featured image

COVID-19

Greetings to the family members, friends, and loved ones of our residents. Thank you for your continued understanding and support of the restriction on visitors due to the pandemic. We are continuing to do whatever we can as a facility to keep your loved one safe. Even with all of the precautions that we have initiated and maintained since March of this year, unfortunately a staff member did test positive for COVID-19. This staff member is recovering at home at this time. Residents were not directly exposed, as this person does not do direct care with residents. We have talked to Nebraska ICAP and public health and they both agree that the residents are very low risk for exposure related to this staff member testing positive. No other staff members have tested positive.

What we have done as a facility related to this isolated case is:

Increased resident symptom monitoring from two to three times a day. What this means is that your loved one will be checked for any signs or symptoms of COVID-19. If they have any symptoms, staff will immediately report the concern to DON or ADON, who will then notify public health of the symptom and to get the resident tested. We also have procedures in place to immediately place this person on isolation status.

Housekeeping has increased cleaning routines of highly touched surfaces.

Nurse management has been doing PPE (personal protective equipment) audits to ensure that all staff are wearing PPE appropriately and will continue to do these audits.

6/12/2020 Update: We have a staff member that has tested positive for COVID-19. This person is asymptomatic and is quarantined at home at this time. There have been no close contacts identified at the facility, which means that no staff or residents have been exposed by this staff person. The facility remains a “yellow” zone at this time. We are continuing to have contact with the local health authorities as well as ICAP Nebraska (infection control experts) to ensure that we are doing everything we can to ensure your loved one is safe. We have no residents that are positive for COVID-19. We continue to have no visitation at this time. Please check the website for any updates regarding COVID-19, including when visitation can be started again. We do not have a projected date at this time for when visitation will be started again.

6/26/2020 We are pleased to announce that there are still no resident cases of COVID-19. Plans for Phase 2 (which includes outside visits using social distancing for about 20 minutes at a time with no more than 2 visitors at a time. Resident and visitors have to wear masks for the entire visit) are continuing to be finalized at this time. Angie spoke to ICAP Nebraska (infection control experts) today, and they do not advise that we come off of yellow zone at this time. To be able to move on to Phase 2, the facility needs to be off of yellow zone. We are using extreme caution with everything due to Scotts Bluff County being in the top 5 hot spots for COVID-19 in Nebraska. We do take the care of your loved ones seriously. Remember, if you would like to do a Zoom call with your loved one to call the facility, as we would be happy to help you schedule this with one of our staff members. Window visits (closed window) are also allowed. We would be happy to assist your loved one with a phone call during window visits. Please continue to check our website for continued updates.

7/13/2020 Update on baseline testing for COVID-19. We have completed 234 tests. So far, we have NO positive results and 221 negative results. We hope to have all of the results in the next 24-48 hours so we can take the facility from yellow zone and move to phase II.

7/15/2020 Update: Unfortunately, we had a staff member that tested positive. No residents have been identified as direct contacts of this staff member. Per guidance of Nebraska ICAP, we will continue with yellow zone at this time. After further guidance is received from Nebraska ICAP, we will update the website.

7/17/2020 A resident tested positive on 7/16/2020. This resident has had no direct exposure to any nursing home residents. We completed some testing related to staff member that came back positive earlier this week. 1 staff member has come back positive. This staff member does not do direct care with residents.

9/23/2020 Unfortunately a staff member has tested positive using a rapid test. PCR testing gave negative results. Per epidemiologist Dr. Ashrat, we are going to be in yellow zone until testing of residents and staff is completed. This means that the facility will be starting back over with the Phasing guidelines. Outdoor visits will be cancelled until further notice. CLOSED window visits are acceptable at this time if the resident is in a bed by the window. Please call social services if you would like to set up a Zoom call with your loved one. We will continue to keep you posted.

10/1/2020 A staff member tested positive using a rapid test. Staff member is getting a PCR test for confirmation as to whether or not it is a true positive case or not. Facility remains in yellow zone at this time. We will continue to test staff and residents every 3-7 days per CMS regulations until there are no more positive cases. We will continue to test staff per CMS guidelines related to county positivity rate. No residents have been identified as an exposure to this staff member. This staff member is not a direct care giver.

10/12/2020 A staff member tested positive using a rapid test. Staff member is getting a PCR test for confirmation as to whether or not it is a true positive case or not. Facility remains in yellow zone at this time. We will continue to test staff and residents every 3-7 days per CMS regulations until there are no more positive cases. We will continue to test staff per CMS guidelines related to county positivity rate. No visitors at this time.

