July 10 Employee Huddle

July 10, 2020

Please Note: Time did not allow us to answer every submitted question, so we will get to unanswered questions at next week's KD Huddle. Submit a question now for next week by e-mailing dvolosin@kaweahhealth.org.

Questions and Answer from the July 10 Employee Huddle

• Question #1: Why aren’t staff informed of patient’s positive status if they cared for them wearing only a surgical mask prior to their known positive result?
  • The surgical mask provides good protection, the N95 is just another layer of protection, but we do have a shortage of N95s, so we are following the CDC recommendation to use the surgical masks, which we have an adequate supply of.
  • We have implemented adding face shields to the standard precautions to protect the eyes of our team members.
• Question #2: Is it safe or necessary to wear a surgical mask under a cloth mask, out in public?
  • No, it is not. Your best protection is a surgical mask. Layering masks actually might cause breaches in the bottom layer mask, causing the seal to break or gap. A cloth mask will protect you around others wearing cloth masks, but if you have access to a surgical mask, use it.
• Question #3: If an inpatient is being transported to an outpatient facility and has tested positive, should the employee with them wear a face shield?
  • If you have close contact with any patient of any kind, you should be wearing a face shield. Regardless of their COVID status, you would wear a face shield if you are within 6 feet for more than 15 minutes.
• Question #4: It has been reported that there is little to no routine cleaning of high touch surfaces and shared equipment (vital sign machines, etc). Is there a way to increase the amount of QT 3 spray per unit?
  • Yes. If you feel that your areas is not clean – please report it. Every area needs increased cleaning. Take ownership and help out where you can in all of our areas. Call EVS at x2244 for more cleaning spray if you need it. They will bring you another bottle. You can have more bottles as needed for patient care areas of high-touch, high traffic. The bottles are refillable so please do not throw them away.
• Question #5: Has KD considered testing all employees for COVID?
  • In a perfect world we would test everyone every 2 weeks, but, we do not have the resources as testing kits are in short supply. Our record high specimen collection has put a big strain on our capacity to do more testing.
• Question #6: I’ve heard from a couple of returning staff that they are returning to work after being COVID positive with having no negative test. How safe is this?
  • We are using the symptom-based recovery strategy recommended by the CDC which allows employees to return to work after 14 days from onset of symptoms if symptom-free for 72 hours without any meds/fever reducers, etc. There is a lot of clinical knowledge that deems this appropriate and safe.
• Question #7: How do you know if someone is no longer contagious?
  • The science of it tells us that once symptoms are gone, the time of contagiousness has passed. Exposure, virus growth, contagious period – all start BEFORE symptoms.
• Question #8: Do you know if someone can get COVID twice?
  • We don’t know at this point. The science tells us if you build up antibodies, you won’t get sick again. But the antibodies aren’t staying so we don’t yet know if you couldn’t get it twice as a result of fleeting antibodies.This virus is new and we know very little about it. We know it leaves behind dead virus cells when you recover – no longer contagious – but on BD Max you will still test positive. Potentially, if we waited for a negative test result, it could take months to release employees back to work. There are many variables still being explored (immune system response, blood types, how antibodies are developing, etc).
• Question #9: Since this is a new surge, and not specific to SNF, is there a new age range?
  • Two-thirds of positive results are now in those younger than the age of 40. The vast majority of those now testing and testing positive are younger. The more at-risk populations are still being cautious (not out in the community, wearing masks, etc). But young people are still getting very sick and are being hospitalized.
• Question #10: With the employee temperature screenings starting next week for the inpatient nursing units and then rolling out to other departments at a later time, can you explain in detail what that process looks like?
  • a. What happens if they have a temp or symptoms?
    • Call your manger and employee health – they will assess and advise you on next steps. They will explore further. The screener is not responsible to send you home. The employee will need to contact their manager.
  • b. How is supervisor or manager notified?
    • The employee needs to call in just as if you were calling in for a shift.
  • c. How do supervisors and managers enter that time?
    • Code it as PTO ( it won’t count as occurrence). Negative test – just an absence, will be PTO. If the employee is Covid positive, it will get changed in the system by the LOA team – coded as EIB or State Disability.
    • There are three phases to this screening roll-out. We will being screening in patient care areas, then employee areas that go onto the floors, and last will be those that do not go to patient care areas.
• Question #11: If you test positive, can you work from home and not use PTO, EIB, etc.
  • No, we need you to stay home and take care of yourself when you are sick. We don’t want you working while you are ill and under quarantine.
• Question #12: Will the data be shared on the number of tests being conducted?
  • Yes, we will work with data team to get that data back onto the daily snapshot to share with the community. We are optimizing that snapshot to share the most important data and make it easy to understand
• Question #13: With the large increase in COVID in our county, are there allowances being made to work from home again or at least part time at home?
  • There is no ‘one size fits all’ for telecommuting based on the department and service, so we’re leaving it to each Vice President and Director to review what’s appropriate for remote or on-site work. Currently, we do have employees still working remotely where spacing is not available. In other areas, employees worked remotely only for a short period of time and migrated back from April to today. Working remotely is effective for some roles and we learned it wasn’t for others as time has gone on. Please connect with your Directors for individual questions.
