Hebrew Rehabilitation Center is actively responding to the COVID-19 coronavirus pandemic and its impact on how we provide care at our Boston and Dedham campuses. As always, our number one priority is protecting our patients and staff. This page is being kept updated with the newest information for the seniors we serve, their families, and their loved ones. Please be sure to review the Q&A sections for details on operations, patient care, patient and employee testing, and reopenings.
About Our Care
Hebrew Rehabilitation Center is a 675-bed long-term chronic care hospital, not a nursing home. As a hospital, people seek help here for their loved ones, usually sicker, more frail, and more compromised than patients in a traditional nursing home. We maintain an in-house, fully accredited Department of Medicine and all patients are under the care of physicians, nurse practitioners, and trained RNs and LPNs. We also have an on-site pharmacy, in-house clinical lab, and radiology services. All staff have the personal protective equipment that is clinically required, and are continually trained by our infection control team about its proper usage.
Testing for COVID-19
COVID-19 tests for Hebrew Rehabilitation Center patients are processed by our acute care hospital affiliate Beth Israel Deaconess Medical Center, with results in under 24 hours. Each Hebrew Rehabilitation Center patient has been offered a test, whether or not they showed symptoms, and many patients have been tested multiple times. Please review the Q&A at the bottom of the page for more on our testing efforts, including our employee testing policy.
Infection Control Efforts
Our population of medically compromised patients who require high touch nursing care is extremely vulnerable to COVID-19 infection and complications. Because up to 25-40% of people with the virus do not show symptoms, and seniors present with different symptoms than younger people, we continue to test asymptomatic patients. By identifying patients who are contagious before they show symptoms, the clinical team can physically separate patients with and without the virus, a key step in infection control.
At Hebrew Rehabilitation Center, this is achieved either by creating positive and negative cohorts, or by strict isolation of infected patients in their rooms, with the highest level of infection control precautions. Patient testing is paired with a process to identify and test asymptomatic staff members who had contact with newly diagnosed patients within the previous 48 hours.
New admissions are tested and quarantined for 14 days in a separate unit before they are admitted to a floor or household.
Reporting and Recovery
There have been no patient cases at Hebrew Rehabilitation Center since May 10 at our Dedham campus and May 21 at our Boston campus. Should a case occur, we will report it on this page.
Consistent with the April surge of the virus in Massachusetts, the majority of the COVID-19 infections and deaths at HRC occurred in April.
At the 455-bed HRC-Boston campus, there were a total of 167 cases, of which 53 patients died and 114 recovered.
At the 220-bed HRC-Dedham campus, there were a total of 58 cases, of which 29 patients died and 29 recovered.
We send our deepest sympathies to the families of those at Hebrew Rehabilitation Center who have passed away.
Following Massachusetts Department of Public Health guidelines, we are happy to welcome family members for limited pre-scheduled visits with their loved ones. In order to protect patients, visitors, and staff, these visits must follow strict infection control protocols. Visits are limited to one person over 18 years old at a time.
Visitors who are traveling from any state other than New York, New Jersey, Connecticut, Rhode Island, Maine, Vermont, or New Hampshire are asked to self-quarantine for 14 days prior to the visit. This follows the state’s guidance regarding self-quarantine for travelers, issued on July 1.
Also in accordance with DPH regulations, we welcome families for end of life family visits for both COVID-19 positive and negative patients. Hebrew Rehabilitation Center clinical staff will determine when these visits are warranted, and will contact the family to coordinate a scheduled time. Each visit will follow a specific protocol, including the appropriate use of PPE to minimize any risk of spread for visitors, patients, and staff. Visits will be limited to one hour in the patient’s room and to two family members who must be over the age of 18.
Since this crisis began, family members have received regular communications from HRC leadership and proactive calls from nurse managers. Staff on each floor have notified health care proxies if their loved one has been exposed to and tested for COVID-19.
Recognizing how important it is for you to have virtual visits with your loved one, we are facilitating one-on-one video chats between patients and families. We are eager to maintain the connection between families during this crisis.
We are physically screening each employee, each shift, for a fever of 100.4o Fahrenheit or higher and other signs and symptoms of illness to protect patients and fellow staff members. As part of our in-house contact tracing program we are testing asymptomatic employees who had contact with newly diagnosed patients within the previous 48 hours.
Families may drop off or have delivered packages and flowers for their loved ones. We still ask family members to refrain from delivering food.
We’ve bolstered our already strict infection prevention and control protocols with increased cleaning of high-touch areas, modification of dining services to accommodate social distancing, and cessation of group programming. Virtual programming, including religious services, is available through closed-circuit television. Our life enhancement and social work teams, among others, have increased their presence with patients in order to engage them with individualized programming, and to help alleviate feelings of social isolation and depression. Local children have been invited to mail pictures, drawings, and cards and these are being shared with patients to bring joy and community connection.
As of June 1, we are starting a phased approach to increased patient socialization in an effort to decrease social isolation. Patients who do not have COVID-19 or who have recovered from COVID-19 (per CDC guidelines) and who do not live on a floor that is experiencing active infections will be assessed for their ability to follow infection control protocols. Those who can adhere to strict guidelines will be able to go outside with a staff member. Additional phases of increased socialization will be implemented as infections decrease and recoveries continue.
Our medical, pharmacy, and food and beverage supplies are being delivered as scheduled. We have an adequate supply of the personal protective equipment (PPE) needed to follow clinical requirements issued by the Centers for Disease Control. We are actively managing our supply chain to ensure continued supply locally as PPE demand increases across the United States.
