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May 13, 2020

Dear Valued Employees,

Thank you for continuing to support our customers in the face of this pandemic. CareGivers America is working diligently to address concerns and keep you, your families, and our customers safe.

With the novel coronavirus (COVID-19), we are in the midst of a global health crisis the likes of which none of us have ever witnessed before. We don't know what's going to happen, and we don't know how long it will take for life to return to any degree of normal. Your performance throughout this pandemic is a testament to what our organization can accomplish when we work together.

We have implemented a number of preventative procedures to minimize the spread of disease among staff and patients. We also have secured needed PPE and have this available in every office. It is imperative that we protect our most vulnerable population and our valued staff.

Caring for clients during such extreme circumstances can be exhilarating and inspiring, but it can also be exhausting. We want to offer our deepest thanks to all of you for the amazing work you do on the frontlines each and every day. You are critically important to our parent company’s mission of being “better together” - the Simplura Health Group.

Know that we would not be whole without the talent and abilities you bring to the organization. You matter and the mission you are a part of matters.

Thank you.

Sincerely,

Mia Haney, President
CareGivers America | Simplura Health Group

Should You Go To Work?

Home Health Care employees should take this short survey to determine if they should go to work OR if they should self-quarantine for the safety of our customers. CGA Offices are monitoring survey results and will contact you if your work status should change based on your answers. We encourage staff to survey themselves prior to every shift. Click Here to Access the Survey

Covid-19 Prevention Plan

Field Staff

Updated: 5/13/2020

Sick Policy. DO NOT ENTER OUR OFFICES OR GO TO A CUSTOMER'S HOME:

1. If you have any symptoms of illness
2. If you have been tested for COVID-19 and are awaiting results
3. If you have been diagnosed with COVID-19 (call your supervisor for return to work instructions upon recovery)
4. If you have been in close contact (within 6 feet for a prolonged period) with confirmed positive COVID-19 individual in the last 14 days.

You put everyone around you at risk if you enter our facilities with any of the above.

Follow Best Practices.

1. Encourage employees and patients to get the flu shot,
2. Wash hands often throughout the day. If warm running water and soap are not available, use alcohol-based hand gel. Wash for a minimum of 20 seconds with soap.
3. Remind employees and patients about cough/sneezing etiquette. Cover your nose and mouth, preferably with your elbow, when coughing. Wash hands promptly.
4. Avoid touching eyes, nose, or mouth.
5. No handshaking, hugging, or other non-essential person to person contact
6. Keep surfaces commonly touched surfaces clean by wiping them down with a household disinfectant and/or soap and water.
7. Do not share pens, utensils, drinks or food.
8. If eating food with your hands, do not touch anything after eating until you have washed your hands. Disinfect surfaces you eat from.
9. Practice Social Distancing.
10. Limit social gatherings.
11. Wear a mask in public places and during work hours

Limited Office Visitation. Visitors and non-essential personnel are not permitted in company office spaces. Employee visitation to local offices should be limited to emergency or business essential needs.

Office staff may lock the doors to the building to keep visitors from entering freely. In this circumstance, the below sign should be placed on all access doors, and accommodations made for how the office will receive mail and deliveries.

Effective 3/13/20, all offices must keep a “Visitor log” to track contact information for all visitors. Should a presumed or confirmed case of COVID-19 come in contact with a CGA office, the log will be used to contact all visitors on and after that date to notify them of potential contamination.

Limited Work Travel Policy. No unnecessary work travel is permitted, this includes travel to conferences, meetings, and other group activities with attendance of more than 10 people that can be attended via webinar or other remote session.

Workspace Cleaning. Employees are asked to participate in the cleaning and disinfection of commonly used areas in patient’s homes, such as countertops, phones, computers, door knobs, light switches, bathrooms, medical equipment and the like. Soap and water or commercial disinfectant will suffice.

PPE. All staff will be able to pick up the following PPE supplies from our local offices during normal business hours. Call in advance so we can arrange for social distancing during the pick up of PPE equipment:

• Gloves
• Surgical Masks
• Soap OR Hand Sanitizer

If a customer is deemed suspected or confirmed COVID-19, staff will be provided with the following:

• KN-95 mask for the customer and employee(s)
• Aprons/gowns for the employee(s)
• Gloves
• Goggles or a face shield

Employees providing care in nursing homes or personal care homes should wear a KN-95 mask and goggles/face shield at all times they are in the facility.

Website Notice. The CareGivers America website has been updated with a virus alert that takes you directly to the PA Department of Health website where up to date information on the virus and preventative measures are being recorded regularly. We encourage staff and patients to visit this website for accurate and up to date information.

Mandatory Patient Preparation Discussions. To prepare for a worst-case scenario, CGA Nurses and office representatives will be calling all patients to discuss the following:

1. Possibility of not having coverage and who the natural support person would be in case of an emergency.
2. Preparation for potential quarantine or lock-down:
• Suggest 2 weeks supply of food and medicine at all times
• If Medicine cannot be provided in advance, the CGA representative should arrange, with participant permission, for automatic refills with home delivery.
• If financially unable to purchase food supplies, identify local resources such as food pantries/food banks that can support this participant

Mask Protocol

Ideally you should use one mask per customer.

