guardian (if applicable), and family (verify if there is a release of information prior to contact). 
  • Follow guidance from the healthcare provider for next steps with treatment.
  • If possible, immediately isolate the resident(s) in a single room, with their own bathroom if possible.
    • If a bathroom is not accessible for only the resident with symptoms of COVID-19, provide the resident with proper cleaning supplies to clean commonly touched areas after use. This would include the sink area, toilet and toilet handle, light switches, doorknobs, soap dispensers, and shower/bathtub.
  • Set protocols for resident communication, such as calling staff when help is needed. 
  • Deliver meals to the resident’s room, if staffing does not allow for meals to be delivered, arrange an alternative schedule for the isolated resident to eat.
    • Used non-disposable food service items used should be handled with gloves and washed with soap and hot water or in a dishwasher. 

Group 4: Resident reports severe symptoms (difficulty breathing or shortness of breath, pain or pressure in chest or abdomen, sudden dizziness or confusion, severe or persistent vomiting or diarrhea, flu-like symptoms that improve but then return with fever and worse cough). 

  • Contact 911 and advise in advance that the resident has symptoms of COVID-19.
  • Follow the instructions outlined in Group 3 (only after receiving directions from emergency personnel).  
  • Maintain routine checks with the resident(s) or hospital staff.

 

  • During all stages of COVID-19, group home operators are encouraged to keep residents in contact with behavioral health service providers for telehealth needs. Service providers can also offer added emotional and social supports during this critical time of need.

Recovery from COVID-19

  • Residents are to be in isolation at home until the resident has recovered.
    • As of May 4, guidelines from the Centers for Disease Control and Prevention are as follows:
      • Residents who are not tested should remain in isolation until at least three full days (72 hours) have passed since recovery (no fever without use of fever-reducing medications and improvement in symptoms) AND at least 10 days have passed since the onset of symptoms.
      • Residents who are tested should remain in isolation until there is no fever without use of fever-reducing medications AND improvement in symptoms AND there are negative results (showing no COVID-19) on at least two consecutive lab tests of respiratory specimens collected at least 24 hours apart.   

Contact the resident’s healthcare provider as needed.

Release from Quarantine

  • Quarantined residents can be released from quarantine if they have not developed symptoms during the 14-day quarantine period.

 

For answers to your COVID-19 questions, call 1-833-4-ASK-ODH (1-833-427-5634).


Your mental health is just as important as your physical health. If you or a loved one are experiencing anxiety related to the coronavirus pandemic, help is available 24 hours a day, seven days a week. Call the COVID-19 CareLine at 1-800-720-9616.


Prevention Infographic


Protect yourself and others from COVID-19 by taking these precautions.

  • Stay home except for work or other needs
  • Wear a face covering when going out
  • Practice social distancing of at least 6 feet from others
  • Shop at non-peak hours.
  • Wash hands often with water and soap (20 seconds or longer)
  • Avoid touching your eyes, nose, mouth with unwashed hands or after touching surfaces
  • Cover your mouth with a tissue or sleeve when coughing or sneezing
  • Clean and disinfect "high-touch" surfaces often
  • Don’t work when sick
  • Call before visiting your doctor


If you have questions regarding Coronavirus/COVID-19 please call 1-833-4-ASK-ODH (1-833-427-5634)


CLEAN ALL "HIGH-TOUCH" SURFACES EVERY DAY

High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a household cleaning spray or wipe according to the label instructions. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves and making sure you have good ventilation during use of the product.



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