CORONAVIRUS INFORMATION

July 30, 2020 | 2:00 pm

Bethany Retirement Living FAQs and COVID-19 Cases as of 7/30/20 2:00pm:

Dear families and friends of Bethany Retirement Living:

We conducted 1,063 swab tests on Monday, July 27th, for residents and staff at both Bethany on 42^nd and Bethany on University.  We conducted 1,063 swab tests on Monday, July 27th, for residents and staff at both Bethany on 42^nd and Bethany on University.  There were seven new staff cases and no new resident between the two facilities.  Two employees at Bethany in 42nd Skilled Care, four employees at Bethany on University Skilled Care and one at Bethany Towers.  All positive residents are moved to a confined COVID-19 skilled care area with designated staff.  Bethany nursing staff, in coordination with the North Dakota Department of Health (NDDOH), will continue conducting weekly COVID-19 surveillance swab testing on all skilled care, basic care, and assisted living residents.  Employees at both Bethany on University and Bethany on 42^nd will be tested bi-weekly.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the North Dakota Department of Health.

Resident testing will be conducted each Monday and the next employee testing dates will be August 10^th and August 24^th.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing is drive-through in the underground parking garage at Bethany on 42^nd and begins at 5:30am and concludes at 5:30pm.

It is anticipated test results will be returned within 48-72 hours.  Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls.  The test is free of charge.  If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or the Nurse in Assisted Living/Basic Care.

At Bethany, if an employee tests positive for COVID-19, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers.  We may add or subtract cases as new test results arrive and, due to the timing of the results, they may not be reflected on the State website at the time of this posting.  At Bethany we require two negative COVID-19 tests before we consider someone to be COVID-19 free.  This may mean that we keep someone in isolation a little longer than what the State website would count as a positive case—meaning we are being extremely cautious before considering someone COVID-19 free.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

July 27, 2020

Joint Letter to Newspapers

To the Editor:

Since the beginning of the COVID-19 pandemic, people have been urged to protect themselves, their neighbors, and their loved ones amidst the worst global health crisis in generations. After months of physical distancing and staying at home, infections and deaths began to decline across our country.

But in the weeks since states began reopening, some steps that were critical to the progress made were abandoned too quickly. We are now watching in real-time as a dramatic uptick in COVID-19 cases is erasing hard-won gains. In some states, hospitals are at or nearing their ICU capacity and shortages of personal protective equipment and testing supplies continue to pose a threat to health care workers and patients alike.

While North Dakota is not a high spread state, we want to do everything possible to keep it that way. This is why as physicians, nurses, long term care administrators, hospital and health system leaders, we urge North Dakotans to take the simple steps we know will help stop the spread of the virus: wearing a face mask, maintaining physical distancing, and washing hands. We are not powerless in this public health crisis, and we can defeat it in the same way we defeated previous threats to public health—by allowing science and evidence to shape our decisions and inform our actions.

There is a growing body of evidence that face masks help prevent the spread of COVID-19. One study shows the infection rate among employees at Mass General Brigham hospitals dropped significantly once all workers were required to wear face masks. Another study in Missouri shows that wearing a face mask prevented the spread of infection from two hair stylists to their customers.

Despite claims otherwise, the prolonged use of face masks when properly worn does not cause CO2 intoxication, oxygen deficiency, or any other harm to the wearer. Surgeons operate for hours wearing them. They don’t have problems. For those who have been waiting for more data before accepting the practice, these findings make it clear: Masks work.

The toll of this pandemic is staggering, and it will take months, perhaps years, to truly understand its impact on our country and our way of life. But what is certain – and what the science and evidence tell us – is that COVID-19 is not behind us. Your actions are critical to stop the spread of COVID-19. We must remain vigilant and continue to take steps to mitigate the spread of the virus to protect each other and our loved ones.

To those of you who are doing your part in helping turn the tide of this pandemic – thank you. There is only one way we will get through this – together.

Your continued partners in health,

Tim Blasl, President                                                                  Courtney Koebele, Executive Director

North Dakota Hospital Association                                       North Dakota Medical Association

Tessa Johnson, MSN, BSN, RN, CDP, President                   Shelly Peterson, President

North Dakota Nurses Association                                         North Dakota Long Term Care Association

July 17, 2020 | 8:00 am

Bethany Retirement Living FAQs and COVID-19 Cases as of 7/17/20 8:00am:

Dear families and friends of Bethany Retirement Living:

We conducted 1,069 swab tests on Monday, July 13th, for residents and staff at both Bethany on 42^nd and Bethany on University.  There were five new cases between the two facilities.  One resident at Bethany on University-Skilled Care, one resident at Bethany Towers Assisted Living, two residents at Bethany on 42^nd Skilled Care and one employee at Bethany on 42^nd.  All positive residents are moved to a confined COVID-19 skilled care area with designated staff.  Bethany nursing staff, in coordination with the North Dakota Department of Health (NDDOH), will continue conducting weekly COVID-19 surveillance swab testing on all skilled care, basic care, assisted living and independent living residents.  Employees at both Bethany on University and Bethany on 42^nd will be tested bi-weekly.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the North Dakota Department of Health.

