Senior Living Infection Prevention Action Steps

Protecting Residents and Teams from COVID-19

Putting gloves onLeaders in the senior living industry have a responsibility to help prevent the spread of coronavirus disease 2019 (COVID-19) and the pathogen that causes it (SARS-CoV-2). On March 11, 2020, COVID-19 was characterized as a pandemic by the World Health Organization (WHO). As of today, the complete picture of the disease is not fully known, therefore, it’s critical to implement proactive practices to lessen the risk of exposure within our communities.

As a leader in the service industry, we at HHS want to open our resources up to you and share some of our policies and best practices we are currently using in the hospitals we serve. Our hope is that you will find the information useful as you continue to provide the best environment for your residents. 

The information below is intended to aid you in that effort, and contains pertinent data from the Centers of Disease Control and Prevention (CDC) and WHO. Additionally, critical infection prevention practices, cleaning procedures, and food handling strategies are listed on behalf of HHS, an expert in hospital housekeeping and food service  with 45 years of experience supporting hospitals. If you have any questions or concerns regarding the information below, contact wscholl@hhs1.com.

Housekeeping Action Steps Dining Services Action Steps
Common Sense Items:
  • Emphasize the importance of hand hygiene to employees and residents  throughout the day. This includes:
    • Regular hand washing for 20 seconds with warm water and soap
    • Using hand sanitizer that contains 60% alcohol 
  • Consider installing hand sanitizer dispensers at building entrances and throughout the community where foot traffic is heaviest. 
  • Practice social distancing and avoid gathering staff or residents in confined spaces.
  • Eliminate hand shaking; instead come up with methods to show appreciation while maintaining social distancing such as waving, making eye contact, smiling, and nodding.
  • Ensure disinfectants are used effectively by consulting your cleaning chemical provider and training your staff on the proper use.
  • If your staff shows signs of sickness, send them home.
  • If one of your residents is showing signs of sickness, ensure they maintain separation from other residents to reduce the risk of exposure.
Housekeeping Infection Prevention Action Steps

Employee washing handsThe following practices are used by HHS to clean and disinfect rooms that have been exposed to the coronavirus or other pathogens that require isolation room procedures. They are not meant to substitute for your own cleaning and disinfecting procedures, but we hope these will help you generate additional ideas on how you can protect your residents.

I. Ensure Compliance with Infection Prevention Best Practices When Cleaning a Suspected Contaminated Room

  • Prepare to enter the room by using the proper hand hygiene and personal protective equipment (PPE) at all times. This includes the following equipment:
    • Disposable gloves and gowns
    • Face shield with side protection
    • N-95 mask or surgical mask if N-95 mask is unavailable
  • Close the door during the cleaning process and ask staff to remain in the room until cleaning is complete. 
  • Use proper disinfectants and understand dwell times. HHS recommends Diversey Oxivir TB Wipes (contact time is 1 minute) for use against SARS-CoV-2, but consult with your current chemical provider. Detailed information provided in section V.  
  • Clean the room systematically, changing cloths/wipes frequently. Ensure all areas are wiped down, not just those that are visibly soiled. Utilize the following best practices:
    • Use enough disinfectant so as not to dry during the recommended dwell time.
    • Apply good friction to surfaces to help remove pathogens.
    • Never return or dip a soiled cloth into clean disinfectant.
    • Dispose of cloths properly by using a soiled linen bag. 
  • Follow a zone cleaning process. To prevent cross contamination, we recommend cleaning rooms from clean to dirty. This usually means the bathroom is the last area to be cleaned. 
  • Perform high-dusting first with dampened microfiber or dusting tools (DO NOT perform any dry-dusting procedures).
  • Mop with a disinfectant.
  • Remove any curtains, draperies, linens, and towels and place in plastic trash liners to have disinfected and cleaned. 
  • Dispose of any paper products (e.g., toilet paper, tissues, paper towels, coasters, etc.).
  • Clean the room TWICE. 
  • Remove gloves and gowns by following the inside-out method, and dispose of them in a plastic trash liner. Thoroughly wash hands with soap and water before cleaning another room or public space. 

