Superior At Home... COVID Protocols

Revision Date: 11.20.2020

Superior at Home continually monitors the various federal, state, and local orders and guidelines related to COVID-19 to adjust and modify our safety protocols. As COVID changes in the public, so too will our practices. Each time we determine a practice modification is necessary, we will communicate this to our clients and employees.

It is important to note that as essential Health Care Professionals, our standards are not the same as the general public’s. We monitor and follow the PA Department of Health’s Health Alert Network (HAN) notices. In every instance where we cannot clearly determine the appropriate practice to follow, our policy is to directly contact the Centers for Disease Control and request guidance for our particular personal care service and that is what we follow. In some cases, we employ stricter practices than the DOH and CDC.

AS OF THIS REVISION, AGENCY HAS IMPLEMENTED THE PRACTICE THAT ALL EMPLOYEES MUST WEAR A MASK AT ALL TIMES WHILE HAVING CONTACT WITH A CLIENT AND IN ALL PUBLIC PLACES.

Masks must be changed in between clients and regularly cleaned according to antiseptic standards (all employees have been provided these standards). The Agency provides cloth masks at no cost to its employees to meet this standard.

All employees are also required to monitor their symptoms each day prior to exiting their home for an assigned shift. If the employee displays any symptoms, the employee must report to the Agency as defined in Protocol I. below, prior to arriving at their first shift.

During this time of rapid viral spread, we expect our employees and even our clients and their families to exercise prudence and caution in all interactions. This includes:

Limiting exposure to public places and crowds of people. This means avoiding activities like parties, group dinners, or any community outing where crowds of more than 10 people are congregated.

Keep your circle of contacts – people you regularly spend time around – as small as possible and ask the same of those in your circle. This reduces the potential risk for all.

When you are in the public or around any person who is not in your close circle of contacts, wear a mask and stay at least six feet apart to avoid close contact.

Monitor your symptoms every day, especially your temperature, and report to the Agency any new symptoms you or anyone in your close circle of contacts experience.

I. Person reports covid-like symptoms (fever of 101.4 or higher, cough, headache, shortness of breath, extreme fatigue, nausea, diarrhea, loss of taste). PAHAN 516 – Update 7/18/2020

Ask the following questions and document answers:
When did you first experience symptoms (especially a fever)?
What exactly are your symptoms?
Are these symptoms normal for you or new?
How long have you had these symptoms?
Were you around any person recently who also had symptoms or who tested positive for covid?

If a person has two or more of the typical covid symptoms and/or a fever of 101.4 or higher – the person must self-quarantine for 24 hours to monitor how they feel. An employee must come off of the schedule and have no client contact during this period. If a client, they are advised to contact PCP and determine if a COVID test or other actions are appropriate. Care will be suspended until PCP advises on the next step.

Employees who display symptoms must report back to the Agency within 24 hours on the status of their symptoms. If symptoms persist, particularly a fever, the employee must assume they are infected and self-quarantine while ill. The employee must:

quarantine for at least 10 days since symptoms first appeared AND
until they are fever-free (less than 100.4) for at least 24 hours without taking medication AND
other symptoms have improved
At that time, they must take a COVID test and report the results to the Agency. NOTE: In the case of an HCP shortage, Agency may elect to waive the COVID test and permit the HCP to return to work using the symptom-based strategy defined above, which follows PAHAN 516 guidance.

For employees who are severely immunocompromised, they should:

quarantine for at least 20 days from appearance of first symptom AND
24 hours have passed with no fever (less than 100.4) and no fever-reducing medication was taken AND
symptoms have improved.
This timeframe should also be followed for HCP’s who tested positive but were asymptomatic. They should quarantine for 20 days from the date of their positive test result.

If the employee’s results are negative, the employee may return to work but must wear a surgical grade mask at all times with all clients. Consideration is given to high-risk assignments and appropriate measures to keep client safe are determined with the client. These measures may include requiring the caregiver to double mask (face mask and face shield) or temporarily reassigning the caregiver. Reassignments will be for 14 days from last reported symptom with no new symptoms reoccurring.

In times of staffing shortages, the Agency may utilize a testing-based strategy, whereby an HCP can return to work sooner than 10 days under the following conditions:

Resolution of fever without fever-reducing medications for 24 hours AND
Improvement in other symptoms AND
Results from two consecutive COVID tests collected at least 24 hours apart are negative.

Clients or family members of clients who report symptoms will have services temporarily suspended until the COVID test is completed and results are negative. If this suspension puts a client in jeopardy, Agency will work with the client, family, and PCP to determine the safest way to provide care.

In each instance where suspected or confirmed COVID infection is detected, the Agency will do a backward contact mapping and notify any person who may have been in contact with the employee or client.

II. Person is exposed to someone who either did test positive for COVID or who displays the symptoms of COVID and is presumed to be positive. PAHAN – 516 Updated 6/1/20

All employees must immediately report instances of exposure or possible exposure to the office. Employees who become aware of clients/family members who were exposed must report to the office immediately upon learning of such exposure.

Ask the following questions and document answers:
When were you last exposed to the infected person?
Did you have close contact with the person (more than 15 minutes, in a confined area, without a mask, and without maintaining six feet of distance)?
How long was your unprotected exposure?
Did this person take a COVID test that was positive?
If yes, when did they actually take their COVID test (not the date they received their results)? If no, is the person going to take a COVID test?
If the person you were exposed to has not received COVID test results that are positive, are they displaying active COVID-like symptoms? If yes, what are they?
Are you displaying any COVID-like symptoms since your exposure?

Employees who have been exposed to a person with a positive COVID test in close contact with no mask for more than 15 minutes, must assume they are at risk of infection and self-quarantine for 14 days from the last date of exposure to the infected person. The employee must be removed from all client assignments during this period.

If the employee is asymptomatic, she/he can elect to get a COVID test but should wait at least 5 to 7 days from date of exposure before getting a first COVID test. Agency does suggest doing this to protect the well-being of any client the employee came into contact with during the period of potential infection, so proper and accurate notification can occur.

Employees must monitor their symptoms daily while in quarantine, as well as all members of their close circle of contacts, and report to the Agency if symptoms appear. If symptoms appear, follow protocol I. above.

If the employee does NOT display any symptoms during the period of quarantining, and none in their circle of close contacts do either, the employee must take a second COVID test (or the first test if the initial COVID test was not taken) no sooner than the 12th day of quarantining. The HCP must quarantine for the full 14 days.

If the results are negative, the employee may return to work but must wear a mask at all times with all clients. Consideration is given to high-risk assignments and appropriate measures to keep the client safe are determined with the client. These measures may include requiring the caregiver to double mask (face mask and face shield) or temporarily reassigning the caregiver. Reassignments will be for 14 days from the last reported symptom with no new symptoms reoccurring.