Resident testing will be conducted each Monday and the next employee testing dates will be July 27^th, August 10^th and August 24^th.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing is drive-through in the underground parking garage at Bethany on 42^nd and begins at 5:30am and concludes at 5:30pm.

It is anticipated test results will be returned within 48-72 hours.  Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls.  The test is free of charge.  If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or the Nurse in Assisted Living/Basic Care.

At Bethany, if an employee tests positive for COVID-19, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers.  We may add or subtract cases as new test results arrive and, due to the timing of the results, they may not be reflected on the State website at the time of this posting.  At Bethany we require two negative COVID-19 tests before we consider someone to be COVID-19 free.  This may mean that we keep someone in isolation a little longer than what the State website would count as a positive case—meaning we are being extremely cautious before considering someone COVID-19 free.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

July 17, 2020 | 8:00 am

Bethany Moving to INDOOR Visitation

Bethany Retirement Living will soon be moving away from outdoor visits, starting July 20^th, 2020.  Instead of doing outdoor visits, we highly encourage family members to take advantage of the indoor visitation schedule.  Bethany staff feels that indoor visits have many more advantages over outdoor visits, such as offering a more controlled environment without any variable weather conditions (rain, wind, extreme heat, etc.).  Indoor visitation allows for a more comfortable seating arrangement for the resident and their family as well as easier access to hand hygiene and PPE.  Indoor visits also offer less background noise, a quieter environment, and more privacy for one-to-one visitation.  Please also note that indoor visits are set for a longer time frame as we allow family members to visit for up to an hour versus a half hour for outdoor visits.

Please see the attached schedule for indoor visitation hours.  You do not need to make an appointment to visit during these designated visitation times.

July 1, 2020 | 8:00 am

Bethany Moving to Phase 2 Visitation

Dear Family and Friends of Bethany Retirement Living:

We are pleased to announce we are moving to Phase 2 visitation based on criteria established by the Vulnerable Population Protection Plan (VP3) task force and the recommendations of the North Dakota Department of Health (NDDoH).

Once a facility enters Phase 2, visitation within the facility may be scheduled, and non-medically necessary trips outside the building may occur with the utilization of masks among residents and staff.

Each service area within Bethany Retirement Living has its own unique visitation guidelines.  Please click on the link to the information specific to the area in which your loved one resides.

Please note that outdoor visitation requirements remain the same.

July 2, 2020 | 8:00 am

Bethany Retirement Living FAQs and COVID-19 Cases as of 7/2/2020, 8:00 am

Dear families and friends of Bethany Retirement Living:

We conducted 1,049 swab tests on Monday, June 29th, for residents and staff at both Bethany on 42^nd and Bethany on University.   There were 4 new cases between both facilities.  One resident at Bethany on University-Skilled Care, one resident at Bethany Towers Basic Care, one resident at Bethany on 42^nd Skilled Care and one employee at Bethany on 42^nd.  Bethany nursing staff, in coordination with the North Dakota Department of Health (NDDOH), will continue conducting COVID-19 surveillance swab testing on all skilled care, basic care, assisted living and independent living residents and staff at Bethany on University and Bethany on 42^nd.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the North Dakota Department of Health.

Testing will be conducted again on July 13^th, July 27^th, August 10^th and August 24^th.  Employee testing will begin at 5:30am and conclude at 5:30pm.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing will be drive-through at Bethany on 42^nd.

It is anticipated test results will be returned within 48-72 hours. Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls. The test is free of charge. If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or the Nurse in Assisted Living/Basic Care.

At Bethany, if an employee tests positive for COVID-19, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.  We also added the new resident cases.  At Bethany we require two negative COVID-19 tests before we consider someone to be COVID-19 free.  This may mean that we keep someone is isolation a little longer than what the State website would count as a positive case—meaning we are being extremely cautious before considering someone COVID-19 free.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

June 25, 2020 | 2:00 pm

Bethany Retirement Living FAQs and COVID-19 Cases as of 6/25/20 2:00pm:

Dear families and friends of Bethany Retirement Living:

We conducted 1,042 swab tests on Monday, June 22nd, for residents and staff at both Bethany on 42^nd and Bethany on University.   There were 3 new staff cases at Bethany on University, one new resident case at Bethany Towers Assisted Living and one new staff case at Bethany on 42^nd.  Bethany nursing staff, in coordination with the North Dakota Department of Health (NDDOH), will continue conducting COVID-19 surveillance swab testing on all skilled care, basic care, assisted living and independent living residents and staff at Bethany on University and Bethany on 42^nd.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the North Dakota Department of Health.

Testing will be conducted again on June 29^th, July 13^th, July 27^th, August 10^th and August 24^th.  Employee testing will begin at 5:30am and conclude at 5:30pm.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing will be drive-through at Bethany on 42^nd.

It is anticipated test results will be returned within 48-72 hours. Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls. The test is free of charge. If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or the Nurse in Assisted Living/Basic Care.  At this time, we have no active resident cases at Bethany on 42^nd Skilled Care, Bethany on University Skilled Care, Bethany Gables or Bethany Towers Basic Care.

