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Lakewood COVID-19 Baseline Testing Update

July 17, 2020

The Virginia Department of Health (VDH) and Department of Social Services (DSS) have mandated skilled nursing facilities and assisted living facilities conduct baseline COVID-19 testing of staff and residents. The baseline testing is used for the detection of COVID-19 and to track possible asymptomatic spread among individuals living and working in the higher levels of care.  

The plan to baseline test conforms to the guidance of VDH and DSS mandating this testing and has been approved by VDH to be implemented. This guidance is directly related to Lakewood’s ability to move into a safe strategy for reopening to the public under a phasing process. The management team is currently in Phase 1 and the completion of this baseline testing will allow the community to move into Phase 2. This baseline testing, and moving to another phase of reopening, is extremely important for residents; transitioning through the phases means residents can experience increased socialization and have visitors which is extremely important to mental and physical wellbeing.

Since Lakewood is a continuing care retirement community with several levels of care, including independent living, team members will need a test based on their primary area of work. 

The plan for testing is as follows:

On August 4–5 Lakewood will complete the following:
  • Team members and residents (or residents’ responsible parties) will review and sign the LifeSpire Informed Consent for Coronavirus (COVID-19) Testing form. The form is attached for review. Residents or responsible parties should return signed forms to Lakewood, attention Myra Conway, infection preventionist. Residents who have not returned forms by August 3 will be contacted by a member of the administrative support team for testing to obtain verbal consent for resident testing. Team members can complete forms at the time of testing. 
  • NOTE:  It is the expectation that all staff who are identified as needing to be tested will comply. If a team member refuses to test, the team member will be required to remain out of work for 14 days from the testing date. No additional paid time off will be issued to cover the employee’s time off from work. The team member may use their own accrued paid annual leave hours if they have hours available to use.
  • NOTE: If residents/residents’ responsible parties decline to test, the resident will be placed on isolation for 14 days and after 14 days, a time-based strategy or test-based strategy will be used when determining to discontinue transmission-based precautions, based on residents becoming symptomatic or remaining asymptomatic during the 14-day period. 
  • If a resident or team member refuses to be tested, Lakewood will educate the refusing individual on the importance of testing in providing protection to other community residents and team members, answer any questions posed by the refusing individual and address any concerns about testing raised by the refusing individual. 
  • Team members may be asked for demographic information, as requested by VDH, that will be included in the testing log. This information, along with resident demographic information, will be kept confidential to the extent possible.
  • Initial COVID-19 tests will be performed utilizing a nasal or nasopharyngeal swab. The test will be performed by a nurse team trained in the collection of the specimen.
Please Note: 
  • Testing supplies/test kits have been secured and are currently in house in preparation for testing day. 
  • Lakewood currently has an adequate supply of personal protective equipment (PPE) to use during the testing of staff and residents. Lakewood also has an adequate supply of PPE for any positive findings amongst residents.
  • All specimens collected will be packaged, stored and delivered to contracted lab providers.
  • Specimen collection for team members will occur in the clinic to allow for physical distancing, proper hand hygiene and proper disposal of tissues and other items that may need disposal during/after testing. 
  • Specimen collection for residents will be performed in residents’ rooms with the door closed. 
  • An attempt will be made to conduct and complete testing within 24 hours of starting; at most the testing will be completed within 48 hours to allow for team members who may be unable to be at the community on the specified day.   
On August 11–12 (these dates are subject to change and contingent on the results of the August 4–5testing), Lakewood will complete the following:
  • A second COVID-19 swab test is required and may be performed 7-10 days after the first round of testing, depending on results from the first test and the health department’s recommendations for skilled nursing facility residents and team members. These tests will also be conducted and completed within a 24 to 48-hour time frame. Testing will follow the same protocols as listed above. Residents and team members in assisted living and memory care are not required to have a step two test.
  • There will be no financial expense to team members, nor will the team member’s insurance be billed. The cost of all team member testing will be covered by Lakewood.
  • Residents’ Medicare information will be shared with the contracted lab, so the expense of the resident test is covered.

What happens if?

We have Positive Test Results-Staff & Resident
  • If the test results indicate a positive result for team members and/or resident: Resident will be assigned and moved to the “Hot/Cohort” isolation care area. Residents will be placed on droplet precautions. Team members will be sent home and isolated until they meet the current return to work guidance as prescribed by the Richmond/Henrico County Health District.
We have Positive Test Results-Resident Only
  • If the test results indicate positive results with asymptomatic and/or symptomatic residents and negative results for team members: The residents who tested positive will be relocated to the designated “HOT” isolation care area, placed on droplet precautions and Lakewood’s designated team will initiate care for a predetermined period as outlined by the Richmond/Henrico County Health District. 
  • Both team members and residents who worked/resided in the “HOT” isolation care area will go through a two-step testing to ensure two negative results. After two negative results, all restrictions will be removed unless other actions are determined by the Richmond/Henrico County Health District. The resident will return to their respective room and the team member may return to work based on the approval of the Richmond/Henrico County Health District.
  • Note:  If the VDH determines further tracing and restrictions are required, the team members associated with prior care of the resident with positive tests results, may be sent home and quarantined for 14 days and residents in the affected area where the positive resident resided may be placed on droplet precautions if deemed necessary by VDH.  After 14 days, a time-based strategy or test-based strategy will be used when determining to discontinue transmission-based precautions, based on residents becoming symptomatic or remaining asymptomatic during the 14-day period. 
We have Positive Test Results-Staff Only
  • If the test results indicate positive results for asymptomatic and/or symptomatic team members and negative results for residents, the team members who tested positive will be asked to self-quarantine at home until they meet the current return to work guidance as prescribed by the Richmond/Henrico County Health District. Reassignment of a positive team member is not an option.
  • The team member will go through a two-step testing to ensure two negative results. After two negative results, all restrictions will be removed and the team member may return to work unless the Richmond/Henrico County Health Department determines further action is needed before staff return to work.
  • Note:  If the VDH determines further tracing and restrictions are required, the resident/residents receiving care from the team member testing positive, may be quarantined for (14) days. After 14 days, a time-based strategy or test-based strategy will be used when determining to discontinue transmission-based precautions, based on residents becoming symptomatic or remaining asymptomatic during the 14-day period. 
Additional Guidance:

If a team member tests positive, he/she may be granted additional hours of PAL (paid annual leave) to assist financially during the quarantine period away from work due to diagnosis and for recovery, per LifeSpire policy. 

Test results will be shared with the team members and residents (residents’ responsible representatives) by Lakewood leadership team, nursing leadership or department directors once received from the lab. Also, team members and resident test results will be shared with the local health department as required by VDH by utilizing a tracking tool such as a line list. Results will be kept confidential to the extent possible. 

The team, residents and families have done a remarkable job mitigating and preventing the spread of COVID-19. The leadership team strongly feels that with ongoing support and diligence in prevention measures, our efforts in the baseline testing goal of 100% negative will be supported.

We are requesting team members to stay home for no less than 14 days during this testing period.  We know our team members will do everything in their power to limit travel and only report to work and return home during this time. We have advised our team that should they have any questions, to please contact their department director for individual guidance.

Other / Future Testing Needs

Lakewood has policies in place regarding the testing of residents and team members for COVID-19.  Residents and team members who develop signs/symptoms of COVID-19 or is suspected of having COVID-19 are tested and will continue to be. 

Please stay informed of Lakewood’s latest information about testing and have all your questions answered by accessing the Lakewood website: https://lmanorprd.wpengine.com/blog/covid19/.