Resident Families

_______________________________________________

POLICY FOR VISITORS/GUESTS DINING WITH A RESIDENT

Created: 3/7/24

The Buffalo Lake Health Care Center welcomes visitors/guests to come and dine with their family member or loved one. The following guidelines should be followed:

Guidelines:

The facility will not limit the number of visitors a resident may have, but the facility may limit the number of meals they can prepare for visitors related to time, space, and staffing in the dietary department.
Visitors should call the facility (320-833-5364) and ask for medical records or notify the kitchen to reserve a meal 2 hours before serving time on days that are not holidays.
For Holiday’s we ask visitors/guests to inform the facility of their intention to dine with a resident 2 weeks ahead of time. This is to allow the facility time to plan for availability of dining space and have adequate supply available. Holiday dining is limited to 3 guests per resident when food is being provided by BLHCC kitchen.
Visitors can dine in the resident’s room if they choose, or reservations can be made with Medical Records for specific open area of the building on a first come first serve basis.
Visitors are encouraged to bring their own food for the meal to eat with their loved one.
The facility can provide coffee, cups, glasses, utensils, plates, etc. You will need to request these items as needed.
The facility will serve ordered meals at the scheduled time for that meal.
Visitors will need to pay $8.00 per meal, this should be paid to the kitchen staff the day of or before.

New price for meals starting March 15, 2024 will be $8.00 for any guest meals.

** There is no meal charge for a spouse of a resident

___________________________________________________________________

Residents, Staff, Families and Friends,

We have completed all rounds of COVID-19 outbreak testing with no additional cases found. However, mask are still required in our building due to the county transmission rate of COVID_19 and other respiratory illnesses.

We want to welcome you in for visiting and fun especially during this holiday season but first we must remind you of the infection control protocols we have in place.

When you arrive at the facility signs will tell you If we are in outbreak status and if masks are required.

Currently:

DO NOT VISIT if you have ANY symptoms of illness.
Masks are required for everyone AT ALL TIMES.
If you are eating/drinking with your loved one you may remove your mask to eat/drink but DO NOT visit if you have any signs of illness.
When visiting your loved one, try to avoid other residents and give ample space between your group and others.
Visits in the resident rooms are the safest. Communal dining and activities are allowed; wear your mask at all times and keep your distance between yourself and others.
If you have not yet received your COVID-19, flu or other recommended vaccines – do so ASAP. Vaccines continue to be one of the most effective ways to avoid severe symptoms or death from various illnesses. If you need assistance for where to go to receive your vaccines, reach out to Kendra Hiles, DON.

Holiday Party Sat. Dec. 16^th – Practice Good Infection Control

DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days!

Indoor visiting increases the possibility of spreading illness to others – wear your mask and stay within your own family or table group, keeping a safe distance apart from other groups.
Wear your mask at all times when you are not eating or drinking.
Sanitize your hands upon entering the building and before and after eating/drinking or assisting your loved one.

We are very fortunate to be able to welcome you into our facility during the holiday season. We know how important it is for everyone to see their loved ones. We also know that illness can be devastating to those we care for, please follow all the guidelines listed above.

Have a blessed Christmas and a Happy New Year to all!

Mark Rust Kendra Hiles

Administrator Director of Nursing

_____________________________________________________________

Reminder: Please don’t forget to RSVP for

December 16th Santa’s Workshop Christmas Party

atotenhagen@blhcc.org or 833-5364 ext. 36

Please include your loved ones name and number of guests, thank you!

**************

We are doing resident/staff holiday dress up days!

BLHCC Staff and Resident Dress Up Days

Monday

18^th

Tuesday

19^th

Wednesday

20^th

Thursday

21^st

Friday

22^nd

Candy Cane Day

Wear RED and WHITE

Make Tuesday Bright

Wear anything that LIGHTS UP, SHINES, SPARKLE

Jingle Bells Rocks

Wear Bells

Merry Pajama Day

Wear Christmas PJ’s!