At Bethany, if an employee tests positive for COVID-19, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.  We also added the new resident case.  At Bethany we require two negative COVID-19 tests before we consider someone to be COVID-19 free.  This may mean that we keep someone is isolation a little longer than what the State website would count as a positive case—meaning we are being extremely cautious before considering someone COVID-19 free.

Facility Name                                                  County             City               Facility Bed Size          Current Active Positive Residents         Current Active Positive Staff           Facility type of positive Resident

Bethany Towers               Cass       Fargo       133                                                                     1                     0        Assisted

Bethany on 42nd              Cass       Fargo       116                           0                                        2                     Skilled

Bethany on University   Cass       Fargo       172                                                                     0                     4        Skilled

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

June 24, 2020 | 10:30 am

Phase 1 visitation in progress with plan on moving to Phase 2 in the next 10-14 days.

On June 5^th, Gov. Doug Burgum signed an executive order that modifies restrictions on visitation at long-term care facilities in North Dakota during the COVID-19 pandemic, allowing for a three phased approach to resuming visitation as outlined in the state’s Vulnerable Population Protection Plan (VP3).  Bethany was given approval to move into Phase 1 and we are now making plans to move into Phase 2 later next week if we are given approval from the State of North Dakota VP3 Taskforce.

Phase 1 allows for limited group activities, but residents must practice social distancing.  Scheduled outdoor visits may occur between residents and their families while exercising social distancing.  Anyone visiting must wear clean face masks, stay 6 feet apart and perform proper hand hygiene.  Please contact the Director of Community Life to set up a Skilled Care outside visit or call the Towers or Gables desk to schedule an assisted living or basic care outside visit.

Once a facility enters Phase 2, visitation within the facility may be scheduled, and non-medically necessary trips outside the building may occur with the utilization of masks among residents and staff.  Visitations will be restricted to one visitor per resident.  Both the visitor and the resident will be required to wear mask and visitors also adding a face shield.  We strongly encourage all family members to get into the habit of being tested for COVID-19 weekly or as often as offered by the ND Department of Health and Cass County Public Health.  (Outdoor drive-up testing will take place in the west parking lot of the FARGODOME from 10 a.m. to 6 p.m. on Thursday, June 25 and Friday, June 26.)  Once visitation in Phase 2 is allowed, we will ask visitors if they have been tested recently.  If visitors have not been regularly tested, we will change from allowing visitation in a resident’s room to a common space far away from all of the residents’ living area to prevent touching of handrails, door knobs, furniture and other high touch areas residents use.  We cannot risk a massive outbreak in our facilities as we introduce hundreds of people into our buildings.  Many residents who live at Bethany have underlying health conditions, so please take advantage of testing when you have the opportunity.

We conducted 1,042 COVID-19 swab tests on Monday, June 22nd, for residents and staff at both Bethany on 42^nd and Bethany on University.  The results should be in by Thursday, June 25^th.  Our next round of testing is next Monday, June 29^th for both residents and employees.  We will be moving from every week testing to every other week testing in July, so our testing dates will be Monday, July 13^th and Monday, July 29^th.  We will be posting updated information after we receive our testing results.

June 17, 2020 |3:30 PM

Bethany Retirement Living FAQs and COVID-19 Cases as of 6/17/20 2:00pm

Dear families and friends of Bethany Retirement Living:

We received great results from the 1042 COVID-19 swab tests completed on Monday, June 15^th, for residents and staff at both Bethany on 42^nd and Bethany on University.   There were only two new staff cases and one new resident case at Bethany on University-Skilled Care.  The resident was a recent admission from the hospital and was only with us for a very short time, he/she most likely contracted COVID-19 before their stay with us and he/she is already discharging home today.   Bethany nursing staff, in coordination with the North Dakota Department of Health (NDDOH), will continue conducting COVID-19 surveillance swab testing on all skilled care, basic care, assisted living and independent living residents and staff at Bethany on University and Bethany on 42^nd every Monday in June.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the North Dakota Department of Health.

Testing will be conducted every remaining Monday in June—June 22^nd and 29^th.  Employee testing will begin at 5:30am and conclude at 5:30pm.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing will be drive-through at Bethany on 42^nd.

It is anticipated test results will be returned within 48-72 hours. Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls. The test is free of charge. If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or the Nurse in Assisted Living/Basic Care.  At this time, we have no active resident cases at Bethany on 42^nd Skilled Care, Bethany Gables or Bethany Towers-Basic Care.

At Bethany, if an employee tests positive for COVID-19, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.  We also added the new resident case.  At Bethany we require two negative COVID-19 tests before we consider someone to be COVID-19 free.  This may mean that we keep someone is isolation a little longer than what the State website would count as a positive case—meaning we are being extremely cautious before considering someone COVID-19 free.

