COVID-19 Resources

Here you will find the latest information on COVID-19 vaccines and how they impact long-term care. We are committed to educating residents, employees, and the public about the importance of vaccines in limiting the further spread of this deadly virus. Resources from the Society for Post-Acute and Long-Term Care Medicine (AMDA) and the Centers for Disease Control & Prevention (CDC) were used in creating this page.

Why Were Long-Term Care Residents & Staff Being Made First Priority for COVID-19 Vaccines?

• The average age of residents in long-term care facilities is over 80 years old. Most individuals have underlying health conditions, and some have multiple chronic conditions. According to CDC data, the risk of mortality from COVID-19 in this age group is 630 times higher than those 18-29 years old.

Are COVID-19 Vaccines Being Mandated?

• Since vaccines were authorized under an emergency use authorization (EUA), they cannot be mandated by the federal government. However, the EUA does not expressly prohibit an employer, state, or locality from requiring vaccination.
• At this time, our company does NOT have plans to mandate the vaccine for residents or employees, but we will continue to follow any changing state or federal guidance on this issue.
• We ABSOLUTELY encourage and recommend that eligible residents and employees receive the vaccine as it is made available.

Is Our Facility Receiving Vaccines from Pfizer, Moderna or Johnson & Johnson?

• Our facility received COVID-19 mRNA vaccines from Moderna for initial vaccination clinics in late 2020/early 2021.
• As we host and schedule vaccine maintenance clinics, we will likely receive vaccines from all three distributors.

What is an mRNA Vaccine?

• To trigger an immune response, many vaccines put a weakened or inactivated germ into our bodies. Not mRNA vaccines! Instead, these vaccines teach our cells how to make a protein—or even just a piece of a protein—that triggers an immune response inside our bodies. That immune response, which produces antibodies, is what protects us from getting infected if the real virus enters our bodies.
• mRNA technology is new in vaccine production but has been used and studied in cancer treatment for more than 10 years. It has played a key role in the advancement of cancer research.
• Moderna & Pfizer are mRNA vaccines.

Are COVID-19 Vaccines Safe?

• YES! Safety was the most important priority in vaccine approval. The Food and Drug Administration (FDA) used the same strict standards it has for decades to ensure vaccines were thoroughly and rigorously evaluated. No steps were “skipped”.
• Two independent advisory committees reviewed the results of clinical trials. Members and experts of these committees had no conflict of interest and were not associated with any vaccine manufacturers.
• The Vaccine and Related Biological Products Advisory Committee (VRBPAC) advised the FDA.
• The Advisory Committee on Immunization Practices (ACIP) advised the CDC.
• To assess safety, the FDA typically advises that a minimum of 3,000 participants be included in a clinical trial. COVID-19 vaccine trials included 30,000 to 50,000 participants.

Are COVID-19 Vaccines Effective?

• YES! Pfizer has reported a 95% overall efficacy, Moderna has reported a 94.1% efficacy. Johnson & Johnson's efficacy has been reported around 74-78% in the United States.
• "Efficacy" is defined as the ability to produce a desired or intended result.
• Similar efficacy was found across different race, ethnicity, and age.

What Should Be Expected?

• Pfizer vaccines come in TWO doses, 3 weeks apart. Moderna vaccines come in TWO doses, 4 weeks apart. Johnson & Johnson is a single dose vaccine.
• BOTH doses are necessary for the Pfizer and Moderna vaccines. It is important to get the SAME VACCINE as the initial dose, be it Pfizer or Moderna.
• Short-term discomfort – fatigue, headache, muscle pain, chills, fever, and pain at injection site – is possible.
• Side effects mean a body is doing its job and making antibodies. THAT IS A GOOD THING!
• Side effects are normal, common, and expected.
• Most side effects occur within 6 weeks of vaccination. Out of the utmost cautious and to ensure the most thorough and comprehensive review, FDA requires 8 weeks of safety monitoring of the COVID-19 vaccines.
• THE VACCINE CANNOT GIVE YOU COVID-19!

When and For How Long Will Vaccines Provide Protection?

• Full protection occurs 1-2 weeks after the second dose of Moderna & Pfizer vaccines and 1-2 weeks after the first dose of the Johnson & Johnson vaccine.
• How long the J&J and Moderna vaccines will protect against COVID-19 is currently unknown. Research suggests the Pfizer vaccine will offer protection for 6 months, but studies are ongoing.
• Overall, more research is needed to determine how long vaccines will protect against COVID-19. It’s possible, but not certain, that a booster may be needed in the future.

It is safe to get vaccinated if you have previously had COVID-19?

• YES! Even if you have previously had COVID-19, it is important to get vaccinated. It could provide longer or better protection against the disease.
• Even if you have positive antibodies, the COVID-19 vaccine is still recommended.

Where Should I Look for Accurate Information on COVID-19 Vaccines?