Mad About Plaid

Wear FLANNEL

_______________________________________________________________________

10/25/2023

Dear Family Member,

For Veteran’s Day, we would like a copy of a photo of your loved one in his/her military uniform to use during our Veteran’s Day program. We are also honoring veteran’s widow, if your loved is a veteran’s widow we would like a photo of their husband/wife in their military uniform as well. If you brought a photo last year, this year we promise to make a copy, so we don’t have to ask again! Please bring, e-mail, or mail a photo to;

Buffalo Lake Healthcare Center 
703 West Yellowstone Trail 
Buffalo Lake, MN 55314 
Attn. Activity Department

E-mail to:

atotenahgen@blhcc.org

We would like to have all photos by Wednesday November 8^th.

Thank You,

Analyn Totenhagen, BLHCC Activity Director

______________________________________________________________________

May 17th, 2023 Residents, Staff, Families and Friends, The Center for Disease Control (CDC) and the Minnesota Dept of Health (MDH) released new guidance on May 11th, the end of the public health emergency. The new information allows facilities to make changes to COVID-19 protocols yet remain conscientious of infection control practices that work to keep everyone safe. The lessons we learned through COVID-19 will be carried forward in a way that encompasses resident rights with safety as our number one goal. Updated Guidelines

Do NOT enter the facility if you have COVID-19 or any other respiratory illness, if you’ve been exposed in the last 10 days to someone who is ill with a respiratory illness (COVID-19 or influenza) or if you have symptoms related to a respiratory illness.
Sanitize your hands upon entering the facility and at each loved one’s room.
Wear a surgical mask and visit only in resident rooms if our facility is in outbreak. (Designated by signs at the entrances)
The facility will monitor the risks of respiratory illness within our community and make changes to infection control requirements as the need arises.
Visiting is allowed in locations where residents are comfortable, resident rooms, outside, or in common areas. If a resident is not comfortable with the location, amount of visitors or any other factor their wishes to leave the visit must be respected. You may eat/visit your loved ones during meals and activities if it does not cause your loved one or any other resident discomfort.
COVID-19 and influenza vaccination for staff, volunteers and resident’s must be tracked. There is no longer a vaccination requirement to work in healthcare.
Vaccination education and vaccine administration will continue to be apart of our infection control mitigation efforts.
New admissions will be tested for COVID-19 upon admission. All residents/staff that present with symptoms associated to COVID-19 will be tested immediately and quarantine procedures will be implemented as needed for the length of time designated by the CDC.
COVID-19 outbreak testing will be initiated as needed when an outbreak is identified.
The facility will send out notifications to families, staff, and residents if significant changes are made to protocols or expectations.

We expect additional changes in CDC and MDH guidance as the recovery from the COVID-19 emergency continues. If you need additional resources or have questions about any of the information in today’s letter, please give us a call. 320-833-5364 Mark Rust Kendra Hiles Administrator Director of Nursing ______________________________________________________ Residents, Staff, Families and Friends, We have completed all rounds of COVID-19 outbreak testing with no additional cases found. This means BLHCC is no longer in outbreak status. Our county transmission rate is also low, which means our facility can finally take advantage of changes in masking guidance! YEAH!!! When you walk into the building, you will see signs that will let you know whether masks are required or optional. The parameters may change daily or even hour to hour. Here’s how we decide when masks are required and when they are optional:

If the county transmission rate (we monitor this once per week) changes to high transmission – MASKS are REQUIRED
If our building goes into outbreak status (one case of COVID-19) – MASKS are REQUIRED
If the county transmission rate drops below high for two weeks in a row and we are not in outbreak – MASKS become OPTIONAL
If you have a high-risk exposure – wear your mask for 10 days following the exposure.
If you were diagnosed with COVID-19 wear your mask for 10 days after your quarantine is over.

Visiting guidance and other infection control requirements have not changed. See reminders below. DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days!