Facility Name                                                  County             City               Facility Bed Size          Current Active Positive Residents         Current Active Positive Staff           Facility type of positive Resident

Bethany Towers               Cass       Fargo       133                                                                     0                     0        Assisted

Bethany on 42nd              Cass       Fargo       116                           0                                        2                     Skilled

Bethany on University   Cass       Fargo       172                                                                     1                     1        Skilled

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

June 17, 2020 |3:30 PM

Bethany Retirement Living FAQs and COVID-19 Cases as of 6/17/20 2:00pm

Dear families and friends of Bethany Retirement Living:

We received great results from the 1042 COVID-19 swab tests completed on Monday, June 15^th, for residents and staff at both Bethany on 42^nd and Bethany on University.   There were only two new staff cases and one new resident case at Bethany on University-Skilled Care.  The resident was a recent admission from the hospital and was only with us for a very short time, he/she most likely contracted COVID-19 before their stay with us and he/she is already discharging home today.   Bethany nursing staff, in coordination with the North Dakota Department of Health (NDDOH), will continue conducting COVID-19 surveillance swab testing on all skilled care, basic care, assisted living and independent living residents and staff at Bethany on University and Bethany on 42^nd every Monday in June.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the North Dakota Department of Health.

Testing will be conducted every remaining Monday in June—June 22^nd and 29^th.  Employee testing will begin at 5:30am and conclude at 5:30pm.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing will be drive-through at Bethany on 42^nd.

It is anticipated test results will be returned within 48-72 hours. Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls. The test is free of charge. If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or the Nurse in Assisted Living/Basic Care.  At this time, we have no active resident cases at Bethany on 42^nd Skilled Care, Bethany Gables or Bethany Towers-Basic Care.

At Bethany, if an employee tests positive for COVID-19, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.  We also added the new resident case.  At Bethany we require two negative COVID-19 tests before we consider someone to be COVID-19 free.  This may mean that we keep someone is isolation a little longer than what the State website would count as a positive case—meaning we are being extremely cautious before considering someone COVID-19 free.

Facility Name                                                  County             City               Facility Bed Size          Current Active Positive Residents         Current Active Positive Staff           Facility type of positive Resident

Bethany Towers               Cass       Fargo       133                                                                     0                     0        Assisted

Bethany on 42nd              Cass       Fargo       116                           0                                        2                     Skilled

Bethany on University   Cass       Fargo       172                                                                     1                     1        Skilled

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

June 17, 2020 |3:00 PM

NDDoH Visitation Guidelines

The North Dakota Department of Health has provided Long Term Care facilities with reopening guidelines for visitation.  A phased-strategy approach will be utilized to gradually relax restrictions.

Bethany is currently in Phase 1 of 3.  We will need to remain in Phase 1 for 14 days.  To move into Phase 2, Cass County will need to be moved from a medium risk county to a low risk county.  When this happens, Bethany will apply for permission to move into Phase 2.

We strongly encourage all family members to get into the habit of being tested weekly or as often as offered by the ND Department of Health and Cass County Public Health.  We may require visitors to provide proof of a recent negative Covid-19 test, in order to be allowed into Bethany to visit as part of our Phase 2 strategy to keep residents safe.  We cannot risk a massive outbreak in our facilities as we introduce hundreds of people into our buildings.  Many residents who live at Bethany have underlying health conditions, so please take advantage of testing when you have the opportunity.  Testing will benefit our residents now, while we are offering outside visitation, and in the future as we plan for internal visitation.  Please see the attached news release for information on testing options.

June 11, 2020 | 7:00 am

Bethany Retirement Living FAQs and COVID-19 Cases

Bethany Retirement Living FAQs and COVID-19 Cases as of 6/11/20 10:00am:

Dear families and friends of Bethany Retirement Living:

We received remarkable results from the 1059 COVID-19 swab tests we completed on Monday, June 8^th, for residents and staff at both Bethany on 42^nd and Bethany on University.   There was only one new staff case.  No new resident cases.  Bethany nursing staff, in coordination with the North Dakota Department of Health (NDDOH), will continue conducting COVID-19 surveillance swab testing on all skilled care, basic care, assisted living and independent living residents and staff at Bethany on University and Bethany on 42^nd every Monday in June.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the Centers for Medicare and Medicaid Services (CMS) and North Dakota Department of Health.

Testing will be conducted every remaining Monday in June—June 15^th, 22^nd and 29^th.  Resident testing will start after 8:00am and be concluded around 11:30am.  Employee testing will begin at 5:30am and conclude at 5:30pm.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing will be drive-through at Bethany on 42^nd.

It is anticipated test results will be returned within 48-72 hours. Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls. The test is free of charge. If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or the Nurse in Assisted Living/Basic Care.  At this time, we have no active resident cases at Bethany on 42^nd Skilled Care, Bethany Gables or Bethany Towers-Basic Care.  The one Towers assisted living resident who tested positive last week was moved to the skilled care area for isolation.