10/22/2020

To Our Residents and Family Members:

We want to remain transparent and provide you with an update on the situation at Monument Rehabilitation & Care Center regarding the novel coronavirus or COVID-19, including the number confirmed cases as well as efforts we are undertaking. The safety and well-being of our residents is our top priority. We are doing what we can to limit the spread of COVID-19 within our facility.

Since May 8, 2020 (when the federal government issued reporting requirements), and despite our continued vigilant efforts to combat the coronavirus from the beginning of the pandemic, the facility identified the first case on 6/12/2020. The Facility has had 16 confirmed cases of COVID-19.

As of 10/22/2020, the Facility has:

  • 3 residents and 13 staff members with confirmed COVID-19.
  • 0 residents and 8 staff members that have recovered from COVID-19.
  • 196 residents and staff have tested negative for COVID-19.
  • It has been 0 days since a new resident or staff member has tested positive.

Monument Rehabilitation & Care Center is staying in very close communication with local and state health officials to ensure we are taking all the appropriate steps under current circumstances. When a resident’s test result is positive, we notify residents and their representative(s) of their condition and implement protocols for their care and treatment.

In addition, the Facility follows guidance from the Centers for Disease Control and Prevention (CDC), the Center for Medicare and Medicaid Services (CMS), Local and State Department of Health, including return to work criteria for staff who tested positive and other measures related to Covid-19 such as:

  • Enhancing infection control measures and staff education
  • Monitoring resident status and screening all staff for COVID-19 symptoms
  • Restricting visitation and entry into the building by non-essential personnel
  • Collecting Rapid Antigen and/or PCR Tests for staff and residents to immediately identify COVID-19 infection based on current protocols and Department of Health recommendations
  • Postponing communal activities and Maintaining social distancing guidelines
  • Adhering to strict infection control core principles
  • Cohorting residents appropriately per CDC guidelines
  • Wearing appropriate and required PPE while caring for residents with confirmed Covid-19 infection or Persons Under Investigation (PUI)
  • Cleaning and disinfecting with EPA approved agents all frequently touched surfaces routinely and as needed
  • Using telehealth for virtual physician/nurse practitioner encounters

Due to government privacy requirements, we cannot divulge specific information about the individuals who have confirmed or suspected COVID-19, unless they are your family member and you have the necessary permissions to receive such information.

We know you are concerned about your loved one, but it is crucial that we restrict visitation to reduce the spread of this virus to others. We will contact you directly if your loved one is suspected or diagnosed with COVID-19.

In addition, this letter may also serve as notification that it may be necessary to transfer your loved one to another room temporarily so the facility can appropriately cohort residents with Covid-19 and mitigate the spread of infection.

We also understand that connecting with family members is incredibly important to our residents. Family members are encouraged to connect with their loved ones through video chat, calling, texting, or on social media. Please contact the facility at 308-635-2019 to reach the Activities Director or Social Worker who will schedule a virtual visit or phone call with your loved one.

We need your help to combat COVID-19. Please visit the CDC website (www.cdc.gov/coronavirus) to learn how you can help prevent the spread in our area, since spiking cases in the community also increases the chance the virus will affect other residents and your loved one.

This is a difficult time for everyone. We will continue to provide you with updates. Please know that we are adhering to guidelines from the local and state health departments, which continue to evolve as officials continue to learn more about this virus.

Of note, the Nebraska Department of Health has visited and surveyed our Facility with a focus on our Infection Control protocols and Covid-19 preparedness plans. The unannounced visit from the department of health revealed no deficient practices despite the presence of Covid-19 in the facility.

We know that you may have questions and we encourage you to contact our center. Please call us at 308-635-2019, email us at awahl@monumentrehab.com or jcoffman@monumentrehab.com if you have any questions, comments, or concerns. Please continue to visit our website at www.monumentrehab.com/covid-19/ for the most recent updates on Covid-19.

Sincerely,

Angie Wahl RN, DON

Jennifer Coffman, Administrator

10/23/2020 We have had a cluster of 3 or more identified positive cases within a 72 hour time period.  Identified staff members are at home and recovering.  Our residents that are positive are remaining in the facility at this time and being cared for by our dedicated staff members on an enclosed unit.

As of 10/23/2020, the Facility has:

  • 10 residents and 14 staff members with confirmed COVID-19.
  • 0 residents and 9 staff members that have recovered from COVID-19.
  • It has been 0 days since a new resident or staff member has tested positive.