We can NOT accommodate large groups of visitors.
Indoor visiting can only occur in a resident room where we have to accommodate for 6 foot social distancing.
Wear your mask when it is required and practice good infection control while visiting.
Indoor visits should only occur in resident rooms. As the weather gets nicer we encourage outdoor visitation whenever possible.
Sanitize your hands upon entering the building and before and after eating/drinking or assisting your loved one.

The population we care for continues to be vulnerable to illness including COVID-19. It’s exciting to not have to wear the mask, but even if you have allergies or what you think may be a simple runny nose – wear your mask even when it’s optional. We have waited so long to take off our masks and be able to see each other again, but we still must remember that COVID-19 did not “go away”. Starting at the delivery of this message – MASKS are OPTIONAL for ALL 😊 WHOO WHO!!! Mark Rust Kendra Hiles Administrator Director of Nursing _________________________________________________________________ Residents, Staff, Families and Friends, We have completed two rounds of COVID-19 outbreak testing with no additional cases found. We will complete ALL staff and resident testing on April 10^th. If no further cases are identified we will be out of outbreak on April 12^th. We will continue to be in outbreak through Easter. See the visiting reminders below. Reminders for visiting: DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Visiting Reminders:

Visiting is not encouraged during times of outbreak.
We can NOT accommodate large groups of visitors.
Visiting can only occur in a resident room where we have to plan for 6 foot social distancing. This means a maximum of 4-6 people in a resident room at one time – including the resident.
Wear your mask at all times and practice good infection control while visiting.
Not recommended by BLHCC: IF the resident is comfortable. You may remove your mask to eat/drink with your loved one in their room.
Visits must only occur in resident rooms. No visits in the public areas or in activities.
Sanitize your hands upon entering the building and before and after eating/drinking or assisting your loved one.
If you plan to visit a loved one who is positive for COVID-19 you must speak with a nurse before entering their room. All appropriate infection control precautions must be practiced and personal protective equipment must be worn. Please note, visiting a positive resident is a danger to your own heath and is NOT advised or encouraged.

March 2023 marked three years since the start of our COVID-19 journey. For long term care that journey continues today. We are thankful for the continued support of families and friends and appreciate our dedicated staff who continue to provide fantastic care during the most stressful times. Happy Easter, Mark Rust Kendra Hiles Administrator Director of Nursing ____________________________________________________________________ Residents, Staff, Families and Friends, Earlier today we identified a resident positive for COVID-19. This resident has mild cold like symptoms, a reminder to all – do NOT visit if you are ill with what might be “the common cold or allergies”. This new case of COVID-19 means we are in outbreak status. We will complete ALL staff and resident testing on Friday March 31^st (48 hrs after first case identified) and again on Monday April 3^rd and April 10^th (every 5-7 days after the last case is identified for 14 days). This current outbreak will continue through Easter. See the visiting reminders below. Reminders for visiting: DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Visiting Reminders:

Visiting is not encouraged during times of outbreak.
We can NOT accommodate large groups of visitors.
Visiting can only occur in a resident room where we have to plan for 6 foot social distancing. This means a maximum of 4-6 people in a resident room at one time – including the resident.
Wear your mask at all times and practice good infection control while visiting.
IF the resident is comfortable. You may remove your mask to eat/drink with your loved one in their room.
Visits must only occur in resident rooms. No visits in the public areas or in activities.
Sanitize your hands upon entering the building and before and after eating/drinking or assisting your loved one.
If you plan to visit a loved one who is positive for COVID-19 you must speak with a nurse before entering their room. All appropriate infection control precautions must be practiced and personal protective equipment must be worn. Please note, visiting a positive resident is a danger to your own heath and is NOT advised or encouraged.