At Bethany, if an employee tests positive for COVID-19, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.   At Bethany we require two negative COVID-19 tests before we consider someone to COVID-19 free.  This may mean that we keep someone is isolation a little longer than what the website would count as a positive case—meaning we are being extremely caution before considering someone COVID-19 free.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.
• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.
• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.
• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.
• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

June 8, 2020 | 4:30 pm

Phased-In Visitation Schedule

Phased approach to resuming visitation

On June 5^th, Gov. Doug Burgum signed an executive order that modifies restrictions on visitation at long-term care facilities in North Dakota during the COVID19 pandemic, allowing for a phased approach to resuming visitation as outlined in the state’s Vulnerable Population Protection (VP3) Plan.  The (VP3) Plan is a three-phased approach for reopening skilled care, basic care and assisted living facilities.  All phases require a minimum of 14 days spent in each phase.  A member of the VP3 task force needs to approve each facility plan to move into the next phase.  Steps in each phase may be altered or changed if any new COVID-19 cases are confirmed or additional risks arise.

Most Fargo/West Fargo facilities are in Phase 1 or making progress towards Phase 1, which advises the same restrictions and practices we are now following, including not allowing any visitors in our facilities, except for end-of-life situations.  Phase 1 does allow for limited group activities, but residents must practice social distancing.  Scheduled outdoor visits may occur between residents and their families while exercising social distancing.  Anyone visiting must wear clean face masks, stay six feet apart and perform proper hand hygiene.  We will communicate how we intend to schedule outdoor visits in the next few days since we just received approval to move into Phase 1.

In order to move into Phase 2, a facility’s county, in our case Cass, must be at a “low-risk level” according to the state’s plan.  Currently Cass County is a moderate-risk level.  Once a facility enters Phase 2, visitation within the facility may be scheduled, and non-medically necessary trips outside the building may occur with the utilization of masks among residents and staff.  Visitations will be restricted to one visitor per resident.  Both the visitor and the resident will be required to wear masks.

To enter Phase 3, a facility’s county must be at a “new normal level” according to the state’s plan and there must continue to be no new cases of COVID-19 in the facility.  At this phase, visitation within the facility is fully opened, communal dining and group activities may resume, and non-medically necessary trips may continue.

June 5, 2020 | 7:00 am

Bethany Retirement Living FAQs and COVID-19 Cases

Bethany Retirement Living FAQs and COVID-19 Cases as of 6/2/20 1:00pm:

Dear families and friends of Bethany Retirement Living:

We received all results from the 1005 COVID-19 swab tests that we completed on Monday, June 1^st for residents and staff at both Bethany on 42^nd and Bethany on University.   There was only one new staff case and two new resident cases.  One resident tested positive at Bethany Towers and one in skilled care at Bethany on University.  The skilled care positive test was a recent admission that was only with us for 2 days before the test, so most likely this case originated in the hospital.  Bethany nursing staff in coordination with the North Dakota Department of Health (NDDOH) will continue conducting COVID-19 surveillance swab testing on all skilled care, basic care and assisted living residents and staff at Bethany on University and Bethany on 42^nd every Monday in June.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the Centers for Medicare and Medicaid Services (CMS) and North Dakota Department of Health.

Testing will be conducted every Monday in June—June 8^th, 15^th, 22^nd and 29^th.  Resident testing will start after 8:00am and be concluded around 11:30am.  Employee testing will begin at 5:30am and conclude at 5:30pm.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing will be drive through at Bethany on 42^nd.

It is anticipated test results will be returned within 48-72 hours. Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls. The test is free of charge. If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or Nurse in Assisted Living/Basic Care.

At Bethany, if an employee tests positive for COVID-19, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.  At this time, we have no active resident cases at Bethany on 42^ndSkilled Care, Bethany Gables or Bethany Towers-Basic Care.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.   At Bethany we require two negative COVID-19 tests before we consider someone to COVID-19 free.  This may mean that we keep someone is isolation a little longer than what the website would count as a positive case—meaning we are being extremely caution before considering someone COVID-19 free.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.
• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.
• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.
• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.
• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

June 2, 2020 | 1:00 pm

Bethany Retirement Living FAQs and COVID-19 Cases

Bethany Retirement Living FAQs and COVID-19 Cases as of 6/2/20 1:00pm:

Dear families and friends of Bethany Retirement Living:

On Monday, June 1st, we conducted 1005 COVID-19 swab tests on residents and staff for both Bethany on 42^nd and Bethany on University.  Bethany nursing staff, in coordination with the North Dakota Department of Health (NDDOH), will be conducting COVID-19 surveillance swab testing on all skilled care, basic care and assisted living residents and staff at Bethany on University and Bethany on 42^nd every Monday in June.  Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the Centers for Medicare and Medicaid Services (CMS).  Even though CMS does not regulate assisted living and basic care, the guidelines will be followed for those care settings also.

Testing will be conducted every Monday in June—June 1^st, 8^th, 15^th, 22^nd and 29^th.  Resident testing will start after 8am and be concluded around 11:30am.  Employee testing will begin at 5:30am and conclude at 5:30pm.  Resident testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.  Employee testing will be drive through at Bethany on 42^nd.

It is anticipated test results will be returned within 48-72 hours.  Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls.  The test is free of charge.  If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or Nurse in Assisted Living/Basic Care.

