Current JSL COVID-19 Plan:

These plans to be evaluated on an ongoing basis.

JSL will follow the requirements of all applicable Executive Orders and Michigan Department of Health and Human Services (MDHHS) Emergency Orders, Orders from the Local Health Department, and Centers for Disease Control Guidance.

 

The current effective Guidance can be found here (in chronological order):

 

MDHHS Amended Requirements for Residential Care Facilities-amended October 4, 2022. http://www.michigan.gov/coronavirus/resources/orders-and-directives/lists/executive-directives-content/October-4-2022-amendment-for-requirements-for-residential-care-facilities

 

Centers for Medicare and Medicaid Services QSO 20-38-NH (Revised-9-23-22)

https://www.cms.gov/files/document/qso-20-38-nh-revised.pdf

 

Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic (September 23, 2022)

https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html

 

Interim Guidance for Managing Healthcare Personnel with SARS-CoV-2 Infection or Exposure to SARS-CoV-2 (September 23, 2022)

https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

 

CDC Use and Care of Masks (September 9, 2022) https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html

 

Stay Up to Date with COVID-19 Vaccines Including Boosters (September 8, 2022)

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html

 

COVID Data Tracker (Community Level)

https://covid.cdc.gov/covid-data-tracker/#datatracker-home

 

Isolation and Precautions for People with COVID-19 (August 11, 2022)

https://www.cdc.gov/coronavirus/2019-ncov/your-health/isolation.html

 

MDHHS May 21st Order: Requirements for Residential Care Facilities

https://www.michigan.gov/documents/coronavirus/5.21.21_RCF__Final_726030_7.pdf

 

 

JSL will continue to follow the protocols below:

Assisted Living (AL) Communities (Fleischman Residence and Coville Apartments)

According to the CDC, in general, long term care settings whose staff provide non-skilled care such as assisted living communities, should follow community prevention strategies based on COVID-19 community Levels, similar to independent living, retirement communities or other non-healthcare settings.

 

Infection Prevention Control

  • Visitors with confirmed COVID-19 infection or similar symptoms should defer non-urgent in-person visitation until they meet CDC criteria to end isolation (after day 5 has past, and prefer visits are delayed past day 10).
    • If the visit is still to occur, see Visitation section.
  • For visitors who have had close contact with someone with COVID-19 infection, it is safest to defer non-urgent in-person visitation until 10 days after their close contact.
  • Hand hygiene practices are to be followed (alcohol-based hand rub preferred).
  • A face covering or mask (covering the mouth and nose) should be used in accordance with CDC guidance.
  • Instructional signage throughout the facility and proper visitor education on COVID-19 signs and symptoms, infection control precautions, and other applicable facility practices will be conducted.
  • Cleaning and disinfection of highly touched surfaces in the facility.
  • Staff will adhere to the appropriate use of personal protective equipment (PPE).
  • The facility will conduct resident and staff testing as per current MDHHS/CMS guidance.
  • Residents will be monitored for signs and symptoms of COVID-19 daily.
  • Couples to be offered option for separate apartments/suites, if available

 

Community Levels – JSL will inform its residents of the following CDC recommendations:

  • At all COVID-19 Community Levels:

Levels

    • Stay up to dateon vaccination, including recommended booster doses.
    • Maintain ventilation improvements.
    • Avoid contact with people who have suspected or confirmed COVID-19.
    • Follow recommendations for isolation if you have suspected or confirmed COVID-19.
    • Follow the recommendations for what to do if you are exposed to someone with COVID-19.
    • If you are at high risk of getting very sick, talk with a healthcare provider about additional prevention actions.

 

  • When the COVID-19 Community Level is Medium or High:

Levels 2

    • If you are at high risk of getting very sick, wear a high-quality mask or respirator(e.g., KN95) when indoors in public
    • If you have household or social contact with someone with COVID-
    • Consider self-testing to detect infection before contact, and consider wearing a high-quality mask when indoors with them
  • When the COVID-19 Community Level is High:

Levels 3

    • Wear a high-quality mask or respirator.
    • If you are at high risk of getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.

