Accucare Travel Policy Effective 3/3/2020
Accucare Nursing has been closely monitoring the recent outbreak of Novel Corona (COVID-19) virus. As of two days ago, there is a confirmed case in New York State (NYC). More cases of COVID-19 are likely to be identified in the coming days, including more cases in the United States. It’s also likely that person-to-person spread will continue to occur, including in communities in the United States. It’s likely that at some point, the widespread transmission of COVID-19 in the United States will occur.
Any nurse who has traveled recently must report to the agency the location they traveled. Accucare Nursing will be notifying patient’s family of any such travel. For instances of domestic travel, it will be the sole discretion of the individual family to decide if a nurse may return to their home immediately, or whether they will ask for a clearance period. International or high-risk travel including cruises will require a 2 week clearance period post-travel. If a nurse is exhibiting any symptoms of sickness or have been exposed to anyone who has traveled, we require that they inform the office immediately.
As part of our pandemic preparedness plan activation, we will identify any nurses or patients who have traveled or plan to travel including those close to them. We will inform patients and nurses of any travel updates.
Important Travel Policy Updates Effective 7/15/20
Four additional states were added to the Tri-State’s quarantine restricted list yesterday- New Mexico, Minnesota, Wisconsin, and Ohio. Delaware was removed from the restricted list. There are a total of 22 states on the list. The intent of this listing is to comply with the New York State’s quarantine restricted list. Please refer to https://coronavirus.health.ny.gov/covid-19-travel-advisory for a confirmed list.
On June 25, 2020, Accucare suspended the policy which allowed a nurse to accompany their patient for all out of state travel. Exceptions will be made for hospital and medical visits. However, those visits must be communicated to the office.
For families requesting to travel with their nurse in-state:
In-state vacation travel requests must be made at least 14 days in advance. In-state travel vacation allowances may be considered and will be decided on a case by case basis by members of the COVID Response Team. Some of the criteria used in making the determination will be COVID Data for the region/county/town requesting to visit, proposed activity, living, and travel arrangements being requested. Please keep in mind, the global pandemic is a very fluid and changing situation. We are unable to predict what will be safe weeks ahead. Therefore, please keep in mind that our policy regarding travel is subject to change at any time. We reserve the right to reverse our decision on prior approved in-state travel vacation plans. Our number one priority has been and will continue to be to protect our patients, families, and staff.
Activities outside of the patient residence /property: Effective immediately, a nurse may only accompany a patient outside of the patient residence/property for necessary and approved functions only. Approved functions currently approved by the COVID Response Team are medical & hospital visits, and school (if applicable).
______________________ Travel Updates Prior to 7/15/20 ________________________
Travel Policy Update Effective 7/7/20
In recognition of the situation, we have added 3 additional states to the travel advisory. The travel advisory now includes Alabama, Arizona, Arkansas, California, Delaware, Florida, Georgia, Kansas, Iowa, Idaho, Louisiana, Mississippi, North Carolina, Nevada, Oklahoma, South Carolina, Tennessee, Texas, and Utah. The intent of this listing is to comply with the New York State’s quarantine restricted list. Please refer to https://coronavirus.health.ny.gov/covid-19-travel-advisory for a confirmed list.
Travel policy Update Effective 7/1/20
In recognition of the situation, we have added an additional state to the travel advisory: Alabama, Arizona, Arkansas, California, Florida, Georgia, Iowa, Idaho, Louisiana, Mississippi, North Carolina, Nevada, South Carolina, Tennessee, Texas, and Utah. The intent of this listing is to comply with the New York State’s quarantine restricted list. Please refer to https://coronavirus.health.ny.gov/covid-19-travel-advisory for a confirmed list.
Travel Policy Update Effective 6/30/20
In recognition of the situation, we have added seven additional states to the travel advisory: Alabama, Arkansas, California, Florida, Georgia, Iowa, Idaho, Louisiana, Mississippi, North Carolina, Nevada, South Carolina, Tennessee, Texas, and Utah. The intent of this listing is to comply with the New York State’s quarantine restricted list. Please refer to https://coronavirus.health.ny.gov/covid-19-travel-advisory for a confirmed list.
