FASNY Firemen’s Home Comprehensive Emergency Management Plan

Pandemic Emergency Plan (PEP)

  1. Upon notification that a pandemic has been declared, the Incident Commander (Administrator or designee) will activate the emergency management plan.
  2. The Facility Information Officer will notify all Members, Staff, Families and/or Responsible parties as well as the Medical Director and the Board of Trustees.
  3. The IC will assemble the Emergency Management team in the Incident Command Center to ensure that all members of the team are aware of their responsibilities with respect to a pandemic.
  4. Unless contraindicated by the NYSDOH, Outbreak Restrictions will be implemented.  They are as follows:
    • Members will remain on their units
    • Staff will stay on their assigned units
    • Group Activities will be cancelled
    • Only medically necessary dental, podiatric and wound care visits
    • Tele-Health will be utilized as necessary
    • Barber/Beauty shop will be closed
    • Members may not go into administration
    • Members will receive tray service in their rooms
    • Visitation will be curtailed per NYSDOH Guidelines
    • Outside organizations may not come in and present programs
  5. The Infection Surveillance Officer (ISO) will initiate the following procedures for identifying and preventing the Pandemic Related Infection (PRI) within the Member and employee population:
    1. Standard Precautions will be utilized on all residents admitted/transferred to The Firemen’s Home. Safe injection practices and respiratory hygiene/cough etiquette have been incorporated into the Standard precautions policy.

      Transmission-based precautions will be utilized in, addition to Standard Precautions, when the route of transmission is not completely interrupted using Standard Precautions alone.

      There are three categories of transmission-based precautions and may be used individually or in combination (based on route of transmission). The three categories include:
      • Contact,
      • Droplet and
      • Airborne

      Additional policies and procedures include but may not be limited to:
      • Appropriate cleaning, storage, disinfecting, disposal of equipment
        • Low level disinfection is used for non-critical equipment
        • Medical equipment, devices and supplies are disposed of in accordance with facility policy
        • The Firemen’s Home does not reprocess any devices labeled and marketed as single use only
        • Glucometers are decontaminated and maintained according to manufacturer recommendations.
      • Appropriate use of personal protective equipment
      • Appropriate use of single use devices
      • Service and/or pet therapy animals
      • Appropriate disposal of medical and regulated medical waste
      • Clinical services
      • Food services, housekeeping and maintenance
      • Resident activities
      • Appropriate storing, processing and transport of linen
    2. When a Member is identified as having a PRI the following will be instituted:
      • The resident will be isolated and cared for using all recommended PRI PPE.
      •  Place the member in a single room if possible pending results of PRI testing.
        • Cohorting members on the same unit based on symptoms alone could result in inadvertent mixing of infected and non-infected members (e.g., members who have fever, for example, due to a non-PRI illness could be put at risk if moved to a PRI unit).
        • If cohorting symptomatic members, care should be taken to ensure infection prevention and control interventions are in place to decrease the risk of cross-transmission.
      • If the member is confirmed to have PRI, regardless of symptoms, they will be transferred to the designated PRI care unit.
      • The PRI unit is defined as follows:
        • Unit 3 East will be the designated PRI area rooms 317, 318, and 319.
        • “Do Not Enter Authorized Personnel Only” signage will be posted at all entrances to the PRI area.
        • Dedicated HCP will work only on the PRI care unit. At a minimum this will include the primary nursing assistants and nurses assigned to care for these members.
          • To the extent possible, restrict access of ancillary personnel (e.g., dietary) to the unit.
          • Housekeeping staff will work only on the dedicated unit.
          • High-touch surfaces in staff break rooms and work areas are frequently cleaned and disinfected (e.g., each shift).
          • HCP practice source control measures and social distancing in the break room and other common areas (i.e., HCP wear a facemask and sit more than 6 feet apart while on break).
      • Roommates of members with PRI will be considered exposed and potentially infected and, will not share rooms with other members unless they remain asymptomatic and/or have tested negative for PRI 14 days after their last exposure (e.g., date their roommate was moved to the PRI care unit).
        • Exposed members may be permitted to room share with other exposed members if space is not available for them to remain in a single room.
        • Monitoring of all members, including assessment of symptoms, vital signs, oxygen saturation via pulse oximetry, and respiratory exam, to 3 times daily to identify and quickly manage serious infections.

          Should a member require hospitalization for a PRI, the facility will hold the bed until the member returns to the facility. Prior to transfer, emergency medical services and the receiving facility will be alerted to the resident’s diagnosis, and precautions to be taken including placing a facemask on the resident during transfer. The member must be tested for the PRI at least 72 hours prior to discharge back to the facility. Upon return to the facility the member will be tested for the PRI and placed on precautions for 14 days.
  6. The ISO or designee will complete the necessary reporting to all local, state and federal health agencies as follows:
    • HERDS
    • NHSN
    • NORA
    • Any other additional required reporting mechanisms

Evidence of this reporting will be kept in the Director of Nursing Office.