10/26/2020 The facility has had several more staff members and residents test positive for COVID-19 using the Abbott cards.  Staff are at home recovering and residents are recovering at the facility.  We will continue to keep you updated of any other findings.  We are continuing to work with ICAP Nebraska on this situation at the facility to ensure we are doing everything we can to stop the spread of this virus.  Thank you for your continued support of your loved one and our staff.

10/27/2020 We have had more residents test positive for COVID-19.  We are continuing to do what we can to limit the spread around the building.

10/30/2020 We have had more residents and staff test positive for COVID-19.  Our staff continue to work diligently at cleaning and sanitizing frequently touched surfaces as well as providing the best care possible to our residents.

11/3/2020 We did have more staff and residents test positive for COVID-19.  Facility continues to work with local Community Health and ICAP Nebraska to mitigate the spread of COVID-19 in the facility.  Facility continues to monitor staff and residents for signs and symptoms of COVID-19 as well as at least twice weekly testing.  Every effort continues to frequently sanitize commonly touched surfaces.

As of 11/3/2020, the Facility has:

  • 63residents and 41 staff members with confirmed COVID-19.
  • 3 residents and 5 staff members that have recovered from COVID-19.
  •  residents and staff have tested negative for COVID-19.
  • It has been 0 days since a new resident or staff member has tested positive.

11/4/2020 Since the update yesterday, we have had 5 staff members and no residents test positive.  Our nursing administration team is completing a final review of resident information, as we have several residents who have recovered from COVID-19.  As we have final updates, we will update our website.  We will also work on timely notifications of family members on resident recoveries.

We have several staff members returning over the next few days who have recovered as well.  Please continue to keep our residents and staff in your thoughts and prayers as we fight this invisible enemy together.  Our team has really really pulled together over the last few weeks to ensure that resident needs have been met.  Our next round of resident testing is on 11/5/2020 and staff will be tested on 11/6/2020.

11/8/2020 One resident and one staff member tested positive today.

11/9/2020 2 Residents and 3 staff members tested positive today.

As of 11/10/2020, the Facility has:

  • 72 residents and 60 staff members with confirmed COVID-19.
  • 40 residents and 30 staff members that have recovered from COVID-19.
  • It has been 0 days since a new resident or staff member has tested positive.
  • 2 staff members and 0 residents tested positive today (11/10/2020).  Numbers have been updated to reflect this status.

11/12/2020 1 staff member and 0 Residents tested positive for COVID-19 today.

As of 11/15/2020, the Facility has:

  • 72 residents and 61 staff members with confirmed COVID-19.
  • 59 residents and 38 staff members that have recovered from COVID-19.
  • It has been 3 days since a new resident or staff member has tested positive.

As of 11/16/2020, the Facility has:

  • 72 residents and 62 staff members with confirmed COVID-19.
  • 60 residents and 46 staff members that have recovered from COVID-19.
  • It has been 0 days since a new resident or staff member has tested positive.  We did have a staff member test positive today.

As of 11/18/2020, the Facility has:

  • 72 residents and 62 staff members with confirmed COVID-19.
  • 60 residents and 49 staff members that have recovered from COVID-19.
  • It has been days since a new resident or staff member has tested positive.

As of 11/19/2020, the Facility has:

  • 72 residents and 62 staff members with confirmed COVID-19.
  • 60 residents and 51 staff members that have recovered from COVID-19.
  • It has beendays since a new resident or staff member has tested positive.

 

As of 11/24/2020, the Facility has:

    • 72 residents and 63 staff members with confirmed COVID-19.
    • 62 residents and 59 staff members that have recovered from COVID-19.
    • It has been 0 days since a new resident or staff member has tested positive, as we did have a staff member test positive today.  Prior to this, the last date for a staff member or resident to test positive was 11/16/2020.

As of 11/26/2020, the Facility has:

    • 72 residents and 63 staff members with confirmed COVID-19.
    • 62 residents and 60 staff members that have recovered from COVID-19.
    • It has been 2 days since a new resident or staff member has tested positive, as we did have a staff member test positive today.

As of 12/1/2020, the Facility has:

    • 72 residents and 64 staff members with confirmed COVID-19.
    • 62 residents and 61 staff members that have recovered from COVID-19.
    • It has been 0 days since a new resident or staff member has tested positive, as we did have a staff member test positive today.

As of 12/9/2020, the Facility has:

    • 72 residents and 65 staff members with confirmed COVID-19.
    • 62 residents and 62 staff members that have recovered from COVID-19.
    • It has been 0 days since a new resident or staff member has tested positive, as we did have a staff member test positive 12/8/2020.
    • Residents that have been negative are continuing to be tested every 3-7 days, and we have had identified no more positive residents.  The last date of a resident positive was 11/9/2020.