Source Control (Masks) and Physical Distancing

  • We have chosen to offer surgical masks as a source control option for visitors, but we will allow the use of a mask or respirator with higher level protection that is not visibly soiled.
  • JSL is not required to provide PPE for visitors.
  • If you are at high risk of getting very sick, wear a high-quality mask or respirator(e.g., KN95) when indoors in public at medium and high community levels
  • When community levels are high, masks are recommended for everyone.
  • Physical distancing and wearing well-fitting masks (if tolerated) is recommended when electing indoor visitation when the community is in outbreak mode.
  • The safest approach is for everyone, regardless of vaccination status, to wear a face covering or mask while in communal areas of the facility and to practice social distancing.

 

Screening and Testing Protocols

  • All staff, residents, and persons entering the facility will continue to be screened.
  • Visitors with symptoms or signs of COVID-19 will not be permitted entry unless they test or agree to wear a KN-95 mask.
  • Staff with signs or symptoms of COVID-19 must test immediately.
  • Routine testing of asymptomatic staff is no longer required but may be performed at the discretion of the facility. JSL reserves the right to require staff to test asymptomatic staff routinely.
  • Staff and residents with signs or symptoms of COVID-19, regardless of vaccination status, must be tested as soon as possible.
  • Residents with symptoms of COVID-19 will be isolated until a nucleic acid amplification test (PCR) or an antigen (POC) test is completed.
  • An AL community is deemed to be in outbreak mode when there is a new COVID-19 infection in any staff member or any facility onset COVID-19 infection in a resident.
    • Upon identification of a single new case of COVID-19 infection in any staff or resident, testing will begin immediately, but not earlier than 24 hours after the exposure, if known.
    • Testing will begin regardless of vaccination status.
    • In general, testing is not necessary for asymptomatic people who have recovered from COVID-19 infection in the prior 30 days
    • Testing will be considered for those who have recovered in the prior 31-90 days. If testing is performed on these individuals, an antigen test (POC) instead of a nucleic acid amplification test (PCR) is recommended.
    • If JSL has the ability to identify close contacts of the individual with COVID-19, JSL can choose to conduct focused testing based on known close contacts. If JSL does not have the expertise, resources, or ability to identify all close contacts, JSL will instead investigate the outbreak at a facility-wide or group-level (e.g. unit, floor, or other specific area of the community).
    • Residents or their responsible party are required to consent to testing and must sign and return the consent form that was sent to them by their building Administrator.
    • Residents who decline testing, if symptomatic, will be placed on Isolation requirements for COVID-19 per the Centers for Disease Control (CDC) guidelines. This means that the resident would not be able to participate in communal dining or programming.
    • Residents who decline testing and are asymptomatic will have additional monitoring, to ensure the resident maintains appropriate distance from other residents, wears a face covering, and practices effective hand hygiene until the procedures for outbreak testing have been completed.
    • Staff who decline to participate in testing will not be permitted to have contact with residents and will be redeployed to other duties, if available.
    • During these outbreak periods, JSL may continue communal dining and programming. During the testing period, if a concern is found, JSL may close dining and programming as deemed necessary by management.
    • JSL will inform you if your community enters into outbreak mode via VoiceFriend voicemail message or text, or by email.
    • If an expanded approach to testing is followed and testing identifies additional infections, testing will continue. Testing will be repeated for residents and staff every 3-7 days until no new cases are identified for at least 14 days.
    • High risk exposures that involve material contact with the eyes, nose or mouth or were with aerosol generating procedures will test at day 1, day 3 and day 5 and will be repeated until no new cases are identified for 14 days.

 

New Resident Admission

  • JSL will antigen test (POC) all new admissions upon arrival to the facility
  • New admissions will be advised to wear source control (mask) for the first 10 days following admission.
  • Residents who are not up to date on vaccinations will be required to wear source control for 10 days following admission.
  • Residents who leave the community for more than 24 hours will be treated like a new admission.