We will send out another update next Wednesday to let you know the results of testing and if there are any changes. As we all look forward to celebrating yet another holiday in the midst of COVID-19, we wish for everyone to be healthy and safe. When it is available to you, please get vaccinated/boosted for COVID-19 and influenza. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing ________________________________________________________________________ March 22nd, 2023 Residents, Staff, Families and Friends, We completed our final round of outbreak testing on March 20^th with no additional cases discovered. Our facility is considered to be out of outbreak on March 24^th. No further testing will be needed past the 24^th unless a new case arises. We need to continue to use good infection control to keep COVID-19 out of our building and keep each other safe. It is only a matter of time before the next case is identified. Follow ALL infection control requirements while you are here to visit and work. Don’t forget to get your vaccines and boosters ASAP! Reminders for visiting: DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Visiting Reminders:

Renville County is a high transmission rate county; wear your mask at all times and practice good infection control while visiting.
Visits must only occur in resident rooms. No visits in the public areas or in activities.
Sanitize your hands upon entering the building and before and after eating/drinking or assisting your loved one.

Thank you for your continued support, Mark Rust Kendra Hiles Administrator Director of Nursing __________________________________________________________ March 16th, 2023 Residents, Staff, Families and Friends, We completed our first round of outbreak testing on Monday, no additional cases were found. We continue to be in outbreak status 14 days after the last positive case was identified. We will complete testing for ALL staff and residents again on Monday March 20^th. In the meantime everyone should watch for COVID-19 symptoms and testing should be completed IMMEDIATELY if any symptoms are present. Residents who show symptoms that are not explained by a recurrent health issue, must be placed in quarantine for at least 48 hours until two negative tests are confirmed and/or symptoms have improved. Reminders for visiting: DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Visiting Reminders:

We advise against visiting but if you must visit, use caution. Wear your mask at all times and practice good infection control.
Visits must only occur in resident rooms. No visits in the public areas or in activities.
Sanitize your hands upon entering the building and before and after eating/drinking or assisting your loved one.
If you are visiting a resident who is positive for COVID-19 you should know that visiting while a resident is infectious is a threat to your own health and others. You should avoid visiting while the resident is in quarantine. See a nurse before entering the room and wear all appropriate PPE required.

Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing ______________________________________________________________ March 11th, 2023 Residents, Staff, Families and Friends, We have identified a positive resident. This resident was in the facility 48 hours prior to testing positive. This means our facility is considered to be in outbreak status and we will begin testing all residents and staff on Monday March 13^th. Staff and Residents will continue to be tested at least every 5-7 days for two weeks (14 days) until no additional cases are identified. Reminders for visiting: DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Visiting Reminders:

We advise against visiting but if you must visit, use caution. Wear your mask at all times and practice good infection control.
Visits must only occur in resident rooms. No visits in the public areas or in activities.
Sanitize your hands upon entering the building and before and after eating/drinking or assisting your loved one.

We will send another update next week. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing _________________________________________________________________________ March 2nd, 2023 Residents, Staff, Families, and Friends, Outbreak testing was completed on Monday with no cases identified. We currently have no positive residents or staff. We are considered to be out of outbreak. We thank you for your help in keeping our facility safe. We will continue to test anyone who is experiencing symptoms or is not feeling well. Reminders for visiting: DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Visiting Reminders:

Wear your mask at all times. If the resident approves, you may eat or drink privately with the resident in his/her room.
Visits must only occur in resident rooms. No visits in the public areas or in activities.
Sanitize your hands upon entering the building and before and after eating/drinking or assisting your loved one.

Renville County remains a high transmission county so masks continue to be required for residents while they are out of their rooms. Staff continue to be required to wear masks. Eye protection is available for staff upon request. If you have not received your most recent COVID-19 booster do so as soon as you can. The COVID-19 vaccines have been proven effective in decreasing hospitalization and death. Click the link below to find a COVID-19 vaccination clinic near you! https://mn.gov/covid19/vaccine/find-vaccine/locations/index.jsp Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

Residents, Staff, Families and Friends, Outbreak testing was completed on Monday with no cases identified. We currently have no positive residents or staff. We are considered to be in outbreak until February 28^th. Outbreak testing will be completed again on Monday the 27^th for ALL residents and staff. Anyone who is experiencing symptoms or is not feeling well will be tested immediately. Reminders for visiting: DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Reminders:

We do not recommend visiting while we are in outbreak status.
If you feel you must visit, visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
ALL visitors and staff are required to wear a mask anytime they are in the building.
Residents MUST wear their surgical masks when out of their rooms.
Use good infection control – sanitize your hands before and after you leave, keep your mask on at all times, and practice social distancing.