• Before putting on a mask, clean hands with alcohol-based hand rub or soap and water.
• To put on your mask:
• How to safely Put on Personal Protective Equipment (PPE)
• Hold the mask to your face by the elastic bands, with the white side facing in.
• Pull the straps of the elastic band behind each ear.
• Squeeze the top of your mask above your nose to secure the mask in place directly under your eye-line.
• Cover mouth and nose with the mask by lightly pulling down on the material at the bottom of the mask (below where it is folded like an accordion).
• Make sure there are no gaps between your face and the mask.
• Avoid touching the mask while using it; if you do, clean your hands with alcohol-based hand rub or soap and water.
• Replace the mask with a new one as soon as it is damp, soiled, damaged, or hard to breathe through.
• To remove the mask:
• How to safely Take Off Personal Protective Equipment (PPE)
• Remove yourself from the client’s home completely.
• Remove the elastic bands from behind your ears (do not touch the front of mask)
• Discard immediately in a closed bin OR store as directed in a brown paper bag (do NOT use plastic – the bag needs to be breathable)
• Close the bag loosely so it is not directly exposed to open air.
• Immediately clean hands with alcohol-based hand rub or soap and water.
• ONLY reuse masks if you can not get another one timely AND if it is a mask you have worn in that client’s home previously. Do not wear the same masks between multiple client homes.

Call your local office to obtain masks! We are receiving more mask shipments each week to keep you safe in our communities and in our patient’s homes.

MANDATORY PROTOCOL
CARING FOR PATIENTS WITH CONFIRMED OR SUSPECTED COVID-19

Work Force Limitations:

The following staff may not be utilized when caring for patients with confirmed or suspected COVID-19:

1. Individuals over the age of 65
2. Individuals with an underlying medical condition such as:
• Heart Disease
• Chronic Lung Disease
• Asthma
• Any other immunocompromising conditions

Return to Work with Healthy Patients:

All employees who support patients with confirmed COVID-19 may not treat other non-symptomatic patients in an alternative setting until:

1. Symptom Free Employees: Employees may treat other patients without a self-quarantine period.
2. Employee with Symptoms (unconfirmed COVID-19): The employee must self-quarantine for 7 days from the onset of symptoms AND be 72 hours symptom free (including fever) without medications.
3. Employees with Confirmed COVID-19: Employees with laboratory-confirmed COVID-19 who have not had ANY symptoms may discontinue home isolation when at least 7 days have passed since the date of their first positive COVID-19 diagnostic test and have had no subsequent illness.

PPE Precautions While Caring for Someone with COVID-19

Staff who enter a health care facility (hospital, SNF or PCH) with known COVID-19 patient(s) should use PPE dictated in the above chart for “Diagnosed COVID-19 patient” regardless of whether the patient they are treating has confirmed or suspected COVID-19.

Mandatory Precautions While Caring for Someone with COVID-19

• Avoid touching or rubbing your eyes, nose, and mouth at all times.
• Perform hand hygiene immediately, using paper towels to dry hands (or a CLEAN cloth that can be laundered after every use)
• before and after glove use
• before and after preparing meals
• before and after touching the patient or the patient’s environment
• after using the toilet
• whenever hands appear dirty
• Use dedicated linens and eating utensils for the patient.
• You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items.
• After the patient uses these items, you should wash them thoroughly.
• Clean all “high-touch” surfaces at least daily
• This includes, but is not limited to counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables
• Use a household cleaning spray or wipe, according to the label instructions.
• Wash laundry thoroughly.
• Wear gloves while washing laundry
• Do not shake laundry
• Avoid laundry coming into contact with your clothes and skin
• Wash at 1400 – 1940 F with common household detergent
• Dry thoroughly
• Garbage cans should be lined with a garbage bag and should have a lid to keep all contaminated items closed in the can.
• Clean your hands (with soap and water or an alcohol-based hand sanitizer) immediately after handling these items.

LOCATION/ENVIRONMENT:

• Patient should be in a well-ventilated single room.
• Limit the movement of the patient in the house.
• Be separated from the patient as much as possible.
• Use a separate bathroom, if available.
• Make sure that shared spaces in the home have good airflow, like an opened window, weather permitting.

VISITORS:

• Limit the number of caregivers, as much as possible.
• Prohibit visitors who do not have an essential need to be in the home.

PATIENT CARE:

• Ensure medication administration and MD orders are followed meticulously.
• Monitor the patient’s symptoms. If the patient is getting sicker, call his or her healthcare provider.
• If the patient has a medical emergency and you need to call 911, notify the dispatch personnel that the patient has, or is being evaluated for, COVID-19.

EMPLOYEE CARE:

• If possible, employees should limit their exposure with other family members within their own homes.
• If possible, remove and bag scrubs immediately upon leaving the patient’s home/setting.
• Wash clothes daily
• Shower immediately upon returning home
• Employees should engage in activities that promote a healthy immune system, such as:
• Taking daily multivitamins
• Exercising 30 minutes/day
• Drinking at least 8 glasses of water per day
• Getting sufficient sleep at night
• Engaging in good hygiene practices

Return to Work with Healthy Patients:

All employees who support patients with confirmed COVID-19 AND who have complied with the above “Mandatory Precautions While Caring for Someone with COVID-19” (especially regarding the use of PPE equipment for the customer and the employee), may treat other non-symptomatic patients in an alternative setting according to the following guidelines:

1. Employees who DO NOT have suspected or confirmed COVID-19: Employees may treat other patients without a self-quarantine period
2. Employee with Confirmed or Suspected COVID-19:

PREFERRED Test-based strategy: Exclude from work until:

• Resolution of fever without the use of fever-reducing medications AND
• Improvement in respiratory symptoms (e.g., cough, shortness of breath) AND
• Negative results of an FDA Emergency Use Authorized molecular assay for COVID-19 from at least two consecutive nasopharyngeal swab specimens collected ≥24 hours apart.

If preferred test-based strategy above is not possible due to lack of quickly available testing, employee should be excluded from work until:

• At least 3 days (72 hours) have passed since recovery defined as resolution of fever without the use of fever-reducing medications and improvement in respiratory symptoms (e.g., cough, shortness of breath); AND
• At least 10 days have passed since symptoms first appeared