 

Visitation

  • Visitors are allowed at all times and will adhere to infection prevention controls as listed above. Visits will be person centered and will consider the residents’ physical, mental, and psychosocial well-being, and support their quality of life. The following protocols will be observed:
  • Visits are allowed for all residents at all times.
  • Visits are allowed indoors and outside.
  • Visitors must enter the community at permitted entrances only.
  • All visitors will be screened as currently practiced. Those with symptoms or exposures will be excluded or must wear a KN-95 mask.
  • Regardless of community level, residents and their visitors when alone in their apartment, may choose not to wear face coverings or masks and may choose to have close contact.
  • Visits will not be limited in frequency, length, number of visitors, nor will they require advance scheduling.
  • Although there is no limit on the number of visitors that a resident can have at one time, visits will be conducted in a manner that adheres to infection control practices and that do not increase risk to other residents.
  • Visits are preferred to take place in the resident’s apartment.
  • When in outbreak mode, visitors must go directly to the resident’s apartment and limit movement within the building.
  • Visits are permitted during dining. Guests may dine with residents in the dining room.
  • Large gatherings (e.g., parties, events) may be permitted indoors. Where large numbers of visitors are in the same space at the same time, physical distancing is advised.
  • While not recommended, residents who are on isolation can still receive visitors. In these cases, visits should occur in the resident’s apartment and the resident and visitor should wear a well-fitting facemask (if tolerated), the visitor should don PPE which can be found outside the apartment, and infection prevention controls should be followed.
  • Physical distancing during visits is recommended to be maintained. Compassionate care visits are permitted at any time.

 

Visits During Outbreak Mode

  • An outbreak investigation is initiated when an onset of COVID-19 occurs (i.e., a new COVID-19 case among residents or staff).
  • While it is safer for visitors not to enter during an outbreak investigation, visitors are permitted. Visitors should adhere to all infection prevention controls.
  • Visitors should wear face coverings or masks during outbreak mode visits, regardless of vaccination status, and visits will occur in the resident’s apartment.

 

Visitor Testing and Vaccination

  • JSL strongly encourages all visitors to receive the bivalent vaccine and flu vaccine.
  • While not required, JSL encourages visitors to test prior to visiting their loved ones in a JSL community while Oakland County remains in high or medium community levels.
  • JSL can offer onsite POC testing or we encourage visitors to be tested on their own before coming to the facility.

 

Volunteer and Service Provider Testing

  • Testing of service providers such as consultants, contractors, volunteers, and caregivers who provide care and services to residents on behalf of the facility must participate in outbreak mode testing pursuant to protocols for staff.
  • JSL prefers that all volunteers be fully vaccinated. If a volunteer is not fully vaccinated they will be required to wear a KN-95 mask.

 

Notification of COVID-19 Positive Cases

  • All residents, guardians and healthcare proxies will be notified when there are any staff or resident cases of COVID-19. This notification will be transmitted via Voice Friend text messaging or email and the information will also be placed on the jslmi.org website under the Response to COVID-19 banner under the specific community.
  • A notice will be posted in a visible and obvious place near the main entrance of the facility indicating the presence of a confirmed COVID-19 positive employee or resident. The notice will continue to be displayed for 14 days after the last positive COVID-19 test result for an employee or resident in the facility.
  • Anyone with a known close contact with an individual diagnosed with COVID-19 will be notified per Centers for Disease Control guidelines.
  • All notifications required per MDHHS order or other officials will be made (local health department, electronic reporting system).

 

Dining, Programming and Resident Outings

  • While adhering to infection prevention controls, communal activities and dining are permitted to occur.
  • Residents and families will be notified if dining or programming is suspended during a surge in COVID-19 cases in either the community at large or within the AL community staff and/or residents.
  • While in high and medium community levels JSL requires the wearing of masks in programming and activities.