We hope you are staying safe and warm during this winter storm. We are so thankful for the dedicated staff who arrived for their shifts and those who stayed at the facility to ensure the residents received the care they deserved. Big thank you to every employee from ALL departments! Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing ___________________________________________________________________ February 15th, 2023 Residents, Staff, Families and Friends, Outbreak testing was completed on Monday with one new case identified. We currently have no positive residents and one positive staff. We are considered to be in outbreak until February 28^th. Outbreak testing will continue on February 20^th and 27^th for ALL residents and staff. Anyone who is experiencing symptoms or is not feeling well will be tested immediately. Reminders for visiting: DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Reminders:

We do not recommend visiting while we are in outbreak status.
If you feel you must visit, visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
ALL visitors and staff are required to wear a mask anytime they are in the building.
Residents MUST wear their surgical masks when out of their rooms.
Use good infection control – sanitize your hands before and after you leave, keep your mask on at all times, and practice social distancing.

Any staff interested in getting a booster should let Kendra or Shyann know. COVID-19 vaccine information can be found on the CDC website. It is recommended that everyone get vaccinated and boosted to prevent illness, hospitalization/death. COVID-19 continues to spread and cause health issues across the globe. Society has moved to “live with the virus” but it is up to us to do what we can to stay healthy and safe. Get vaccinated or boosted today! Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing ______________________________________________________________________ February 8th, 2023 Residents, Families and Friends, Outbreak testing was completed last on Monday with no new cases identified. We currently have two residents and one staff member in quarantine. This means we continue to be in outbreak status. ALL staff and residents will be tested Monday 2/13. If other cases are discovered we will continue testing for 14 days after the last positive test. Follow all infection control guidelines while you are out or visiting at BLHCC. DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Reminders:

Due to our outbreak status we are not recommending people visit at this time.
If you feel you must visit, visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
ALL visitors and staff are required to wear a mask anytime they are in the building.
Residents MUST wear their surgical masks when out of their rooms.
Use good infection control – sanitize your hands before and after you leave, keep your mask on at all times, and practice social distancing.

With Valentine’s Day right around the corner we are making plans to celebrate safely. Be sure to check out our Facebook page to keep up with all the fun activities that our resident’s partake in. Have a great week, Mark Rust Kendra Hiles Administrator Director of Nursing ________________________________________________________________________ Feb. 1st, 2023 Residents, Families and Friends, We have completed two rounds of outbreak testing which did result in additional positive cases. We currently have one resident and one staff member in quarantine. This means we continue to be in outbreak status. COVID-19 seems to show up, most often, as what looks like the common cold. Being vaccinated and boosted continues to be the best option to prevent hospitalization or death. Resident close contacts will be tested today and Friday February 3^rd. ALL staff and residents will be tested Monday 2/6. If other cases are discovered we will continue testing for 14 days after the last positive test. Follow all infection control guidelines while you are out or visiting at BLHCC. DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Reminders:

Due to our outbreak status we are not recommending people visit at this time.
If you feel you must visit, visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
ALL visitors and staff are required to wear a mask anytime they are in the building.
Residents MUST wear their surgical masks when out of their rooms.
Use good infection control – sanitize your hands before and after you leave, keep your mask on at all times, and practice social distancing.