Travel Policy Update Effective 6/25/20
In light of the Governor’s recent executive order, any employee or family voluntarily traveling to or through a location identified as having a COVID-19 ‘high infection rate’ will be subject to a 14-day mandatory quarantine. For Accucare employees, the mandatory quarantine period will be unpaid. For families, Accucare will be temporarily suspending services and resume nursing care after the completion of the 14-day mandatory quarantine. Per the Joint Travel Advisory announced on June 24, 2020, by the governors of New York, New Jersey, and Connecticut, a “High Infection Rate” location is a state or locales where there is confirmation of at least 10 COVID-19 infections per 100,000 residents on a seven-day rolling average or at least 10% of the state’s total population are infected by COVID-19 on a rolling seven-day average. If you choose to travel to or through a High Infection Rate location, you may be exposing yourself to and/or increasing your risk of contracting or spreading COVID-19 and you will be subject to mandatory quarantine upon returning from your travel. The states currently defined as “High Infection Rate” include Alabama, Arkansas, Arizona, California, Florida, South Carolina, North Carolina, Utah, Texas, and Washington. However, that list is expected to expand as necessary. While previously, an Accucare nurse has been permitted to travel with their patient after obtaining temporary licensure in the traveling state, Accucare is suspending that policy effective immediately. Nurses will no longer be able to accompany a patient out of state during the COVID Emergency. Exceptions can be made in advance for a hospital and/or medical visits. Accucare must be notified in advance of any travel plans both domestic and international for employees and families. Travel deemed safe and low risk may require additional PPE post travel as deemed necessary by the COVID Response Team. If an employee or family is exhibiting any symptoms of sickness or has been exposed to anyone who has traveled, we require that they inform the office immediately 845-624-0260.
Accucare Mask Policy 3/3/2020 Updated 4/5/2020
Weare encouraging all of our nurses to wear masks at the bedside. Accucare Nursing has been closely monitoring the recent outbreak of Novel Corona (COVID-19) virus. It’s likely that at some point, the widespread transmission of COVID-19 in the United States will occur. At that time, we may require that masks be worn. Please remember, although we are only encouraging the wearing of masks currently, your patient’s family has the right to insist that you wear one. If you need masks, please let us know as soon as possible so that we may accommodate you.
A face covering is required when social distancing is not possible including but not limited to during patient care.
Clinicians will screen and document with each patient echart for possible COVID-19 exposure, risk and symptoms. In addition, a representative from the agency will contact each family twice per week for patient screening.
Clinicians are instructed to self-monitor, screen for COVID-19 symptoms. They are directed to notify the agency if any symptoms develop. In addition, clinicians are required to submit a COVID-19 form prior to patient care. The agency sends out daily shift reminders, along with a reminder to complete the COVID-19 form.
Monitoring and Assigning Work Restrictions:
The agency has a plan for monitoring and assigning work restrictions for ill and exposed providers. Jenny Van Sise and Carlo Kalisch have been assigned the responsibility of conducting audits of daily screening assessments done by clinicians and families. They will report to their findings to the COVID response team as necessary.
Clinicians with possible COVID symptoms:
If a clinician is experiencing any possible COVID-19 symptoms, they are immediately removed from patient care. We will advise the clinician to isolate and call the DOH COVID Hotline or their own provider to arrange testing. The agency will begin precautionary tracing and make notifications pending the COVID-19 testing results. The agency will share the results of COVID-19 testing with anyone the clinician came in contact with.
Patients with possible COVID symptoms:
If a patient or family member of the patient is experiencing any possible COVID-19 symptoms, we will advise them to call the DOH COVID Hotline or their own provider to arrange testing. The agency will begin precautionary tracing and make notifications pending the COVID-19 testing results. The agency will share the results of COVID-19 testing with any clinicians the patient or family came in contact with. Any clinicians actively providing patient care to a household with suspected or confirmed COVID-19, will be given the necessary PPE. The agency will notify the local health department of COVID-19 infection and remain in contact with the local health department as necessary.
