Spring Reopening: LPC Member Post-Vaccine Solutions

Members | March 25, 2021 | by Dee Pekruhn

With the advent of the COVID vaccines, and their majority of residents now vaccinated, LPC members are starting to reopen key areas of their communities that are most used by residents. Which areas to open – and how to manage a mix of vaccinated and unvaccinated people in those spaces – remain the most pressing questions that members are considering. Here, we offer a variety of solutions gathered from members in various states. Members who shared these specific solutions are from Connecticut, Florida, Maine, Maryland, New Hampshire, Ohio, Oregon, Pennsylvania, Vermont, and Virginia, but certainly may apply to members in any state.

Now that almost all residents are vaccinated – and a fair majority of staff members – LPC members are reopening public spaces and loosening restrictions on travel and visitor restrictions. The tough sticking point is this: how do we safely co-mingle people who are vaccinated with those who are not, while protecting the health and privacy of all? While guidance is available from CMS and CDC for health care settings, similar guidance from federal agencies for Independent Living remains elusive. In its absence, members have creatively found solutions to move forward with reopening, which we highlight below.

Dining Rooms & Services

Members fall on two sides of each coin when it comes to resuming meals and services in the IL Dining Room. Below, we describe each issue and the thinking behind ‘both sides’ of the solution.

· Social Distancing – or NOT: While many members plan to continue social distancing in dining rooms (e.g., spacing out tables at 6 feet apart, reducing the number of people at each table), others are planning to eliminate social distancing when their resident population is 100 % fully vaccinated. Rationale for this approach is that residents will be fully protected, and visitors are not going to be present (see notes below.) On the flip side, those members who will maintain social distancing feel it is prudent, given that either their staff vaccination rates are below their target goal, or that they do plan to allow visitors back into the Dining Room who may not yet be vaccinated.

· Buffets with Servers – or NOT: The ever-popular buffet is making a comeback in some member communities, with a twist: rather than being self-serve, staff servers will be positioned to plate the food based on resident choices. In other instances, members are not yet planning to reopen their buffets, to avoid groupings of people around the area or because they do not have the staff resources needed to serve from the buffet.

· Keeping Delivery Service – or NOT: During this COVID year, residents and members have come to rely on meal delivery services to ensure all residents have access to safe, nutritious meals every day. With Dining Rooms reopening, some members are planning to eliminate the free meal delivery, while others will keep it going or offer it for a fee. Those members who plan to eliminate the free delivery service are doing so based on budgetary or staff limitations; those who plan to keep it going are doing so because many of their residents are hesitant to return to in-person dining.

· Reservation Only – or NOT: To continue to discourage groupings of people at the entry to the Dining Room, many members are using a “reservations only” approach to reopening. Another benefit of this approach is that members can ensure residents have equal opportunity to come back to the Dining Room, especially in states where there is a reduced capacity for in-person dining. On the other hand, some members are allowing “walk ins” in their more casual dining venues, such as a bistro or tapas bar, with set capacity restrictions to manage the size of groups within those spaces.

· Visitors Allowed – or NOT: Allowing visitors in the Dining Room is a point of debate that requires a close look at the member community’s overarching visitor policy. And, because many members are still deciding how and when to permit visitors to return to public spaces, most are not yet allowing visitors into the Dining Room. Those who are plan to keep other requirements in place, such as social distancing, wearing masks, and limiting visitors to those who can demonstrate they are fully vaccinated. One member shared anecdotally that because visitors are not permitted in their Dining Room yet, the resident traffic in the Dining Room has been far below even their reduced capacity.

· Masks – With or Without: While most members plan to have their staff continue to wear masks in the Dining Room, which is in accordance with most states’ requirements for dining venues, members vary in their approach with residents. Some members will continue to require that residents wear masks except for while eating, while others are allowing residents to forego masks in the Dining Room entirely. Again, members are basing these decisions on what percentage of both residents and staff have been vaccinated.

· Reduced Capacity to Meet State Guidelines: Outside of social distancing, members who plan to reopen their Dining Rooms must do so within their state’s guidelines for indoor capacity. Many states’ guidelines offer a certain percentage of capacity, such as 50%, to determine the number of ‘patrons’ allowed in the space at a given time. This is where members find that using a reservation system and incorporating social distancing are necessary to meet their state’s requirements.