  1. The ISO will insure that all staff, vendors and visitors (if allowed) upon entering the facility are monitored for signs and symptoms of the PRI.  Written logs of this information will be kept in the Director of Nursing Office.  If there is any required testing for the PRI for the aforementioned individuals the results of those tests will be kept in the Director of Nursing Office.
  2. HEALTHCARE WORKERS and MEMBER/FAMILY EDUCATION:
    • Infection prevention and control provides education, based on surveillance findings, outbreak analyses or changes in scientific knowledge/guidelines in the area of infection prevention and control to employees, members and families as appropriate.
    • New employee orientation in addition to orientation specific to new nursing professionals is provided as scheduled.
    • Mandatory educational offerings, including communicable disease and general infection prevention/control occur no less than annually.
    • Infection prevention and control, in collaboration with other direct member care providers, provides education to members, families and visitors as appropriate.

HCP have been trained on infection prevention measures, including the use of and steps to properly put on and remove recommended personal protective equipment (PPE). Video instruction is broadcasted 24 hours throughout the facility.

If PPE shortages exist, strategies to optimize PPE supply will be implemented on the unit, such as:

  • Bundle care activities to minimize the number of HCP entries into a room.
  • Extended use of respirators (or facemasks if respirators are not available), eye protection, and gowns. Limited reuse of PPE may also be considered.
  •  Prioritizing gown use for high-contact resident care activities and activities where splash or spray exposures are anticipated.

Dedicated resident care equipment (e.g., vitals machine) to the cohort unit. Cleaning and disinfection of shared equipment will be performed between residents and the equipment should not leave the cohort unit.

PRI Cart stored in 3 East medical storage room.

  1. The Facility Information Officer (FIO) will initiate the facility Pandemic Communication Plan as follows:
    1. The Nurse Manager/Supervisor will update authorized family members and or healthcare proxy of infected members at least once per day and upon a change in a member’s condition.
    2. Social Services will provide a weekly update to all members and authorized families on the number of infections and deaths at the facility, by electronic or such other means as may be selected by each authorized family member or healthcare proxy.
    3. Social Services will maintain a record of all authorized family members and guardians, including a secondary (back-up) authorized contact, as applicable.
    4. Members will be provided at no cost, daily access to remote videoconferencing via iPad, skype or telephone to communicate with family members.

When visitation is necessary or allowable (e.g., in end-of-life scenarios), efforts will be made to allow for safe visitation for residents and loved ones.

 For example:

  • Suggest refraining from physical contact with residents and others while in the facility.
  • Practice social distances with no hand-shaking or hugging, and remaining six feet apart.

Members still have the right to access the Ombudsman program.

If in-person access is not available due to infection control concerns, member communication will be facilitated (by phone or another format) with the Ombudsman program.

  1.  The Facility Logistics Officer (FLO) will do the following:
    1. Activate the Personal Protective Equipment stockpile located in Central Supply which consists of a 60-day supply of the following:
      • N95 respirators 
      • Face shields
      • Eye protection
      • Gowns/isolation gowns
      • Gloves
      • Surgical Masks
      • Sanitizer and disinfectants in accordance with current EPA Guidance

        The FLO will also insure that the stockpile of over the counter   medications is activated.
    2. The FLO will notify the following vendors that a Pandemic has been declared:
      • PharMerica (Medications) –  1-518-944-3870
      • E.A.Morse & Co Inc.(Cleaning Products) -1-518-209-4326
      • Johnston Paper Co. (Paper Products) – 1-800-800-7123
      • McKesson Supply Inc. (Nursing Supplies)- 1-804-956-6375
      • Medline Industries Inc. (Nursing Supplies) – 1-800-847-968-7757
      • Airgas USA, LLC (Oxygen) – 1-518-452-4427
      • Ginsberg’s (Food) – 1-518-828-4004
      • Sysco (Food) – 1-800-797-2627
      • Whorles (Food) – 1-800-628-6114
      • Freihofers / Bimbo (Bread)– 1-518-847-8887
      • American Quality Foods – 1-800-348-7416
      • Hood Dairy (Milk/Dairy) – 1-800-662-4468
      • Gillette Creamery (Milk/Dairy) – 1-845-419-0900
      • Pepsi – 1-800-562-6800
  2. The IC will monitor the NYS DOH and CDC websites daily for any updates to the requirements relative to the Pandemic.
  3. After Action

    Upon notification from the NYSDOH and CDC that the Pandemic has ended the facility Emergency Management team will meet to debrief and evaluate the performance of the facility as a whole during the Pandemic.  Modifications will be made to the PEP based on the recommendations of the team at that time.

    The FIO will communicate any relevant activities regarding recovery/return to normal operations, with staff, families/guardians and other relevant stakeholders