 

COVID-19 Exposures

  • In general, asymptomatic residents do not require isolation while being evaluated for COVID-19 following close contact with someone with COVID-19 infection.
  • Residents should wear a maskas soon as they find out they were exposed.  Mask wearing should continue for 10 full days.
  • Those who have not recovered from COVID-19 infection in the prior 30 days should be tested as described in the testing section.
  • Day 0 is the day of last exposure to someone with COVID-19
  • Day 1 is the first full day after the last exposure
  • For 10 Full Days residents will:
    • Wear a high-quality mask or respirator (e.g., KN95) any time around others inside the home or indoors in public.
    • Be instructed to not go places where unable to wear a mask.
    • Take extra precautions around people who are more likely to get very sick from COVID-19.
    • Resident will be monitored for symptoms by staff daily.
  • After 5 full days after the last exposure, residents will be tested even if they do not develop symptoms.
  • If a resident develops symptoms before testing day, they will isolate immediately and be tested.
  • If the test result is positive, CDC guidelines on isolation will be followed. https://www.cdc.gov/coronavirus/2019-ncov/your-health/isolation.html.
  • If test is negative
    • precautions should continue through day 10.
    • A high-quality mask should be worn when around others at home and indoors in public.

 

Management of Residents with Confirmed COVID-19

  • Residents who test positive for COVID-19 will be placed on isolation.
  • Staff will use full PPE (gowns, gloves, eye protection, and a NIOSH-approved KN95 or equivalent or higher-level respirator) while in the resident’s apartment.
  • Residents should continue to wear masks, if capable until symptoms resolve or, for those who never developed symptoms, until they meet the criteria to end isolation below.

 

  • Residents who were asymptomatic throughout their infection and are not moderately to severely immunocompromised will be isolated until:
    • At least 10 days have passed since the date of their first positive viral test.
  • Residents with mild to moderate illness (see CDC definition) who are not moderately to severely immunocompromised will be isolated until:
    • At least 10 days have passed since symptoms first appeared; and
    • At least 24 hours have passed since last fever without the use of fever-reducing medications; and
    • Symptoms (e.g., cough, shortness of breath) have improved.

 

  • Patients with severe to critical illness (per CDC definition) and who are not moderately to severely immunocompromised will be isolated until:
    • In general, residents who are hospitalized for COVID-19 infection will be maintained in isolation for the time period described for patients with severe to critical illness;
    • At least 10 days and up to 20 days have passed since symptoms first appeared;
    • At least 24 hours have passed since last fever without the use of fever-reducing medications;
    • Symptoms (e.g., cough, shortness of breath) have improved; and
    • The test-based strategy as described for moderately to severely immunocompromised patients below can be used to inform the duration of isolation.
  • Residents will be monitored closely while in isolation.
  • Medically unstable residents will be transferred to the hospital for evaluation. Medically stable residents will be isolated in their apartments and will be monitored closely for changes in condition.  Should their medical condition change, residents will be transferred to the hospital.  Attempts to transfer the resident to a Care and Recovery Center will be considered on a case-by-case basis if they are still being utilized.
  • Residents will be evaluated by nursing staff who will consult the resident’s primary care physician.
    • JSL will coordinate transportation for resident to be taken to the hospital for treatment, if needed and follow 911 protocols.
    • JSL will assist with tracking any contact between an impacted resident and those with whom they may have interacted.
    • JSL will work with hospital to track resident’s results and progress as appropriate and permitted and discharge plan accordingly.

 

Recordkeeping

  • Records of vaccination will be maintained for staff and residents and can consist of the AL community’s electronic medical record system reflecting a resident’s receipt of the vaccine and bivalent booster, Michigan Care Improvement Registry (MCIR) or other official immunization record from a doctor, local health department, hospital, pharmacy or health system or a copy of a valid CDC vaccination card.
  • All MDHHS reporting via Qualtrics and COVID testing shall be completed as required.

