Today’s update will focus on changes to our COVID practices and the current infection rate in Lancaster County. 

First, the good news is that the positivity rate in Lancaster County continues to decrease rapidly. As of March 3, the positivity rate is 6.08. At the time of my last update, the rate was 25.61%. The chart below shows the LGH/Penn Medicine COVID hospitalizations as of February 28, 2022. Again, an impressive decline from one month earlier. Compare the February 28 data with the January 31 data. From my perspective, it does not get much more optimistic than these two graphics! 

LANCASTER GENERAL HOSPITAL 02/28/2022

LANCASTER GENERAL HOSPITAL 01/31/2022

On Wednesday, March 2, our COVID-19 Task Force met and had a lively discussion for almost 90 minutes. In short, there were two discussions. One topic focused on Skilled Nursing and Assisted Living, and the other, Residential Living. When discussed in silos, the conclusions are straightforward. However, at Moravian Manor Communities, we are unable and should not operate in silos. 

The Center for Disease Control (CDC) has loosened the masking requirements nationally based upon positivity rates. As shared earlier, our rates in Lancaster County are better than in many months. In terms of loosening up some of our requirements in Residential Living, the question became, “if not now, when?” We decided to focus on the now. 

Effective immediately, masks are not required for residential living residents in non-care areas. However, if you desire to wear a mask, please continue to do so. The change is a difficult transition for our clinicians as we have had two years of preaching and attempting to enforce masking guidelines. 

Our Task Force wants to emphasize that the masking requirements in skilled nursing, personal care, and assisted living have not changed. Our staff have enough duties to perform; they should not have to chase down visitors in these areas and ask them to mask up. 

Several other updates accompany the change in masking requirements at MMC. I note them below. 

• The Owl’s Nest will open to the broader community for lunch service effective Tuesday, March 8. We will post signs that outside guests must be vaccinated to enter. Our staff will not be checking vaccine cards. 
• At this time our hours of service will not change. Due to the limited hours, the Owls Nest will not accept outside reservations for evening dinner service. Residents can bring guests to all meals. Your guests should be vaccinated. 
• The café area will reopen for folks to enjoy their breakfast or lunch on Monday, March 7. So, for the first time in two years, residents will be able to socialize. Hallelujah! 
• It is important to note that this update does not change our hours of service or types of service. For example, our “short-order” grill is not reopening. Food items available in the café will remain the same for the present time. 
• Residential Living residents entering the Woods apartment building or the main entrance at the Founders Campus will no longer need to check-in at our kiosks if they are using the common areas (Steinman Hall, Café, Garden Court Dining Room, and Library). However, if you are coming to visit someone in our care areas, you are still required to check in and wear a visitor’s badge. Please help our staff make their days more tolerable by heeding these instructions. 
• Staff will continue to be required to mask up in all interior areas until further notice. 

Give your neighbors space, and do not push them to participate in activities or dining experiences if they are still uncomfortable. Every individual is at a different place on this journey. For instance, my wife is a much more social creature than I am, and she is busy planning things “to do and people to see.” We have decided that I will remain behind “catching up on domestic duties” on some of the ventures!” Give each other space. 

The task force conversation became lengthy because of the distinct possibility of non-compliance. It is much easier to manage when not operating in gray areas. At the same time, our team recognizes that keeping residents safe is a broader mission than just the physical aspect. Many are struggling with depression, loneliness, and the need for socialization. We are at a place now where the physical challenges are under control, and we must start addressing the other aspects of our being. 

It has been a long two years. I have been blessed to be part of a very supportive community from the residents, staff, and family members. Thank you for your continued support of our team. Whether you know it or not, residents are the ones that give us the energy and courage for another day. 

According to the Department of Health’s Interim Guidance for Skilled Nursing Facilities, we are required to develop a Reopening Implementation Plan during COVID-19.

View the DOH Reopening Plan and the CMS Nursing Home Visitation document. For any additional questions or information regarding our PPE plan, please contact me directly at virginiab@moravianmanor.org

Virginia Boyle, MSW

Today’s update will focus on the effects of the Omicron variant and what it means to our staff and residents.

First, the good news is that the positivity rate in Lancaster County is plunging. As of today, the positivity rate is 25.61%. Several weeks ago, we were above 40%. The declining rate translates into improving hospital data as well. The charts below compare LGH/Penn Medicine COVID hospitalizations from January 3 versus January 31.

LANCASTER GENERAL HOSPITAL
01/03/2022

LANCASTER GENERAL HOSPITAL
01/31/2022

Note the hospitalization numbers have reduced from 121 to 87. Patients on ventilators declined from 23 to 16. I watch the ICU numbers and the ventilator numbers. Only one patient on a ventilator has been vaccinated; this statistic brings me comfort.

The Omicron variant has taken its toll on our staff. We have had many staff test positive with county-wide positivity rates over 40% two weeks ago. Thus far, all have had minor symptoms and continue returning to work. However, having further reductions in staff available has proven challenging. The Center for Disease Control (CDC) released return to work guidelines last month. As a result, Moravian Manor Communities (MMC) has been operating under the “Contingency” level for the past month. The Contingency level allows workers who have tested positive to return to work sooner. It has been a great help. See the chart below to understand the implications of Contingency level staffing.

Our returning staff are required to use appropriate PPE. In January, we have had 29 staff test positive. During this time, we have had six residents test positive. MMC had one resident pass away from COVID-related pneumonia during this time.

We continue to vaccinate our staff and residents, and booster clinics are offered regularly by Phoebe Pharmacy. In addition, MMC requires all new employees to be vaccinated. Reading multiple sources of literature on the pandemic, I believe that we will continue to learn to live with COVID as the pandemic transitions to an endemic. It would appear the key to this transition is directly related to vaccinations.

Our care areas continue to be a challenge to operate with reduced staff. MMC’s skilled nursing area is limited to 75 residents. We would prefer this to be 95. Two years of working in health care during a pandemic has taken its toll on our staff. We have some of our team on leaves for reasons other than COVID. I wonder if there is a correlation?

Our Wellness Center (Baer Center for Assisted Living) is the response center for our Residential Living call bells. Given our staffing shortage, our LPN’s are unable to physically respond to those call bells, at this time. A member of our security team or maintenance team will continue to respond to your calls, and/or a triage system may take place over the phone versus a physical visit. However, please understand, a physical response will be from non-medical personnel, maintenance or security versus nursing staff. Our directive has not changed. If you are suffering from a possible acute health care crisis, call 911 immediately. In a health crisis (i.e., stroke), time matters. Our response system is not designed to take the place of 911. Fortunately, most of our calls are not serious. However, some are and we want you to know the proper procedure.

We continue to explore ways to provide service with fewer team members. Our service areas most acutely affected by staffing are the clinical areas and dining services. We have increased our dining hours with the introduction of a buffet. Buffet service will occur in the Owls Nest and Garden Court Dining Room. This modified service reduces the need for staffing and provides an opportunity for residents to break bread and enjoy each other’s company. Residents have positively received the buffet format.

Earlier today our maintenance team ran two fire drills. Those of us who are not immediate responders are to report to a central area. As the employees gathered, the noise level got to the point where we could not hear the two-way radio. It was not the noise of the fire alarms. It was the noise of people connecting. While it was inappropriate in that setting, it was music to my ears.

Continue to find ways to connect with others. We all need Human interaction, which is essential for our emotional and spiritual health. Thank you for your continued support as we muddle through these challenges!