Updated Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following COVID-19 Exposure:
In compliance with the New York State Department of Health guidelines released March 31, 2020 healthcare personnel (HCP) who have been exposed to a confirmed or suspected case of COVID-19, or who have traveled internationally in the past 14 days, whether healthcare providers or other facility staff, to work if all of the following conditions are met: Furloughing such HCP would result in staff shortages that would adversely impact operation of the healthcare entity. HCP who have been contacts to confirmed or suspected cases are asymptomatic. HCP who are asymptomatic contacts of confirmed or suspected cases should self monitor twice a day (i.e. temperature, symptoms), and undergo temperature monitoring and symptom checks at the beginning of each shift, and at least every 12 hours during a shift. HCP who are asymptomatic contacts of confirmed or suspected cases should wear a facemask while working, until 14 days after the last high-risk exposure. To the extent possible, HCP working under these conditions should preferentially be assigned to patients at lower risk for severe complications (e.g. on units established for patients with confirmed COVID-19), as opposed to higher-risk patients (e.g. severely immunocompromised, elderly). We understand as a pandemics grows, all staff will need to be assigned to treat all patients regardless of risk level. HCP allowed to return to work under these conditions should maintain self -quarantine when not at work. At any time, if the HCP who are asymptomatic contacts to a positive case and working under these conditions develop symptoms consistent with COVID-19, they should immediately stop work and isolate at home.
Updated Protocols for Personnel in Healthcare and Other Direct Care Settings to Return to Work Following confirmed or suspected COVID-19:
All staff with symptoms consistent with COVID-19 should be managed as if they have this infection regardless of the availability of test results. To be eligible to return to work, HCP with confirmed or suspected COVID-19 must have maintained isolation for at least 7 days after illness onset, must have been fever-free for at least 72 hours without the use of fever reducing medications, and must have other symptoms improving. If HCP is asymptomatic but tested and found to be positive, they must maintain isolation for at least 7 days after the date of the positive test and, if they develop symptoms during that time, they must maintain isolation for at least 7 days after illness onset and must have been at least 72 hours fever-free without fever reducing medications and with other symptoms improving. Staff who are recovering from COVID-19 and return to work after seven days should wear a facemask while working until 14 days after onset of illness, if mild symptoms persist but are improving. To the extent possible, staff should preferentially be assigned to patients at lower risk for severe complications (e.g. on units established for patients with confirmed COVID-19), as opposed to higher-risk patients (e.g. severely immunocompromised, elderly). We understand as a pandemics grows, all staff will need to be assigned to treat all patients regardless of risk level.
For purposes of coronavirus, there are both a mandatory quarantine protocol and a precautionary quarantine protocol. By definition, mandatory quarantine is the classification which can be directed by legal order if not complied with. Agency will utilize the following definitions in determining whether or not to institute a mandatory or precautionary quarantine:
- Status for Required Mandatory Quarantine – Person has been in close contact (6 ft.) with someone who is positive, but is not displaying symptoms for COVID-19; or person has traveled to China, Iran, Japan, South Korea or Italy and is displaying symptoms of COVID-19;
Status for Required Mandatory Isolation – Person has tested positive for COVID-19, whether or not displaying symptoms for COVID-19. LHDs must immediately issue an order for Mandatory Quarantine or Isolation once notified, which shall be served on the person impacted. Given the virulence of COVID-19, we also have precautionary protocols.
Return to work post-illness for clinicians:
After the necessary quarantine/ isolation period determined by NYS DOH and CDC, clinicians will be allowed to resume patient care as long as they are not currently symptomatic. (fever free for 72 hours without fever-reducing medicine).
Personal Protective Equipment:
Agency will maintain an adequate supply of PPE including but not limited to facemasks, respirators, gowns, gloves and eye protection. Agency has a process in place to monitor supply levels and current burn rate. Agency has implemented a respirator protection program and policy. Agency has developed a contingency plan that engages health department and healthcare coalition when experiencing supply shortages. Agency will follow Department of Health and CDC recommendations for acceptable extended use of PPE.
Dispersing PPE while the office is closed:
The agency will have two pickup distribution sites (Rockland County and Orange County) for clinicians to pickup PPE for a patient’s home. We will ask only one clinician on a case to pick up supplies for a household to limit exposure. If clinician pickup is not possible, we will mail the PPE supplies. In the event of an emergency, a representative from the agency will drop off the PPE outside the patient’s residence.
Face coverings during a pandemic:
A face covering is required while social distancing is not possible ( ie. while performing patient care or in the office).