• It is important to seek information from reliable sources. Social media is full of misinformation and opinions based on that misinformation.
• Here are some helpful links:
• CDC
• FDA
• Centers for Medicare & Medicaid Services (CMS)
  • Pfizer
  • Moderna
  • Johnson & Johnson
• State and local health department websites are also great resources for locality-specific COVID-19 vaccine information.

Tips for a Meaningful Visit

Visitation can be conducted through different means based on the facility structure and resident needs including dedicated visitation areas, outdoor visitation areas, window visits and compassionate care visits. We will communicate any changes to our visitation status on this website and to immediate family members via phone or email.

We ask that residents limit their visits to one per day whenever possible out of consideration for other residents and limited scheduling opportunities.

Criteria for Visitation According to CMS

• The resident receiving a prospective visitor is not on isolation precautions.
• The local health department has not prohibited visitation at the facility.

Additional Criteria for Indoor Visitation According to CMS

• Visitation will occur, when possible, but will be limited in the following circumstances due to the high risk of COVID-19 transmission (PLEASE NOTE: compassionate care visits will still be permitted).
• The resident is unvaccinated and CMS COVID-19 county positivity rate is > 10% (High) and < 70 % of residents in the facility are fully vaccinated.
• Fully vaccinated refers to a person who is more than two weeks removed from receipt of the second vaccine in a two-dose series (Pfizer or Moderna), or more than two weeks removed following receipt of a single-dose vaccine (Johnson & Johnson), per the CDC’s Public Health Recommendations for Vaccinated Persons.
• Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated, until they no longer require transmission based precautions.
• Residents in quarantine, whether vaccinated or unvaccinated, until they have met the criteria for release from quarantine.

Indoor Visitation During an Outbreak

• When a new case of COVID-19 among residents or staff is identified, the facility will start outbreak testing and suspend all visitation (except for those required under federal disability rights law), until at least one round of facility-wide testing is completed. Visitation can resume based on the following criteria:
• If the first round of outbreak testing reveals no additional COVID-19 cases in other areas (e.g. units) of the facility, then visitation can resume for residents in areas/units with no COVID-19 cases. However, the facility will suspend visitation on the affected unit until they meet the criteria for discontinuation of outbreak testing.
• If the first round of outbreak testing reveals one or more additional COVID-19 cases in other areas/units of the facility (e.g. new cases in two or more units total), then the facility will suspend visitation for all residents, both vaccinated and unvaccinated, until the facility meets the criteria to discontinue outbreak testing.

VISITORS - What to Know Prior to Arriving

• Visitors are encouraged to contact our facility to schedule an appointment.
• Those who show up unannounced may have to wait for other visits to be completed.
• A prospective visitor is strongly encouraged to provide proof of a negative COVID-19 test before proceeding with a visit.
• If the test is completed at the facility, an additional 15-20 minutes is necessary prior to visitation to provide time for the result to be obtained. This negative test result can be provided by the prospective visitor from a test taken within 72 hours prior to visiting the facility or;
• A test is available and can be administered upon arrival at the facility.
• Visitation will not be prohibited for those who refuse to provide or participate in testing. It is our hope visitors will understand the reasons we encourage testing – for the continued health and safety of, and out of caution and respect for, our residents.
• Visitors are strongly encouraged to share their vaccination status with our facility.
• A maximum of TWO visitors per resident will be permitted for visits.
• Visitors must be 13 years or older.
• Visitors must be willing and able to:
• Wear a face covering for the duration of their visit.
• Follow hand hygiene requirements.

VISITORS - What You Should Know Upon Arrival

• Visitors should arrive 15 minutes prior to a scheduled visit.
• As mentioned above, if a COVID test is completed at the facility, an additional 15-20 minutes is necessary prior to visitation to provide time for the result to be obtained.
• Visitors will be screened for temperature and signs and symptoms of COVID-19.
• If a visitor has a temperature at or above 100 degrees and exhibits any symptoms of the virus, he or she will not be permitted to enter the facility.
• Visitors must provide legal federal or state identification upon screening. A telephone number will also be required.
• Visitors must complete required education and attestation prior to their initial visit.

VISITORS - What to Expect During Your Visit

• Visitors and residents are required to wear a surgical mask. The facility will provide visitors with a new surgical mask upon arrival.
• Visitors are asked to use alcohol-based hand rub before and after visitation, and any time during the visit as deemed necessary.
• Visitors must enter and exit through a specified area of the facility and follow a designated route to and from the visitation area.
• Visitors should stay in their designated visitation area.
• All visitors must maintain social distance from other residents, visitors, and facility staff.
• Poor behavior by visitors and disregard for state or Federal orders is NOT ACCEPTABLE.
• Failure to adhere will result in termination of the visit.
• Restroom access will be restricted unless an emergency arises.
• This policy is in place to ease the burden on our facility’s housekeeping staff.
• Food and drink may be brought to a visit but should not be shared.
• Smoking is NOT permitted during a visit.
• To ensure smooth and timely functioning of the visitation process, please do not engage facility staff with your concerns during your visit. If you have questions about the established guidelines or protocols, please complete your visit and address these concerns in an email or telephone call to the facility administration following your visit.
• PLEASE NOTE: A resident has the right to refuse to receive visitors and the facility staff must honor those wishes. If this occurs, facility staff will attempt to connect the resident with their visitors by offering a window visit, or a live video/phone call.