Renville County continues to be a high transmission area. Use precautions while out in the community and DO NOT VISIT if you have any symptoms similar to COVID-19 or the common cold (cough, runny nose, congestion, sore throat, muscle aches, fever etc.) As always thank you for your support, Mark Rust Kendra Hiles Administrator Director of Nursing _______________________________________________________________________ January 25th, 2023 Residents, Families and Friends, Yesterday afternoon, we were informed that a staff member tested positive for COVID-19. They had been in the building 48 hours prior to their positive test/symptom onset. We are unable to identify all close contacts, so we will initiate outbreak testing for ALL residents and ALL staff. Everyone will be tested today, 1/25, on Friday 1/27 and again on Monday 1/30. If no additional cases are identified we can stop testing. If other cases are discovered we will continue testing for 14 days after the last positive test. Follow all infection control guidelines while you are out or visiting at BLHCC. DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
If you feel you must visit, visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms.

Staff are encouraged to get vaccinated or boosted for COVID-19 as soon as possible at their local clinic or pharmacy, or let Kendra or Shyann know and we will add you to our list. Residents will also be receiving their boosters as needed; at their clinic appointments as able or at BLHCC when available. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing ______________________________________________________________________ January 18th, 2023 Residents, Families, and Friends, Our facility is no longer considered to be in outbreak as of January 16th. Renville County is in high transmission so we still have infection control guidelines that need to be followed. Residents and staff should continue to test if symptoms are present. BLHCC will be providing a COVID-19 vaccine booster clinic on January 24^th for residents and staff that need their booster shots. We ask that visitors continue to follow our reminders listed below. Reminders:

DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days!
ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms in public spaces unless eating or drinking. Residents may resume eating together in the dining rooms for meals/coffee time, if they choose. The activity department will return to providing snacks/food.
Visitors must continue to only visit in resident rooms. No visits during coffee time or in activities.
We currently have NO COVID-19 positive residents in our building. Use caution when you come to visit and if you see a stop sign on your loved one/friends door – talk to a nurse before entering.

Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing ____________________________________________________________________ January 11^th, 2022 Residents, Families, and Friends, We completed our last round of outbreak testing on Monday, no new cases were discovered. Our facility will continue to be in outbreak until January 16^th. Residents and staff should continue to test if symptoms are present. The transmission of COVID-19 in Renville County continues to be high so we ask that visitors continue to follow our reminders listed below. Reminders:

DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days!
ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms in public spaces unless eating or drinking. Residents may resume eating together in the dining rooms for meals/coffee time, if they choose. The activity department will return to providing snacks/food.
Visitors must continue to only visit in resident rooms. No visits during coffee time or in activities.
We currently have NO COVID-19 positive residents in our building, but that can change in minutes. Use caution when you come to visit and if you see a stop sign on your loved one/friends door – talk to a nurse before entering.

Our year at BLHCC seems to be off to a good start. We have great staff who are dedicated to the care they provide and we have residents, who through it all, have remained patient and understanding. We are blessed to have your support and trust. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing _________________________________________________________________ January 9th, 2023 Please click HERE for Minnesota Nursing Home Report Card Letter ____________________________________________________________________ January 5th, 2023 Residents, Families and Friends, We are currently providing care to 1 positive COVID-19 patient and any resident that is showing symptoms is placed in quarantine and tested. We currently have one staff member who is recovering at home. We completed outbreak testing on Monday and had no new positive residents. All residents and staff will be tested again on January 9^th. DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Reminders:

Visiting is NOT recommended at this time.
ALL visitors and staff are required to wear a mask anytime they are in the building.
If you feel you must visit, visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. Residents are eating ALL meals in their rooms and the activity department is not serving food at this time. These mitigation efforts will stay in place until we are out of outbreak status.
Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Visiting a resident who is in quarantine for COVID-19 is a risk to your health and we do NOT advise visiting. If you feel you must visit a resident who is positive for COVID-19, a mask, face shield, gown and gloves MUST be warn. Staff will assist you with applying your PPE (ask them for assistance)