Independent Living (Meer, Hechtman, Prentis and Teitel Apartments)

Independent Living COVID-19 practices are determined based on the CDC COVID-19 Community Levels which were issued on February 25, 2022 and are as follows:

Levels Independent Living

 

  • At all COVID-19 Community Levels:

Levels

  • Stay up to date on vaccination, including recommended booster doses.
  • Maintain ventilation improvements.
  • Avoid contact with people who have suspected or confirmed COVID-19.
  • Follow recommendations for isolation if you have suspected or confirmed COVID-19.
  • Follow the recommendations for what to do if you are exposed to someone with COVID-19.
  • If you are at high risk of getting very sick, talk with a healthcare provider about additional prevention actions.

 

  • When the COVID-19 Community Level is Medium or High:

Levels 2

  • If you are at high risk of getting very sick, wear a high-quality mask or respirator(e.g., KN95) when indoors in public
  • If you have household or social contact with someone at high risk for getting very sick, consider self-testing to detect infection before contact, and consider wearing a high-quality mask when indoors with them

 

  • When the COVID-19 Community Level is High:

Levels 3

  • Wear a high-quality mask or respirator.
  • If you are at high risk of getting very sick, consider avoiding non-essential indoor activities in public where you could be exposed.

 

If the level in Oakland County rises, JSL may resume more cautious guidelines.

Masking and Social Distance

  • Although masks are not mandatory at the current level, if you are immunocompromised or at high risk for severe illness you are advised to talk to your healthcare provider about the precautions you should take, such as wearing masks or respirators in public. As a reminder, people who are older and people with certain medical conditions are more likely to become very sick with COVID-19.
  • Please strongly consider wearing a mask in public places, within and outside your JSL community.
  • If you chose not to get vaccinated or to be fully vaccinated which currently requires obtaining the bivalent vaccine, we are requesting that you mask at all times when in public areas of the building. Please be respectful of your health and that of your neighbors.
  • Surgical masks are preferred over cloth masks.
  • Social distancing is no longer required, but is advised.

 

Screening and Testing Protocols

  • All residents, unvaccinated staff and persons entering the facility will continue to be screened.
  • Staff with symptoms or signs of COVID-19, must report their illness to Human Resources, leave the building immediately and have a PCR test regardless of vaccination status. Staff will be excluded from work until they are clear to return to work by Human Resources.
  • Residents are not required to test if they have signs or symptoms of COVID-19 but are urged to obtain a POC or PCR test per CDC guidelines regardless of vaccination status.
  • Visitors with symptoms or with a diagnosis of COVID-19 will be excluded from entering the facility unless they can provide evidence of a recent (within 48 hours) negative COVID-19 test.
  • If you live with or have social contact with someone at high risk for severe illness, consider testing yourself for infection before you get together with them and wear a mask when indoors with them.
  • Staff are no longer subject to routine testing.

 

Notifications of COVID-19 Cases

JSL will notify all residents, guardians, and healthcare proxies when there are any staff or resident cases of COVID-19 in the community as soon as possible via Voice Friend and on the JSL website (jslmi.org) under the Response to COVID-19 banner.  Notices of positive cases will be posted in a conspicuous place in all communities as per JSL protocol and HUD guidelines.  Anyone with a direct exposure will be notified.  The Oakland County Health Department will be notified of any COVID-19 cases among staff or residents.

 

Visitors

All visitors must enter and be screened and logged in at permitted entrances only.  Those with symptoms or exposures will be excluded.

 

COVID-19 Exposures

  • In general, asymptomatic residents do not require isolation while being evaluated for COVID-19 following close contact with someone with COVID-19 infection.
  • These residents should still wear a mask and those who have not recovered from COVID-19 infection in the prior 30 days should be tested as described in the testing section.
  • Residents will be instructed to wear a mask as soon as they find out they were exposed.
  • Day 0 is the day of last exposure to someone with COVID-19
  • Day 1 is the first full day after last exposure
  • For 10 Full Days residents will:
    • Wear a high-quality mask or respirator (e.g. KN95) any time you around others inside apartment or indoors in public.
    • Be instructed to not go places where unable to wear a mask.
    • Take extra precautions around people who are more likely to get very sick from COVID-19.
  • If a resident develops symptoms, they should isolate immediately and should be tested. Residents have been advised how to obtain free tests from the Federal distribution program and local free distribution options.  Tests can also be purchased at local stores and are now readily available.
  • If the test result is positive, isolation recommendations should be followed.
  • After 5 full days after the last exposure, residents should test per CDC recommendations, even if they do not develop symptoms.
  • If test is negative
    • Residents should continue taking precautions through day 10.
    • Residents should wear a high-quality mask when around others at home and indoors in public.