The North Dakota Department of Health website has been updated to reflect active cases of COVID-19 for residents and staff rather than aggregate numbers they previously reported which included inactive cases and lumped resident and staff cases together.  At Bethany, if an employee tests positive, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.  At this time, we have no active resident cases at Bethany on 42^nd Skilled Care, Bethany Gables, Bethany Towers-Basic Care and Assisted Living.  Our active resident cases at Bethany on University Skilled Care are all on one isolated, self-contained unit.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.  At Bethany we require two negative COVID-19 tests before we consider someone to COVID-19 free.  This may mean that we keep someone in isolation a little longer than what the website would count as a positive case—meaning we are being extremely cautious before considering someone COVID-19 free.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings.Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day.Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day.Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers.Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift.A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed.This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only.Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health.A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift.If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health.Residents who have in a decline in health status may be transferred to the hospital as directed by their physician. Bethany would call 911 in an emergency situation.

June 1, 2020 | 5:00 pm

Bethany Retirement Living FAQs and COVID-19 Cases

Bethany Retirement Living FAQs and COVID-19 Cases as of 6/1/20 5:00pm:

Dear families and friends of Bethany Retirement Living:

We appreciate your ongoing support and prayers for our residents and staff during this challenging time.  I want to recognize the amazing employees we have at Bethany.  They continue to work hard and provide outstanding care while dealing with the very challenging pandemic.  The North Dakota Department of Health website has been updated to reflect active cases of COVID-19 for residents and staff rather than aggregate numbers they previously reported which included inactive cases and lumped resident and staff cases together.  At Bethany, if an employee tests positive, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.  At this time, we have no active resident cases at Bethany on 42^nd Skilled Care, Bethany Gables, Bethany Towers-Basic Care and Assisted Living.  Our active resident cases at Bethany on University Skilled Care are all on one isolated, self-contained unit.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

May 29, 2020 | 3:00 pm

Bethany Retirement Living FAQs and COVID-19 Cases

Bethany Retirement Living FAQs and COVID-19 Cases as of 5/29/20 3:00pm:

Dear families and friends of Bethany Retirement Living:

We appreciate your ongoing support and prayers for our residents and staff during this challenging time.  I want to recognize the amazing employees we have at Bethany.  They continue to work hard and provide outstanding care while dealing with the very challenging pandemic.  We are excited to announce that the North Dakota Department of Health website has been updated to reflect active cases of COVID-19 for residents and staff rather than aggregate numbers they previously reported which included inactive cases and lumped resident and staff cases together.  At Bethany, if an employee tests positive, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.  At this time, we have no active resident cases at Bethany on 42^nd Skilled Care, Bethany Gables, Bethany Towers-Basic Care and Assisted Living.  Our active resident cases at Bethany on University Skilled Care are all on one isolated, self-contained unit.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience https://www.health.nd.gov/diseases-conditions/coronavirus/north-dakota-coronavirus-cases .  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.

Here are the latest COVIDD-19 numbers as reported on the North Dakota Department of Health website.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

May 28, 2020 | 11:00 am

Bethany Retirement Living FAQs and COVID-19 Cases

Bethany Retirement Living FAQs and COVID-19 Cases as of 5/28/20 11:00am:

Dear families and friends of Bethany Retirement Living:

We appreciate your ongoing support and prayers for our residents and staff during this challenging time.   I especially want to recognize the amazing employees we have at Bethany.  They continue to work hard and provide outstanding care while dealing with the very challenging pandemic.   On Friday, May 22^nd, we conducted 1013 COVID-19 swab tests on residents and staff for both Bethany on 42^nd and Bethany on University.   We had only four new staff cases and one new resident case.   These results were very good news.  Our updated numbers are below.  Please pay special attention to our self-reported numbers and not the numbers reported in the media.  The cases the media report appear to come from the Department of Health website and they are very misleading.  The cases reported, by NDDoH, are total cases—past and present, so this means that our numbers will never go down.  The information the Department of Health posts is not just resident cases; they also include employee cases that are both active and recovered.  At Bethany, if an employee tests positive, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.  The media reports make it seem as if all cases (past and present) are still in our building, which is not factual.   We continue to have no active resident cases at Bethany on 42^nd Skilled Care, Bethany Gables, Bethany Towers-Basic Care and Assisted Living.  Our active resident cases at Bethany on University-Skilled Care are all on one isolated, self-contained unit.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience (https://www.health.nd.gov/diseases-conditions/coronavirus).  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.
• We will do our best to ensure our numbers tie to what the Governor’s office is reporting, but due to timing situations and employees working at other facilities, the numbers may not always reconcile.

Current active cases are as follows:

Bethany on University:  Total Cases=36

• Staff: 21
• Residents: 15 (5 of these residents we admitted knowingly from other facilities)

Bethany on 42^nd:  Total Cases=7

• Staff: 7
• Residents: 0

Current inactive cases are as follows:

• Residents/Patients: If a case is not active it means the resident may have discharged, recovered or passed away.
• Employee: If a case is not active it means the staff member recovered or is no longer employed.

Bethany on University:  Total Inactive Cases=10

• Staff: 2
• Residents: 8

Bethany on 42^nd:  Total Inactive Cases=14

• Staff: 8
• Residents: 6–one of these is double counted for both Assisted Living and Skilled Care.