After we have at least 2 weeks with no positive cases, we hope to facilitate some sort of visitation.  Please keep posted here and we will provide updates as to what the expectations will be for residents, staff, and visitors.

12/13/2020 A staff member reported positive PCR results today.  No residents have been identified as exposed to this staff member.  Staff member is at home recovering.  No residents have tested positive for COVID-19 this past week.  We anticipate getting COVID-19 vaccines over the next few weeks.  We will be calling necessary parties to get permission to administer vaccines to your loved ones.

As of 12/13/2020, the Facility has:

    • 72 residents and 66 staff members with confirmed COVID-19.
    • 62 residents and 62 staff members that have recovered from COVID-19.  We are anticipating the return of 2 more staff members tomorrow.
    • It has been 0 days since a new resident or staff member has tested positive, due to the staff member’s results coming back positive today.

As of 12/21/2020, the Facility has:

    • 72 residents and 67 staff members with confirmed COVID-19.
    • 62 residents and 64 staff members that have recovered from COVID-19.  We are anticipating the return of 2 more staff members tomorrow.
    • It has been 0 days since a new resident or staff member has tested positive, due to a staff member’s results coming back positive today.  We are working on identifying any close contacts this staff member has potentially had with any residents not following social distancing guidelines.  This staff member has been faithfully wearing an N-95 mask while in facility.
    • We are anticipating communication from our pharmacy tomorrow (12/22/2020) on when we will be receiving our COVID-19 vaccines.  If you haven’t given permission for your loved one yet, please reach out to Angie at 308-635-2019 or at awahl@monumentrehab.com as soon as possible.  Staff members that haven’t responded yet, please let Angie know as soon as possible.  Thank you!

12/23/2020 Our COVID-19 Vaccine clinic day is 12/28/2020.  We will be getting the Pfizer vaccine.  If you have not given permission to your loved one to receive this, we need to know by today.  Consent forms have to be turned in to our pharmacy today.  Epipens will be onsite and available should the need arise.  Residents and staff will be monitored by a nurse for any adverse effects for 15-30 minutes after the injection.

12/28/2020 The first round of our COVID-19 vaccines are completed.  We have some staff and residents that plan on participating next time to get their first dose.  We vaccinated around 39 staff members and 53 residents so far.  No life threatening adverse reactions have been reported at this time.  We will be doing our second dose in 21 days, along with first doses for those that missed the first round.  If you haven’t replied about getting your loved one vaccinated, please call the facility as soon as you can if you want your loved one to receive the vaccine. Thank you for your support.

As of 1/4/2021, the Facility has:

  • 72 residents and 67 staff members with confirmed COVID-19.
  • 62 residents and 67 staff members that have recovered from COVID-19.
  • It has been 14 days since a new resident or staff member has tested positive.
  • We will be communicating with our local community health department and Nebraska ICAP to discuss going back through phasing and being able to incorporate in person visits, following social distancing guidelines.  We will post details here as they become available.  The next date of COVID-19 vaccines will be 1/18/2021.

 

1/27/2021  The following letter will be going out in the mail tomorrow to main contacts for our residents:

To our valued Family members and Visitors of Monument Rehabilitation and Care Center:

We are excited to announce that our Facility will reopen outdoor visits starting on 2/9/2021.   We are committed to remaining vigilant in our efforts to keep our residents and employees safe. The new visitation process incorporates various steps based on local, state, federal agencies and CDC guidelines as we continue to provide scheduled virtual visits for residents and families, while carefully transitioning to in-person visits.

The following protocols will be strictly enforced and subject to change without notice, during the New Visitation procedures as determined by Monument Rehabilitation and Care Center which include the following but are not limited to:

