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Update 4/16:

The last several weeks have been trying times for everyone; residents, their family members and nursing facility/healthcare providers. There has been a lot of of news about some nursing facilities having significant challenges with COVID-19 and in some cases- based on news reports, what appear to be some tragic situations.

First and foremost, it is important to acknowledge and validate the anxiety, fears and sadness that many loved ones feel about the entire situation. The affect of restricted visitation, news reports and other factors are adding to an already very stressful situation.

Specific to Andrus on Hudson, there has been a significant effort to communicate timely news, information, updates. etc in a manner in the interests of being open but also taking into account privacy laws and protected health information.

While we are confident our approach has been comprehensive, by no means does that mean we haven't had shortcomings--to say otherwise would be disingenuous.

With the absence of physical contact/visitation, we have been working hard to keep AOHConnect (our facetime/skype program) as accessible and available as possible but there have been times of major bottlenecks when demand is high. We are continually working on this and while we are still not where we would like to be, we are making improvements to this system. We apologize for this shortcoming.

During high demand periods, we have had multiple issues of routing phone calls to various units for family members to speak with managers to check on their loved ones-- this has been a problem because of the clinical demands of the managers on the floors and allotting enough time to ensure these communications take place as much as reasonably possible. Our managers are doing an exceptional job (as is our entire team)- we are working on different options to make significant improvements on this issue within the next several days.

A general status update:

* All residents are remaining in their rooms- there are times when a resident may need direct supervision from nursing and may not be able to remain in their room for extended periods reasons-- when this occurs, we are utilizing social distancing.

* Andrus on Hudson has all private rooms, we do not have have semi-private rooming situations which could potentially place residents at higher risk of contracting a communicable illness such as COVID19

* AOH has a general approach of placing any resident that is experiencing any symptoms of a respiratory illness (including CVD19) on a COVID protocol with enhanced monitoring and clinical interventions as needed. Because testing is not available to us, we have to operate out of an abundance of caution.

* We have had residents that have tested positive for CVD19 as they were tested at a hospital (while they were at hospital for related or unrelated needs)

* We are maintaining a strict policy of employees remaining out of work if they are sick and/or CVD+ As with many health care providers, we have experienced at times considerable staffing challenges and we are working every day to maintain staffing levels and supplement staffing when needed

At this time we do not have an anticipated date when the state mandated restriction will be removed-- of course we all hope that day comes soon and we understand the hardship this has caused loved ones and residents.

Summary of Response:

To date, Andrus on Hudson has worked on and implemented a multitude of infection prevention and control counter-measures. Some of the measures may have limited value but because there is no "silver bullet" however the strategy is to: Prevent, Contain and Target any potential spread of the virus from as many directions and in as many ways as possible, including (but not limited to):

* Communication with the New York Department of Health

* A CVD19 Task Force was established in early March which meets on generally every weekday morning to ensure a flow of communication, organizational alignment on CVD19 related initiatives occurs, discussing openly and candidly any concerns, process improvement needs and resource availability bottlenecks

* All persons entering the building must have their temperature taken and are asked several screening questions

* There are multiple programs in effect to better ensure any staff that have respiratory infection signs or symptoms or related CVD19 symptoms, stay home

* Actively monitoring and ensuring adequate stocks of protective equipment are available and utilized

* All staff members have been issued N95 and face masks and medical protective glasses and are using them to "reverse isolate"

* Full face shields have been issued

* Enhanced infection control cleaning frequency and resources through an outside commercial/healthcare cleaning vendor to supplement internal infection control cleaning

* Activated Contingency Plans to manufacture/assemble "in-house" protective equipment and sanitizing chemicals to serve as backup "safety stock" in the event the materials/PPE cannot be obtained through vendor supply sources

* Regular and consistent dialogue and updates including regular town hall meetings with staff/clinical care staff to ensure new protocols, guidelines, etc. are being communicated-- and for staff to directly and openly ask questions, share concerns, ideas or any other need directly with the senior management of AOH

* Residents are generally not going to non-critical medical appointments to reduce the risk of contracting illness at an outside office, etc.

* Placement of H13 HEPA (Medical Grade) Air Purifier Systems throughout the building as a measure to potentially capture aerosolized viral particles

* Pilot of an in-house generated program for the placement of copper/alloy on some high touch areas as Copper has been shown to potentially kill the virus on its surface faster than plastic, wood and other materials

*AOH is providing restaurant prepared free breakfast and lunch to all employees, everyday to thank them for their exceptional work, every single day

Andrus on Hudson's team of professionals across many departments are working every day to serve and care for its residents, provide support to loved ones -- and combating CVD19 "an invisible enemy" with as many resources as possible to keep everyone as safe as possible. We will never let up on this fight.

We appreciate your support and understanding as we work through one of the most difficult and prolonged situations that we have ever faced.

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