For COVID-19 and vaccination updates, view our information for the community. If you're experiencing symptoms, call your primary care provider.

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COVID-19 Update

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November 15, 2021

Dear Residents and Families of Dunklau Gardens:

As we are well into fall now and have tasted our bit of cold and snow we hope this finds you all well and looking forward to the upcoming holidays. We wanted to get out several pieces of important information to our residents and families with the first being THE MOST important with the CMS update on Nursing Home Visitation Guidance QSP-20-39-NH revised 11/12/21. These changes during the COVID-19 public health emergency and the impact of COVID-19 vaccination in addition to the standard core principles of masking, hand hygiene and social distancing have facilitated some significant loosening of visitation controls that have been in place for nursing facilities since March 2020. While our community transmission rates remain very high and the hospitalizations and capacity challenges remain at issue, CMS has deemed that these alone will not factor into limitations on visitation in nursing facilities as they have in the past. Below we will summarize these changes for our facility effective Thursday 11.18.21.

Nursing Home Visitation Guidance:
  • Dunklau Gardens has and continues to educate current and new residents/staff on the risks and benefits of vaccination, offering to administer the vaccine and reporting all data on vaccination to the NHSN as required. Current vaccination status for our residents is 95% and staff vaccination status is much higher than the average at 88%. We also have a 97% booster vaccination rate for all eligible residents. We are proud of these rates and only strive to improve these percentages.
  • While visitation, especially with others that are unvaccinated, poses a risk and this is elevated where the county transmission level of COVID-19 is high CMS feels that that adherence to the core principles of infection prevention mitigates these concerns. Core principles continue to be masking, hand hygiene, social distancing, visitor education on signs and symptoms of COVID-19, cleaning of high touch surfaces, effective cohorting of residents based on isolation status, and effective resident/staff testing based on CMS guidance. Therefore, residents may make choices about aspects of his or her life being aware of the risks associated with visitation and the visit occurs in a manner that does not place other residents at risk.
  • The frequency of visitation, duration of the visit, or the number of visitors per resident will no longer be limited under this new guidance. Therefore, advanced scheduling will no longer be required. We will still require adherence to the core principles, which includes social distancing during peak times.
  • Screening for all visitor/staff/vendor continues to be required! This can only be ensured if visitors enter through the front entry where they can be assisted if needed, given a mask and offered the assistance that may be required. Education on the “core principles” will be immediately viewed at this location.
  • Visitor movement will be limited throughout the facility during the visitation. This means that visitors should not travel throughout the facility and onto other units, going directly to the resident’s room or designated visit location. Visitors should also adhere to social distancing of 6’ from other residents in the facility.
  • If a resident’s roommate is unvaccinated or immunocompromised (regardless of vaccination status), visits should not be conducted in the resident’s room posing an unnecessary risk to the roommate.
  • Our organizations policy is for all staff and visitors to wear surgical grade masks during entry into any of our healthcare facilities. If the resident and the visitors are all fully vaccinated and in the resident’s private room or other private location, they may “chose” to not to wear face coverings and to have physical contact. They must wear the mask again once they leave this area and are among others in the facility. Unvaccinated residents and/or visitors may choose close contact and physical touch and will be educated on the risks of potential exposure.
  • While NOT recommended, residents who are in precautions or quarantine may still receive visitors. Visits will be confined to the resident’s room and should wear a well fitted surgical grade face mask. Visitors will be made aware of the potential risk of visitation and the precautions required during visitation. Adherence to the core principles is expected by all visitors.
  • When a new case of COVID-19 has been identified, either in a staff member or a resident, the facility will continue to proceed into “outbreak” status and continue the defined outbreak testing protocol. While it is safer for visitors NOT to enter the facility during an outbreak, visitors will still be allowed in the facility. Signage will be posted at the entrance to the facility to notify all staff and visitors that the facility is currently in “outbreak status” and adherence to the “core principles” is required. Visits should ideally occur in the resident’s room unless this poses an undue risk to the roommate (as defined above).
  • The facility ALWAYS encourages all staff and visitors to get vaccinated and can provide available education and locations for any visitors to seek their vaccination. Point of Care (POC) testing, for COVID-19, may be offered to visitors on a case by case basis. Visitors are encouraged to pursue their own testing before coming to the facility.
  • Dunklau Gardens will continue to use the cohort plan (green, yellow, gray, red) to track and identify areas or residents that are in current quarantine or isolation status so that appropriate education to the visitor can occur prior to the visit and that adherence to the “core principles” is reinforced for safety.
  • Communal activities such as bingo, crafts, movies etc. may be done while adhering to the core principles for infection prevention and appropriate alterations may be warranted to accomplish this.
  • As we are doing currently, resident may leave the facility as they choose with the appropriate safety plans in place. The resident will be educated on the associated risks of being in the community and how to ensure their protection. Upon return they will assessed for the level of risk for COVID-19 exposure and the associated protocol will be followed. This may include POC testing and placement in quarantine for a known direct exposure.
  • Any resident or staff member presenting with symptoms of COVID-19 will be tested, whether they are vaccinated or unvaccinated. We will do the standard POC test (simple nasal swab) and potentially a confirmatory PCR test (nasopharyngeal swab) if necessary.
  • Visitors who have a positive test for COVID-19, symptoms of COVID-19, or currently meet the criteria for quarantine (meaning they have had a direct exposure to someone with COVID-19) and SHOULD NOT enter the facility.

As you may already know, the Methodist Health System has mandated staff vaccination, with allowable and approved medical and religious exception. Additionally, the Biden Administration has now mandated that all providers of Medicare and Medicaid services must have mandatory vaccination of staff no later than December 5, 2021. We believe our facility is in an excellent position to meet this regulation, but due to the limitations on possible exemptions that were allowed under our organizational policy we are optimistically cautious that we can achieve the 100% requirement without compromising a single staff member.


To meet the regulatory requirement, we are notifying you that the facility has identified a positive staff member. We will complete contact tracing to identify any other potential exposures. We do not anticipate any isolation as long as all infection control parameters were followed consistently, such as masking. We will follow the testing protocols for two times a week testing for those at risk of exposure until we are deemed clear of positives after 14 days.

Dunklau Den

The “Dunklau Den” is nearing its completion. We continue to have supply chain challenges as is everyone and we continue to wait for some electronic equipment and gaming pieces to finish off the space. The signage has been hung outside the door to the space and we will be hanging some movie posters and décor to make the space homey. We look forward to scheduling the open house when everyone can enjoy the space! Looking forward to enjoying a great movie in the recliner or a competitive shuffleboard game. We really want to thank the Methodist Fremont Health Foundation and its associated donors to this awesome project for our residents.

Enclosed you will find some additional informational pieces on our contracted provider for audiology, dental, vision and podiatry, 360 services. Please read through the material and we look forward to speak with each resident about these services as a benefit to you and they are available to Medicaid recipients as well as no additional expense to the recipient. More information on these services and how to sign up to receive whichever services might be best for you will be forthcoming. Please contact your social worker at Dunklau Gardens should you wish for more information.

Let’s see 2021 wind down these next few months with much lower prevalence of COVID-19. Thank you again for your ongoing support and compliance with the many regulations and changes along the way. We are blessed to have had very limited impact in the past few months and hope to keep it that way. Please feel free to contact us if you have any questions. Have a Blessed Thanksgiving, there is ALWAYS something to be thankful for.

If you have any questions, please do not hesitate to contact us.

Jayma Brown, BSN, MSHA
Director of Nursing, Dunklau Gardens

Rachel Reiman, PT, MSHA, LNA
Administrator, Dunklau Gardens