  • There has been no new onset of COVID-19 cases in the last 14 days and the facility is not currently conducting outbreak testing.
  • Visitations will occur on Tuesday, Thursday and Friday with 20-minute time slots for each visit.
  • Only 2 visitors will be allowed to visit per resident. Visitors also need to maintain six feet apart.
  • Physical contact with any resident is not allowed unless approved by facility administration for compassionate care visits.
  • Children may visit if able to safely adhere to facility guidelines. No PETS will be permitted.
  • Facility reserves the right to determine if a visitor meets all requirements to safely visit with the resident.
  • Visitors who are unable to adhere to the “Core Principles of COVID-19 Infection Prevention” listed below will not be permitted to visit and asked to leave.
    • Visitors must adhere to all facility screening, safety, infection prevention and control measures.
    • Visitors and Residents must maintain social distancing at 6 feet apart.
    • Visitors must perform hand hygiene or use alcohol-based hand rub upon arrival.
    • Visitors must avoid touching frequently touched surfaces while in the facility.
    • Visitors must wear a mask covering the nose and mouth at all times.
  • Instructional signage and proper visitor education on COVID- 19 signs and symptoms, infection control precautions, other applicable facility practices will be available upon arrival.
  • If a resident or staff member develops Covid-19 infection, all in person visits will cease immediately until further notice.
  • For residents with extended families, visits will be alternated weekly to allow quality time with other loved ones.
  • Visitors who live or travel to or from a Covid-19 location “hot spot” or have had a possible exposure to COVID-19, will not be permitted to visit in person until 14 days of self-quarantine and hope that you would consider their safety and well-being.
  • Visitation guidelines will be available upon arrival and followed during facility visit.
  • Facility shall limit movement in the facility and Visitors will not walk around different halls of the facility.
  • Facility staff will complete screening and direct visitors to designated area after clearance.
  • Visitors must arrive before their scheduled appointment to complete the screening process.
  • For situations where there is a roommate and the health status of the resident prevents the resident from leaving the room, facility will attempt to enable in-room visitation while adhering to the Core Principles and Visitor is required to have a negative PCR test collected within previous 72 hours.
  • Visitors will inform the facility of handicap requirements when scheduling a visit to make proper arrangements.
  • Food and beverages are not permitted during the visits.
  • Visitors bringing items for any resident must leave the package at the front desk and disinfected by staff.
  • A staff member will be assigned to monitor the resident and visitor to ensure adherence with visitation guidelines.
  • No unscheduled visits will be permitted.
  • Facility shall use the COVID-19 county positivity rate, found on the COVID-19
    Nursing Home Data site as additional information to determine how to facilitate indoor visitation:

    • Low (<5%) = Visitation should occur according to the Core Principles and facility policies (beyond compassionate care visits);
    • Medium (5% – 10%) = Visitation should occur according to the Core Principles and facility policies (beyond compassionate care visits);
    • High (>10%) = Visitation should only occur for compassionate care situations according to the Core Principles and facility policies.
  • Our Facility requires all in-person visitors and within a resident’s room to obtain testing within 72 hours of visitation and providing results to facility staff upon arrival. CMS visitation guidance encourage visitor testing.

Compassionate Care Visitation can be conducted by family members as well as any individual that can meet the resident’s needs, such as clergy or lay persons offering religious and spiritual support. All compassionate care visits should be conducted using social distancing; however, if during a compassionate care visit, a visitor and the facility identify a way to allow for personal contact, it should only be done following all appropriate infection prevention guidelines, and for a limited amount of time.

Outdoor Visitation pose a lower risk of transmission due to increased space and airflow. Therefore, all visits should be held outdoors whenever practicable. The Facility may create accessible and safe outdoor spaces for visitation, such as in courtyards, patios, or parking lots.

To schedule your indoor or outdoor visit with your loved one, please contact the facility at 308-635-2019.  Due to limited visitation availability you will be required to schedule your visit 48 hours in advance.  Please not as above, if the county positivity rate is high, compassionate care situations will only be permitted visits.

We thank you for your ongoing support and understanding through these difficult times and hope that you and your family are healthy and safe.

Jennifer Coffman, LNHA

Administrator

Angie Wahl, RN

Director of Nursing

Please note: At this time, the county positivity rate is HIGH at 15.5%.  CMS will update their numbers again on 1/31/2021.  This is updated every 2 weeks.  The following link is the where we have to access our data that we go by for positivity rates.

https://data.cms.gov/stories/s/COVID-19-Nursing-Home-Data/bkwz-xpvg/

3/23/2021 Our facility implemented a new visitation policy related to the new guidelines put out by CMS on 3/10/2021. Unfortunately, we had to stop those today due to a positive staff member.  One positive staff member or one resident places the facility at “outbreak” status until all residents and staff are tested.  We were able to complete the majority of the testing today and plan on testing the rest of the staff tomorrow.

As of 3/23/2021, the Facility has:

    • 0 residents and 1 staff member with confirmed COVID-19.
    • 0 residents and 0 staff members that have recovered from COVID-19.
    • It has been 0 days since a new resident or staff member has tested positive, due to the staff member’s results coming back positive today.
    • Please continue to check back on our website for further updates.  Thank you for your understanding.