  • Going back to March, our leadership teams made the decision, to limit exposure (due to believe virus was airborne), each VP and director was given discretion to determine who could telecommute in their role. We had close to 300 employees telecommuting for a period of time. From April on, some have come back and some have remained at home. Things looked very positive in May, and we planned to bring people back as of July 6th, with safety precautions in place. The surge came in June and we have paused on bringing everyone back and we continue to support those still telecommuting. It is still at the discretion of the VP and director for each department. We want to create a safe environment and limit exposure where possible.
• Question #14: If schools do not open in the fall will employees be able to telecommute?
  • There has not been an announcement from the schools yet, to my knowledge. If schools don’t reopen, this will impact our M-F employees greater than our 12-hour shift staff (who work 3 days a week). We may be able to work around these (and may finally have full staffing on weekends). A few departments are evaluating the possibility of flexible shifts, such as 12’s where employees are currently working 8’s. The effectiveness of telecommuting with children at home is a question we have to consider.
• Question #15: In regards to the upcoming changes in employee benefits, can we get an estimate of how many hours may possibly be needed to keep our part-time and full-time benefits?
  • We are going to do our best to maintain 48 hours a pay period for eligibility for employee benefits, but it may mean more cost or some plan design changes. At the outside, the eligibility would be 60 hours. We have much to work through in the next couple of months before we’ll have decisions finalized. We want to try to make changes to the plans that are transparent to employees, such as renegotiating contracts behind the scenes. Changes that impact employees will be effective January 1, 2021.
  • We rely heavily on part time employees in our workforce and are exploring as many options as possible. Higher deductible plans? Lower coverage plans? We are doing everything we can to minimize the impact on our employees.
• Question #16: When COVID-19 first hit, the PTO bank was temporarily extended to 500 hours to accommodate those that were close to capping out, and unable to take PTO. However, there are many that are still unable to take PTO, and will not be able to take advantage of the PTO payout for next year. Is there a plan to increase the PTO limit until the payout is brought back?
  • Most likely the cap will be extended again and will be under executive review in the next couple of weeks. We don’t want people to lose their PTO, but we certainly encourage you to take some time off, get some rest, and utilize those hours.
• Question #18: If an employee has reached their 5-year mark will anything be matched at this point?
  • a. If you hit the 5 year mark you are vested and you own the contributions to the plan. For 1/1/20 – 12/31/20, none of that will be matched for the 2020 year although you still own and continue to make tax exempt contributions to your plan and that is a huge benefit for your retirement. We always reserve the right to make changes to these decisions. Depending on FEMA claims and other factors, things may change (we may operate in the positive instead of at our 0% margin as planned). We are writing a plan amendment to include an allowance for the change to be made.
  • b. The Match for 2019 calendar year is coming in July (typically 6 months after the plan year). The $9 million match is being made for the full 2019 calendar year. The no-match decision affects the 2020 calendar year.
• Question #18: The 6% match benefit helps KD retain highly qualified staff. Will the match freeze impact our ability to retain staff?
  • Our objective is to retain as many jobs as possible. All options were reviewed and this was the best way to not have to cut additional jobs and wages.
• Question #19: Is there anything employees can do to bring awareness for Fed COVID relief programs not making up for lost revenue?
  • Kaweah Health receives a fixed amount per patient depending on their condition. There is a fixed payment for diagnosis that need a respiratory system. COVID is a respiratory virus. Medicare has bumped up the normal rate for a respiratory syndrome patient by an additional 20%. That 20% was put in place because of the belief that COVID patients will stay longer, assume more resources, staff will need more personal protective equipment, providing different drugs, etc. The cost of care for the patient went up for us more than that 20% reimbursement rate. I can assure you that hospitals are not making profit off taking care of COVID patients. We lost $28 million in just three months.
• Question #20: Will the Hospital Foundation be doing any fundraisers to target supplies and equipment needs of the hospital in general?
  • The Foundation is always fundraising and they exist solely to raise money for KD. It is an incredible organization that has raised over $50 million for the hospital and it’s services and facilities. The next campaign is Hope in Motion which will be used to purchase a Safe Gait System for our rehab patients and staff. Our current campaign also offers the option for staff to donate to the We Give Stronger Together fund which offers staff the opportunity to submit grant requests for equipment.
• Question #21: Is the Golf Classic going to take place as originally planned? Are those potential funds already targeted for a specific area?
  • Yes, the Golf Classic is going to take place as originally planned. We are working closely with the Country Club to take extra precautions for social distancing and safety. We have limited space for golfers, individual golf carts, pre-wrapped food and snacks, etc. The funds from the Golf Classic are going to the COVID relief fund. It will assist in providing financial support for hospital services, medical equipment, and technology.

Please share all school information with HR. Email questions to dvolosin@kaweahhealth.org