Sincerely,

Shawn Stuhaug, CEO

Frequently Asked Questions:

What have you done to decrease the risk of COVID-19 for residents and educate family members?

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health.
• Among the first acts undertaken to limit potential exposure was to restrict visitors and lock the entrances to Bethany buildings. Only limited access to family members is granted on a case-by-case basis for compassionate reasons such as end of life.
• All visitors are screened as they enter the buildings.

• The Bethany website has been enhanced by adding a “Coronavirus Information” tab to share up-to-date information about the pandemic in general and at Bethany Retirement Living.

• Numerous emails have been sent to families from our Social Services team.
• Everbridge (Mass Communication System) messages have been distributed by the CEO for education to family member primary contact.
• Letters have been mailed to primary Skilled Nursing Facility (SNF) resident contacts, SNF residents without dementia/memory issues, and residents of Towers, Gables and Grace Pointe.

• All potential admissions are screened for symptoms and fever.
• All SNF admissions are initially processed through one unit (TCU) with increased monitoring of potential symptoms.
• A negative COVID test is required for all new admissions or for hospital returns.
• Bethany may admit COVID positive residents periodically if we have a COVID-positive area set up.
• Screening of all SNF residents occurs two times/day and, at times, three times/day. Symptoms monitored include a full set of vital signs along with the observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Screening of all Assisted Living and Basic Care residents occurs daily and, at times, two times/day. Symptoms to monitor include temperature, pulse and O2 stats along with observation of any of the following: coughing, shortness of breath, weakness, fatigue, sore throat, chills, nausea, vomiting, diarrhea, headache, muscle aches and loss of taste/smell.
• Resident Activities of Daily Living (ADL) sheets are updated to include prompts for hand sanitizing of resident hands and resident mask placement.
• All non-emergent resident appointments are being decreased or canceled.
• No group activities are scheduled.
• Residents are required to stay in their own rooms.
• No therapy is being conducted in the therapy/wellness centers. Individual therapy sessions are being done in the resident rooms.
• No communal dining for SNF residents unless the resident eating in their room is a safety risk.
• No communal dining for Towers or Gables assisted living residents.
• Use of masks is encouraged for all residents.
• Use of hand sanitizer is encouraged for each resident interaction.

Telemedicine is encouraged.

• Each Bethany campus has a designated Infection Preventionist to provide surveillance and oversight.
• Visual alerts such as signage and posters have been added throughout the facility to encourage hand sanitizing for both residents and staff.

What have you done to educate staff and decrease the risk of COVID-19?

• See above question above as some information applies to both questions.

• Everbridge (Mass Communication System) messages to staff related to education.
• Several YouTube Videos (10 total) that have been produced and sent to ALL staff cell phones.
• Educational videos and verbal education are reviewed at shift change/daily huddles etc.
• Mandatory Healthcare Academy Education on Personal Protective Equipment (PPE), Hand Hygiene, COVID-19 and infection prevention have been assigned and made mandatory for all employees.
• Surveillance and auditing of employees is being conducted to ensure proper use of PPE and handwashing is occurring.
• Hand sanitizer is required for all nursing staff to have on the person (this is not new, but an uncommon practice for most SNFs).
• Facemasks are required for staff when in resident areas.
• Facemask and face shield requirements have been enhanced as guidance has evolved.
• Employees are monitored for Covid-19 symptoms at the start of each shift, as well as with staff that call in ill prior to their shift. A detailed spreadsheet enables close tracking of all employees with symptoms and tracks adherence to the Return-to-Work guidance from the North Dakota Department of Health (NDDoH).
• A daily phone call is placed to all employees that have been taken off the schedule due to Covid-19 symptoms.
• ALL employees are requested to limit employment to “Bethany Only” or be removed from schedules until the COVID-19 crisis has passed. This was a difficult decision for both Bethany and our staff, but the risk of infection when working many different jobs and coming in contact with many different people works against the concept of social distancing to limit the spread.
• A COVID-19 Leadership team meets three times weekly to discuss PPE supply and to analyze additional vendors for increased PPE supply, new guidance on COVID-19, etc.
• Meetings are held five days a week to discuss employees who are furloughed and their plans for return to work.
• Leadership team members are on-call 24 hours per day/7 days a week to deal with employee and family questions and concerns.
• Weekly meetings and/or conference calls/webinars/education reviews are held with the NDDoH, Centers for Disease Control, Public Health, ND Long Term Care Association, and American Health Care Association.
• Contact tracing if/when applicable is coordinated with the ND Department of Health.
• Excess chairs have been removed in our break room areas to limit tables to two staff members at a table only. Additional space has been opened up for employee breaks to allow for social distancing.
• Visual alerts such as signs and posters have been added throughout all buildings that encourage staff hand hygiene, resident hand hygiene and proper use of PPE.
• Increased hand hygiene stations have been installed throughout all buildings.

We have received notification that a resident at Bethany has tested positive for COVID-19 and we have the following questions.

Will all residents now be tested?