REMEMBER, this is a stressful time! Everyone is doing their best to manage. Please be mindful of our residents, associates and other visitors to the building. Thank you for your cooperation and understanding.

How has Ciena worked to stop the potential spread of COVID-19?

• Our facility has been implementing and acting on guidance from external agencies such as the Centers for Disease Control and Prevention (CDC), Centers for Medicare and Medicaid Services (CMS), and the Department of Health and Human Services at the state and local level since February 28, 2020.
• We have restricted visitors from entering our facility since the national advisement in mid-March, ceased group activities within the building, and have continually monitored residents and screened staff members and essential external personnel for symptoms according to CDC guidance.
• We are continually monitoring ALL residents for CDC-recognized symptoms and changes in conditions.

What happens if a resident tests positive for COVID-19?

• Residents who have tested positive receive supportive care in an appropriate care setting per CDC guidance. If additional treatment for a resident is required, we will transfer to the local hospital and communicate with loved ones accordingly.

Will the facility update me on the status of my loved one during visitation restrictions?

• If you have a loved one who has tested positive, we will communicate with you regularly and keep you apprised of any changes to his or her health. You are also welcome to call or email the facility at any time.
• If you have a loved one who has NOT tested positive, we will contact you if he or she is suspected or diagnosed with COVID-19.

How can I stay in contact with my loved one during visitation restrictions?

• You can send non-urgent messages – photos, updates, letters – to connecttocienahealthcare@cienafacilities.com. A member of our staff checks this email daily and will relay your message to your loved one.
• We also encourage you to contact our facility to set up FaceTime, Zoom and Skype sessions with your loved one.

Why hasn't the facility tested my loved one for COVID-19?

• The attending physician, in conjunction with the county health department, is given ultimate decision authority by CDC and makes the decision on who and who not to test. It is not a decision made by administrative staff at the facility.
• It is important that we share our belief that skilled nursing facilities should be a higher priority for testing; that is, "universal testing" of both residents and staff to truly know the extent of COVID-19 in our community and throughout the state. Testing only those who are symptomatic, as we understand now, is not enough as many people who have the virus can spread it without showing symptoms (asymptomatic).

Does Ciena have PPE?

• You probably have heard about PPE shortages in the news. PPE stands for Personal Protective Equipment. Early on, PPE was in drastic shortages. We have been fortunate that our company has been able to secure PPE, though we have had to wait for what has seemed like a very long time to receive our supplies. With conservative practices in place as identified by CDC, we have PPE. Of course, it never feels like enough, but we have what we need today.
• That being said, we are in support of the goal to make skilled nursing facilities a higher priority for PPE. In lieu of PPE, items like homemade masks, aprons, lab coats, open-back gowns, coveralls, and ponchos – to name a few – can be used as alternatives to provide some level of protection, with CDC guidance and recommendations. We continue to accept donations of these items in the event future PPE shortages arise.

Why are skilled nursing facilities like Ciena continually in the news?

• Unfortunately, much of what you hear about skilled nursing facilities (or "nursing homes") in the media today is negative. By and large, news outlets are not familiar with our health care setting or the services we provide, and it is reflected in how they report and cover our facilities. Rest assured, our team is full of caring and compassionate individuals who are working day and night to care for our residents and that is our priority.
• We encourage you to follow us on Facebook to see the many positive things happening in our facilities that often go unreported. Our employees remain committed to "exceeding expectations" even in an unprecedented time like this. Please feel free to leave a positive comment of encouragement or even share the positive vibes.

How can I stay informed of what is happening at the facility?

• Please be sure your contact information, including email address, is current. If you need to make changes or confirm your information, please call the facility.
• Periodically visit the facility website to see if there has been new information posted.
• Watch for opportunities to attend virtual gatherings, such as care plan meetings, family council meetings or other activities, some of which may be held by platforms such as Zoom.
• Schedule a window visit or virtual visit with your loved one. Our staff will be happy to assist you.

Last updated: May 28, 2020

Additional Resources

American Health Care Association COVID-19 Page

Center for Disease Control & Prevention COVID-19 Information

Centers for Medicare & Medicaid COVID-19 Page

Department of Health and Human Services COVID-19 Page

June 15 MDHHS Emergency Order on Skilled Nursing Facility Testing

Just The Facts: What Caused COVID-19 Outbreak in Nursing Homes?

New York Times COVID-19 Tracker

Health Care Association of Michigan COVID-19 Page

Michigan Department of Health and Human Services COVID-19 Page