II. Focus on Disinfecting High-Touch Areas 

Increase the cleaning and disinfecting of high-touch items and surfaces in the following areas:

Lobbies, Public Spaces, Dining Rooms, & Hallways

  • Telephones and remotes
  • Water fountains
  • Doors, door handles, push plates, and push bar exit devices for doors
  • Light switches
  • Coffee tables/lobby tables, chairs, ottomans, and the outside of furniture, including furniture crevices
  • Dining room tables and chairs
  • Menus
  • Hallway and stair handrails
  • Reception desks
  • Nurse stations

Public Restrooms

  • Countertops
  • Doors, door handles, and push plates
  • Light switches
  • Paper towel and toilet paper dispensers
  • Automated hand blowers
  • Outsides of trash containers
  • Sink areas (e.g., soap dish or dispensers, the area around the base of faucets and handles, the front and sides of the sinks and counters, and the pipes under the sink)
  • Toilet and flush valve

Elevators

  • Handrails
  • Automatic door open buttons
  • Elevator doors, walls, and mirror
  • Elevator buttons

III. Provide Quality Assurance

Direct daily inspections to the aforementioned areas, and institute a process of inspecting 100% of all room daily cleans to ensure that you are using the correct cleaning and disinfection processes. Inspect public areas throughout the day to monitor compliance with the initiatives detailed above.

IV. Educate Your Teams

Utilize the CDC’s Communication Resources to educate your teams on COVID-19. Refer to the following articles:

V. Understand Dwell Times and Disinfectants

  • Reach out to your designated suppliers for recommendations regarding cleaning chemicals. 
  • Ask about specific dwell times or contact times that disinfecting products need to sit on a surface in order to kill pathogens. 

If your supplier does not carry the correct disinfectants, HHS recommends utilizing Diversey and the following products:

VI. Implement Steps For Emergency Situations

If you suspect that a resident with COVID-19 or an infectious disease was in your community before moving into a hospital, follow these steps:

  • Keep the resident’s room locked down for at least 24 hours.
  • Do not allow anyone in the room unless they have been properly trained in infection prevention cleaning procedures. 
  • Hire a professional housekeeping organization that has experience handling infection prevention cleaning. If you have trouble finding someone local, HHS can help find a company that can assist in this area. Please contact wscholl@hhs1.com
Dining Operations Action Steps

The following action steps are used in HHS culinary partnerships to ensure dining service operations continue to run efficiently during an emergency situation. They are not meant to substitute for your own culinary procedures, but we hope these will help you generate additional ideas on how you can protect your residents and provide them with the nourishment they need.

I. Develop a Plan for Various Scenarios

Ensure that your plans meet the needs expected during a pandemic or an emergency situation. Areas to consider include:

  • Determine what your service looks like with 15 percent and 30 percent fewer associates, but without changes in the number of residents or resident conditions (e.g. the spread of COVID-19). 
  • Discuss and write action plans for your community to address these different scenarios:
    • What if the community is under quarantine?
    • What if public transportation or utilities are down, limiting staff?
    • What if schools, daycare centers, etc. are closed, limiting staff?
  • Try to determine when you would switch from a full menu to a non-select-only menu. Then determine when you would switch to the disaster menu (based on staffing and procurement availability). 
  • Determine at what point you would stop serving therapeutic diets. Mechanically altered diets and allergies always need to be honored. 
  • Determine which food service positions would be required to use PPE. 
  • Implement high touch cleaning in all kitchen and pantry areas. 
  • Add additional sanitation stations in the kitchen areas and sanitize all moveable equipment such as mobile hot carts, before and after service.

II. Purchasing Protocols

  • Review your distribution center’s emergency response plan. 
  • Determine and maintain a 14-day inventory of approved supplies of:
    • Single-use gloves (non-latex)
    • Antibacterial hand soap
    • Virus-effective hand sanitizer
    • Quat sanitizer
    • Disinfectant
  • Ensure nonperishable food supply stocks are on-site based on par levels for designated menus.
  • Ensure emergency water supplies are available. 
  • In the event of a food product recall, react immediately and adhere to all instructions regarding the handling of any recalled product present in the unit.

III. COVID-19 Food Contamination

Coronaviruses are generally thought to be spread from person-to-person through respiratory droplets. Currently, there is no evidence to support the transmission of COVID-19 associated with food. Before preparing or eating food it is important to always wash hands with soap and water for 20 seconds for general food safety. Throughout the day, ensure that employees wash hands after blowing their nose, coughing or sneezing, or going to the bathroom. It may be possible that a person can get COVID-19 by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes, but this is not thought to be the main way the virus spreads. In general, because of poor survivability of the coronavirus on surfaces, there is likely very low risk of spread from food products or packaging that are shipped over a period of days or weeks at ambient, refrigerated, or frozen temperatures.

Your housekeeping and dining service teams are on the front lines helping to keep your residents safe and ensure they have a positive experience. Therefore, it’s imperative to make every effort to ensure the safety of your team, resident, and everyone who enters your community. For live updates on COVID-19, please refer to the CDC Situation Summary. 

For more details on HHS’ action steps, contact wscholl@hhs1.com. 

Additional Resources
For information regarding helpful articles to keep you and your family stay safe at home, visit COVID-19 Resources