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JCF Healthcare skilled nursing facility, home health and hospice departments taking special precautions


There are still so many unknowns when it comes to Covid-19, the novel coronavirus which has swept across the world.

What is known is that the virus is especially dangerous for the vulnerable population, particularly the elderly.

With that in mind, the John C. Fremont Healthcare District is taking steps to keep its skilled nursing residents and home health/ hospice clients safe.

Katrina Anderson, director of the hospital’s skilled nursing unit, outlined some of the precautions being taken to protect the vulnerable, older population at the hospital.

She said all skilled nursing residents have been moved to what is commonly referred to as the Ewing Wing, a wing of the hospital specifically for those residents. Normally, some of the skilled nursing residents don’t reside in the Ewing Wing itself due to space limitations, but now, all skilled nursing residents will be stationed in the Ewing Wing.

“As far as the Ewing Wing, what we have done is transferred all of our (skilled nursing) residents that were residing on the side of the hospital that houses the acute and ER, over to the Ewing Wing section,” she said.

As of about 2 p.m. on Monday, all the residents began sheltering in place in the Ewing Wing.

“Ewing Wing staff will not be allowed to go into the main body of the hospital, nor will the Ewing Wing residents. This is to prevent possible transmission of infection from Covid-19 patients that may be admitted into the acute ward or come into the ER,” said Anderson.

Anderson said hospital officials have activated their “surge plan” in order to better handle the situation. A surge plan is a plan for a pandemic or another event or disaster. It assists hospitals in developing or updating their plans, accommodations or preparations for a “surge” of patients into the hospital.

“We’ve been trained on this for years … that we would transfer all the residents of the skilled nursing facility into the Ewing Wing and shelter in place there to minimize exposure,” said Anderson. “We’ve activated our surge plan and submitted a waiver to CDPH that allows us to increase our room size to two residents each to three residents each.”

Anderson said California Department of Public Health surveyors came to inspect the building last Friday and reviewed the surge plan with hospital officials.

“We’re very pleased with what they saw,” said Anderson. “They surveyed what we’ve done as far as moving all those people over. One said she hopes other facilities model their plan after what we’ve done.”

Naturally, some adjustments have had to be made with more residents in the Ewing Wing.

“Privacy and dignity are being maintained. We’ve put up privacy curtains as room separators. We’re still adhering to all the safety requirements put forth by CDPH,” Anderson said.

Anderson explained that, as much as possible, a regular routine is still being observed by the residents of the Ewing Wing, while still adhering to recommendations related to Covid-19.

“We are monitoring the residents twice a day for any signs and symptoms of respiratory illness. We are taking their temperature and monitoring for coughs, shortness of breath, and any respiratory distress at all. If they have any of that … they are isolated in their room,” she said. “Because we have a large population of dementia patients, they don’t understand having to stay in their rooms. We want to continue to provide as normal a routine as possible while still adhering to the infection control practices that are necessitated.”

Anderson also said all skilled nursing facility staff members are being screened for signs of illness prior to starting their shift, and are being encouraged to not go into highly public areas during their non-work hours.

“The Ewing Wing team is doing an amazing job. They have all been showing up to work ready and willing to face whatever this is head-on,” said Anderson. “There has been no hesitancy on their part to come to work, and I can’t tell you how much I appreciate that. There is a lot of fear involved. They all have families and children at home and (still come into work). I can’t tell you how much I love and appreciate them.”

Anderson also said she is appreciative of the understanding which families of skilled nursing facility residents have demonstrated during this difficult time.

“We completely appreciate their cooperation with us during this horrific time for our nation,” said Anderson.

Mariposa County Health Officer Dr. Eric Sergienko was complimentary of the JCF skilled nursing department on Monday, praising the staff for their handling of the situation.

“Staff at the Ewing Wing has been utterly conscientious. The Ewing Wing is regarded by the state as a high performing skilled nursing facility. They, as a staff and a team, want to prevent as long as possible, infection coming into that space,” said Sergienko. “They have been active in messaging to visitors and limiting visitation at this point.”

Anita Long Bothwell, the healthcare district’s home health and hospice clinical coordinator, said many of the steps which the district is taking are common sense when it comes to being cautious.

“It’s not rocket science,” she said.

She said on the hospice side, “we are reducing any non-essential visits, just to protect that population. We are still going to see patients that need visits, but anyone that is stable, we are just going to limit those visits.”

She said the district is self-screening staff “at the start and end of our shifts” and “practicing good hand hygiene as well as (encouraging) patient hygiene.”

She said caregivers are taking many precautions with home health patients as well.

“Any patient who is Covid-19 test pending or positive, we will be using personal protective equipment before we enter the house and leave, and limiting our face-to-face interaction, trying to gather as much information on the telephone as we can,” she said.

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