Rehabilitation services for long-term chronic care patients at HRC-Boston and HRC-Dedham, including physical and occupational therapies, have resumed. Speech-Language Pathology Services have remained open and continue operations as usual.
Circle of Fitness programming has resumed at HRC-Boston on the units, and in the 2nd and 3rd floor gyms at HRC-Dedham.
The shoe clinic remains suspended, while we review the safety and process for outside vendors to enter our health care campuses.
Select outpatient services at HRC-Boston and HRC-Dedham, including outpatient rehab therapies, have reopened for limited in-person visits and continue to offer virtual visits. Exact reopening plans may vary for individual practices and specialties.
Hebrew SeniorLife's Center for Memory Health has reopened for limited in-person visits. They continue to provide telemedicine and virtual support services to patients and families via videoconference and telephone. To learn more, please call 617-363-8600.
Adult day health and Get Up and Go remain closed at this time.
FAQs for HRC Families
We are committed to sharing updates on our campuses in as timely a manner as possible. In addition to the frequent letters to families and phone calls to families from floor managers and social workers, we maintain a dedicated COVID-19 section on our website where families can learn the latest updates.
Each floor team has established a schedule for virtual visits for all patients in their care. The goal is to ensure that each patient and family can meet at least once a week. If you have not had someone contact you about a schedule, please notify the social worker or the manager of the floor to request one.
Despite our best efforts, in this fast-paced situation there may have been an unintentional oversight and we welcome you to contact our staff to correct the oversight. Please know that these virtual conversations are not only important to you as family members but also to us as well. We are doing our best to manage these calls in and around taking care of our patients and their health needs.
Patients are accompanied outside by staff to enjoy fresh air, walks, and gardening. In addition, we have reinstated small gatherings consisting of up to six patients, who wear masks and stay six feet apart. We have found the most engaging programs that have kept patients and staff the safest are those with a nonverbal component such as movement and visual art programs.
Concerts are streamed twice weekly through the in-house TV channel, using performers who are familiar to our patients, and maintaining the entertainment schedule that has become routine to the community over the years. Technology also plays an important part in our programming. For example, we help patients and family members schedule video calls, and we offer patients iPods and iPads for music listening and viewing of musicals.
We also provide joint virtual sing-alongs and encourage patients to participate in other video programming, such as art lectures, fitness programs, and regular religious/spiritual observances and celebrations. We often incorporate patients’ artwork into broadcasted programming and are consistently asking for their feedback to encourage their choices and to ensure satisfaction.
Sick patients are quarantined in their rooms and placed on enhanced infection control precautions, following guidelines from Infection Control/CDC/DPH. Although we have full confidence we are following every best practice, we, along with every other health care organization, are fighting against a virus that is largely unknown. Our providers and nurses are working together 24/7 to identify symptoms, order testing, and then determine a plan to prevent further spread.
Patients who need feeding assistance continue to receive that support through their direct care team. Nurse and patient care associate support is provided by staff who have been redeployed to assist the front line and who have completed training. These individuals have taken on “meal mate” positions. They have been trained by a speech pathologist or other trained professionals prior to assisting with meals. Any other training needs, such as use of PPE, has been provided by our Professional Development team. Meal mate assignments are overseen by the nursing staff. Having “extra hands” has ensured that there is more 1:1 support before, during, and after meals. Meal mates become “friendly visitors” and help with providing engagement and coordinating video chats between patients and family members.
Staff are continually monitoring all patients to watch for any symptoms of COVID-19 or changes in health status. The decision to test patients is made by our on-site medical team based on the impact it will have on clinical care and infection control. Through a special relationship with our acute care hospital affiliate Beth Israel Deaconess Medical Center, all COVID-19 tests for Hebrew Rehabilitation Center patients are run at the hospital and returned in less than 24 hours.
When a COVID-19 confirmation results from the testing, Hebrew Rehabilitation Center’s infection protocols continue and in addition, we conduct in-house contact tracing to allow the clinical team to determine if other patients or employees may have been exposed. If yes, then these cases are evaluated on an individual basis to determine the need for additional testing or surveillance.
Initially, there were only a limited number of testing kits available in Massachusetts. Because we had access to very few kits, our focus was on testing symptomatic patients and other patients who may have been exposed. We now have an adequate supply of testing kits and have been able to offer tests to all symptomatic and asymptomatic patients, and continue to offer tests as the clinical team determines is necessary. Some patients have been tested multiple times.
The rate of COVID-19 infection has remained low in Massachusetts, but the threat to our community and the necessity for vigilance remains. We are conducting mandatory surveillance testing of all Hebrew Rehabilitation Center employees who are likely to have direct patient contact.
While we are not currently mandated by the Massachusetts Department of Public Health to test our long-term chronic care hospital employees, we are taking this critical step to protect both our patients and staff. Any employee who tests positive as a result of surveillance testing, including those who are asymptomatic, will be required to follow a 14-day quarantine protocol. Contact tracing will identify any additional patients and staff who may have been exposed and require testing.
Employees who have a cough, fever, sore throat, or any other symptoms are required to contact Occupational Health and may not report to work. If an employee presents at work with symptoms, they are to leave immediately and we begin back-tracing of their contacts.
Staff cannot return to work if they continue to have upper respiratory symptoms, even if they test negative for COVID-19. Our Occupational Health team follows each employee closely, managing each situation based upon the staff’s medical condition and clinical factors. Staff members whose symptoms have resolved and test negative for COVID-19 can return to work. Staff members who test positive for COVID-19 are required to stay out of work for two weeks and must be symptom-free for 72 hours before returning.
Other mitigation strategies include taking the temperature of each employee at the beginning of every shift, meticulous hand hygiene, and wearing a mask at all times.