· Relaxed Cohorting: In some member communities, residents were already permitted to eat together in the Dining Room in a “pod” or small cohort of neighbors. For such members, some are planning to eliminate that requirement, and allow residents to mix freely with others in the setting. (Ohio)

· Testing Unvaccinated Staff: Most, if not all members continue to test and screen staff for COVID 19. Members are considering, once state testing mandates start to relax, whether to continue testing unvaccinated staff. Recently, a member shared that they had reopened their Dining Room, but had to shut it down again, when an unvaccinated staff member tested positive.

Common/ Public Spaces

A similar dichotomy exists in member approaches to managing common and public spaces as with the Dining Room. Members are tackling questions of social distancing, masking, and reduced capacity in a very similar vein as above. Many members have already reopened their fitness centers, pools and outdoor spaces; some are now gently reopening other service areas such as beauty salons by reservation only.

Whether visitors may access and spend time in these spaces remains the big point of debate among members. Some members are allowing visitors only in public spaces, and not in private residences, with the rationale that visitors can be observed for compliance with COVID protocols in public more easily than in private settings. On the flip side, some members are allowing visitors only in private residences and not in public spaces, with the rationale that this minimizes the risk for public spread and is consistent with the CDC guidance for vaccinated people in the general public.

Visitors

One of the toughest decision points facing LPC members at the moment is how and when to allow visitors to return to Independent Living settings. At the center of this decision is how to manage – if at all – the vaccination status of visitors who may enter the community. There are three primary approaches, outlined below, that members are taking to address the issue.

· Designated Visitor Programs.” Many members were already offering this program for limited visitation in Independent Living. Essentially, residents could identify one or two visitors who would be allowed to visit only within their private residence, provided visitors meet certain parameters around screening, testing, masking, and social distancing. These programs do not require that the visitor be vaccinated or demonstrate a vaccinated status for participation. Now, post-vaccine, members are considering expanding this program to permit more “designated visitors” per resident.

· Vaccinated Visitor Programs.” In an attempt to give some visitors “unlimited access” to the community, a few members have started visitor programs that are contingent on vaccination status. Visitors will be required to demonstrate that they are full vaccinated; those who do so will be given a special badge or access card to indicate they may freely visit the community spaces, both public and private, as invited by residents.

· Testing and Screening. Along with the above, many members are planning to continue their screening and/or testing protocols with visitors. Vaccinated visitors, if the program exists in the member community, may be exempt from these screenings.

Staff Vaccination Status

Members have broadly shared that one predominant challenge is protecting the privacy of the staff while acknowledging the residents’ and families’ desire to know who has and has not been vaccinated. Many members have taken an approach of total non-disclosure; others have made it possible for staff to voluntarily disclose that they have been vaccinated in exchange for extra benefits or privileges. Most members plan to require that all staff continue to wear masks, but some are stipulating that unvaccinated staff should also wear a face shield. Members almost uniformly describe a no-tolerance approach to harassment or bullying of staff by residents or families wishing to know vaccination status; one member has informed residents that if they refuse to receive services from a non-vaccinated staff member, then they will not receive services from any staff member who performs the same function.

Transportation

Not surprisingly, residents are eager to get back “out and about” in the local community, and members are weighing whether and how to facilitate this using the community transportation services. Some members plan to limit transportation to medical appointments only; others are going to allow “social” outings on the bus, following protocols such as social distancing and a reduction in overall capacity. One member shared that their residents “now love it that we do their grocery shopping, and don’t want it to end;” another set up a rotating shuttle service to the local downtown area, so residents could ‘hop on and off’ while still being socially distanced.

Travel

Similar to the above, members are looking for ways to accommodate both residents and staff with the “travel bug.” First and foremost, most members are deferring to their state’s requirements for local and international travel as they revise these policies. Where states are being more lenient, members typically are too; members are offering the greatest flexibility and permissions to travel (without the requirement of testing and quarantining upon return) to those residents and staff who are fully vaccinated. For those who are not vaccinated, if members have relaxed travel restrictions, they plan to continue to require testing and self-quarantining.

 

These Member Solutions are a representative sample of anecdotes and ideas that members have shared with us from around the country. We will continue to update this as new Solutions are shared. Have one you’d like to add? Please email Dee Pekruhn at dpekruhn@leadingage.org.