If any staff member or resident would like to get vaccinated for COVID-19 or would like a booster please let Kendra or Shyann know. Date of vaccination TBD. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing _____________________________________________________________________ December 28th, 2022 Residents, Families and Friends, We are currently providing care to 5 positive COVID-19 patients and any resident that is showing symptoms is placed in quarantine and tested. We currently have one positive staff member. Staff who seem ill are also tested immediately. We will continue outbreak testing weekly for 14 days until no new positive cases are identified. All residents and staff will be tested again on Monday January 2^ndand January 9^th. DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Reminders:

Visiting is NOT recommended at this time.
ALL visitors and staff are required to wear a mask anytime they are in the building.
If you feel you must visit, visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. Residents are eating ALL meals in their rooms and the activity department is not serving food at this time. These mitigation efforts will stay in place until we are out of outbreak status.
Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Visiting a resident who is in quarantine for COVID-19 is a risk to your health and we do NOT advise visiting. If you feel you must visit a resident who is positive for COVID-19, a mask, face shield, gown and gloves MUST be warn. Staff will assist you with applying your PPE (ask them for assistance)

As the New Year approaches we wish for an end to this current outbreak of COVID-19 and continue to be thankful for all of your support. Cheers to 2023! Mark Rust Kendra Hiles Administrator Director of Nursing __________________________________________________________________ Residents, Families and Friends, We are currently providing care to 6 positive COVID-19 patients and any resident that is showing symptoms is placed in quarantine and tested. Staff who seem ill are also tested immediately. We will continue outbreak testing weekly for 14 days until no new positive cases are identified. All residents and staff will be tested again on Monday Dec 26^th and January 2^nd. Our patients with COVID-19 are showing mild, cold like symptoms. Most would tell you “it’s just a cold”, but we know how devastating some strains of COVID-19 can be. As the illness progresses, symptoms can get worse. Vaccination and booster shots can be accredited for the mild symptoms. This round of COVID-19 shows up as a runny nose, cough, congestion and mild fever, the same symptoms you see with the common cold. We warn you again – DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! Residents who are experiencing symptoms, not explained my other health issues, are to be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart and/or they are feeling better. Staff – you are doing a GREAT job at noticing changes and getting people quarantined early! Thank you! Reminders:

Visiting is NOT recommended at this time.
ALL visitors and staff are required to wear a mask anytime they are in the building.
If you feel you must visit, visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. Residents are eating ALL meals in their rooms and the activity department is not serving food at this time. These mitigation efforts will stay in place until we are out of outbreak status.
Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Visiting a resident who is in quarantine for COVID-19 is a risk to your health and we do NOT advise visiting. If you feel you must visit a resident who is positive for COVID-19, a mask, face shield, gown and gloves MUST be warn. Staff will assist you with applying your PPE (ask them for assistance)

We know that this most recent outbreak couldn’t have come at a worse time of year, Christmas and we want everyone to enjoy the holidays in the safest way possible. Reach out to the facility if you’d like to make plans with your loved one(s) and let us know if you have any questions or concerns. Merry Christmas to All, Mark Rust Kendra Hiles Administrator Director Nursing ________________________________________________________________________ December 14^th, 2022 Residents, Families and Friends, We have identified an additional staff and resident case for this COVID-19 outbreak. Our facility will continue to be in OUTBREAK status until December 27^th. We will complete outbreak testing for ALL residents and ALL staff; today 12/14, Friday 12/16 and Monday 12/19. If any other cases are discovered, we will continue testing every 5-7 days. Visiting is NOT recommended at this time. If you must visit, please follow all reminders listed towards the end of letter. Be sure to use good infection control while out in the community; COVID-19, Influenza and many other illnesses are spreading rapidly – DO NOT VISIT IF YOU ARE FEELING ILL or have tested positive for COVID-19 in the last 14 days! If anyone, resident or staff, develops symptoms similar to COVID-19, complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms, not explained my other health issues, should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols. Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Nursing staff should be the only department entering the room of a positive resident, they will assist with bringing in meals, cleaning, and other duties as needed.