• Resident testing (mass surveillance testing of all residents) is coordinated and directed by the ND Department of Health. A resident that is symptomatic is tested at the direction of the resident’s physician.

Will all staff be tested?

• Bethany employees complete a health screening at the start of their shift. If an employee triggers a concern on the health screening, they are immediately removed from the schedule.   A Bethany staff member then works with the employee on symptom monitoring, communication with their physician and return to work protocol.
• Staff testing (mass surveillance testing of all staff) is coordinated and directed by the ND Department of Health.

Will COVID-19 positive residents be taken to the hospital?

• A transfer to the hospital is coordinated by the resident’s physician, Bethany staff and the ND Department of Health. Residents who have in a decline in health status may be transferred to the hospital as directed by their physician.  Bethany would call 911 in an emergency situation.

May 26, 2020 | 4:00 PM

Bethany Retirement Living Surveillance Testing

We are pleased to announce that Bethany nursing staff in coordination with the North Dakota Department of Health (NDDOH) will be conducting COVID-19 surveillance swab testing on all skilled care, basic care and assisted living residents at Bethany on University and Bethany on 42^nd.   Ongoing testing is an important step to comply with the nursing home reopening guidelines recently published by the Centers for Medicare and Medicaid Services (CMS).  Even though CMS does not regulate assisted living and basic care, the guidelines will be followed for those care settings also.

Testing will be conducted every Monday in June—June 1^st, 8^th, 15^th, 22^nd and 29^th.  Testing will start after 8am and be concluded around 11:30am each Monday in June. Testing will take place in the residents’ rooms and will be coordinated by the Skilled Care and Assisted Living/Basic Care nursing teams.

It is anticipated test results will be returned within 48-72 hours. Bethany staff will attempt to contact all residents, regardless of the results, but will prioritize positive test calls. The test is free of charge. If you have any questions or concerns about the test, please contact the social worker or unit manager in Skilled Care or Nurse in Assisted Living/Basic Care.

Residents, family members and others are urged to monitor the Bethany Retirement Living website (www.bethanynd.org) for the most up-to-date information related to COVID-19 and Bethany.

May 26, 2020 | 2:00 PM

Bethany Retirement Living FAQs and COVID-19 Cases

Dear families and friends of Bethany Retirement Living:

We appreciate your ongoing support and prayers for our residents and staff during this challenging time.   I especially want to recognize the amazing employees we have at Bethany.  They continue to work hard and provide outstanding care while dealing with the very challenging pandemic.   On Friday, May 22^nd, we conducted 1013 COVID-19 swab tests on residents and staff for both Bethany on 42^nd and Bethany on University.   We had only four new staff cases and one new resident case.   Our updated numbers are below.  Please pay special attention to our self-reported numbers and not the numbers reported in the media.  The cases the media report appear to come from the Department of Health website and they are very misleading.  The cases reported, by NDDoH, are total cases—past and present, so this means that our numbers will never go down.  The information the Department of Health posts is not just resident cases; they also include employee cases that are both active and recovered.  At Bethany, if an employee tests positive, they are immediately removed from the schedule and told to quarantine at home until they have two negative test results.  The media reports make it seem as if all cases (past and present) are still in our building, which is not factual.   We continue to have no active resident cases at Bethany on 42^nd Skilled Care, Bethany Gables, Bethany Towers-Basic Care and Assisted Living.  Our active resident cases at Bethany on University-Skilled Care are all on one isolated, self-contained unit.

Bethany will continue to provide updates via e-mail and our website as our COVID-19 cases change.  You are also able to call us with any questions.  Please refer to the frequently asked questions below.  We are providing this link to the North Dakota Department of Health (NDDoH) COVID19 website for your convenience (https://www.health.nd.gov/diseases-conditions/coronavirus).  As we update our information, here are a few guidelines we will be following.

• We are following recommendations and guidance from the Centers for Disease Control, Centers for Medicare and Medicaid Services and the North Dakota Department of Health
• We will not be identifying employees, residents or patients who test positive due to confidentiality.
• All employees who are ill are not allowed to work for 14 days and will need two negative COVID-19 tests prior to return to work.
• We will not give information on resident deaths due to confidentiality.
• We will do our best to ensure our numbers tie to what the Governor’s office is reporting, but due to timing situations and employees working at other facilities, the numbers may not always reconcile.

Current active cases are as follows:

Bethany on University:  Total Cases=38

• Staff: 21
• Residents: 17 (5 of these residents we admitted knowingly from other facilities)

Bethany on 42^nd:  Total Cases=7

• Staff: 7
• Residents: 0

Current inactive cases are as follows:

• Residents/Patients: If a case is not active it means the resident may have discharged, recovered or passed away.
• Employee: If a case is not active it means the staff member recovered or is no longer employed.

Bethany on University:  Total Inactive Cases=8

• Staff: 2
• Residents: 6

Bethany on 42^nd:  Total Inactive Cases=14

• Staff: 8
• Residents: 6–one of these is double counted for both Assisted Living and Skilled Care.

Sincerely,

Shawn Stuhaug, CEO