 

Management of Residents with Confirmed COVID-19

  • People who are confirmed to have COVID-19 or are showing symptoms of COVID-19 need to isolate regardless of their vaccination status.
  • Residents who have a positive viral (PCR) test or Point of Care (POC) test for COVID-19, regardless of whether or not they have symptoms are considered confirmed for COVID-19.
  • Residents diagnosed with COVID-19 will be instructed to isolate per the CDC recommendation.
  • Current CDC guidelines for isolation will be followed (day 0-day 5)
  • Residents participating in the meal program will have their meals delivered to their apartment and the fee for delivery will be waived during the period of isolation.
  • Staff will use full PPE (gowns, gloves, eye protection, and a NIOSH-approved KN95 or equivalent or higher-level respirator) if the need arises to enter the apartment.
  • Resident will be encouraged to be evaluated and seek medical treatment with their own primary care physician. Residents should also isolate if sick and suspect that they have COVID-19 but do not yet have a test
  • Residents should wear a mask when around others at home and in public for an additional 5 days.

 

Dining and Activities

  • Communal dining and group activities will be permitted.
  • While in high and medium community levels JSL will be require the wearing of masks in programming and activities.
  • Access to hand hygiene will be available.
  • Residents who wish to continue to receive meals in their apartment will be charged the customary delivery fee.
  • During an increase in the County Community Level, JSL will determine when it is appropriate to temporarily suspend dining or programming. Residents and families will be notified when a temporary suspension occurs.

 

Salon and Wellness Center

  • While masking and social distancing is not required, it is recommended and requested.
  • During an increase in the County Community Level, JSL will determine when it is appropriate to temporarily suspend the use of the salon and/or wellness center. Residents and families will be notified when a temporary suspension occurs.

 

Transportation

  • Transportation will be offered for medical appointments, essential appointments, and social appointments where and as available. Masks are required.
  • During an increase in the County Community Level, JSL will determine when it is appropriate to temporarily suspend the use of transportation. Residents and families will be notified when a temporary suspension occurs.

For All JSL Communities

Miscellaneous

  • JSL staff are required to follow our MIOSHA/OSHA work plan.  If you would like to see a copy of our plan or any other staff protocols, please speak with your building Administrator.  Topics covered in this plan include the following:
    • Engineering controls – barriers between the worker and exposure to the virus including masks and facial coverings.
    • Administrative controls – policies, procedures and practices such as staggered work schedule, teleworking and increase social distancing measures.
    • Basic infection prevention measures – handwashing and facility cleaning, in accordance with CDC guidance.
    • Health surveillance – screening protocols to identify known or suspected COVID-19 cases at the start of work shifts, employees should report any signs or symptoms of COVID-19.
  • Marvin’s Bistro and the Krolik Café are currently open. If there is an increase in local cases, JSL will determine when it is appropriate to temporarily suspend the use of the Bistro or Krolik café.  Residents and families will be notified when a temporary suspension occurs.
  • Boutiques, where provided, are currently open. If there is a COVID-19 surge in the County, JSL will determine when it is appropriate to temporarily suspend the use of the boutique. Residents and families will be notified when a temporary suspension occurs.
  • Tours available.
  • Move-ins and move-outs are permitted and subject to protocols and policies for the same.
  • Continued vigilant sanitation building-wide.
  • Congregating in common areas of the buildings is permitted.  Although masking and social distancing is not required, they are recommended and requested.

 

Plan of action in the event of an outbreak of multiple cases of COVID-19 at a JSL Community:

  • Take instruction from the Oakland County Health Department and follow recommendations.

If you have questions about any of the above information, or require additional information or clarification please contact your building administrator.