Remember that being fully vaccinated and up to date on ALL vaccines is a huge benefit to your health and the health of those around you. Vaccines are proven effective on protecting against severe illness and death. Vaccination information can be found on the CDC website. If you have any questions or concerns, reach out to (320)-833-5364 and ask to speak with Kendra Hiles, Director of Nursing. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing ___________________________________________________________________

Happy Holidays!

We are doing in-room party on December 17th starting at 2PM and we have a few things for you to enjoy working with your loved one. (We will leave a copy of instruction in your loved ones room.)

Turn TV on Channel 991 for a Christmas Entertainment by Shyann Topel

We will deliver food and beverages room to room.
Take a picture with Santa and open gifts.

-We will come and get you-

Ugly sweater vest Contest- vest is provided for you to help your loved one color and enter our “Best Ugly Sweater Vest” contest!

-$50 price for the winner!

*please note that we won’t know the winner until next week, if you are planning to keep the vest, please have us take a picture. We will collect the vest and donate them to Little Stangs or BLHS pre-school once we have a winner!

Mini Gingerbread House Contest- Gingerbread house kit is provided for you to help your loved one build a gingerbread house made out of graham crackers.

-$50 price for the winner!

*please note that we won’t know the winner until next week. -Sign up for a prize drawing, we will come around- -Residents are automatically signed up-

See you Saturday!!

__________________________________________________________________________ December 7^th, 2022 Residents, Families and Friends, We identified a second case of COVID-19 for this outbreak. Our facility will continue to be in OUTBREAK status until December 22^nd. We will complete outbreak testing for residents and staff who had a high risk exposure; today, 12/9 and 12/11. We want to continue to caution everyone when visiting. Reminders for your visit can be found later in the letter. Be sure to use good infection control while out in the community; COVID-19, Influenza and many other illnesses are spreading rapidly this season. This is the time of year where everyone wants to get together and be close, but it may be best to keep your outings few and your gatherings small. We will be sending out holiday guidance once again as Christmas approaches. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms (that are not explained my other health issues) should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols. Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Nursing staff should be the only department entering the room of a positive resident, they will assist with bringing in meals, cleaning, and other duties as needed.

Remember that being fully vaccinated and up to date on ALL vaccines is a huge benefit you your health and the health of those around you. Vaccines are proven effective on protecting against severe illness and death. Vaccination information can be found on the CDC website. If you have any questions or concerns, reach out to (320)-833-5364 and ask to speak with Kendra Hiles, Director of Nursing. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing __________________________________________________________________________ November 28^th, 2022 Residents, Families and Friends, We identified a positive case of COVID-19 among one of our staff yesterday afternoon. This single case of COVID-19 does put our facility back in OUTBREAK status. Per CDC guidance and BLHCC facility policy; Testing for COVID-19 will be completed today November 28th, Wednesday November 30^th and on Friday December 2^nd. Testing is required for ALL residents and all staff. If all tests are negative we will be done testing, if more cases are identified we will continue to test every 3-7 days for 14 days until no new positive cases are identified. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms (that are not explained my other health issues) should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols. Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Nursing staff should be the only department entering the room of a positive resident, they will assist with bringing in meals, cleaning, and other duties as needed.

We will send out another update next week. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing _____________________________________________________________________ November 23^rd, 2022 Residents, Staff and Families, All required outbreak testing is complete with no new cases identified. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms (that are not explained my other health issues) should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Outbreak/High Transmission Rate During the Holidays Our facility continues to be in outbreak status and will remain there until Nov 25^th as long as no additional cases are identified. Renville County is currently in a lower level transmission rate, but we must continue to follow the high transmission rate guidelines until next week. With the holidays coming up we want to remind everyone of the visiting guidance during times of outbreak and high transmission.

Visiting is not encouraged during times of facility outbreak as it is a threat to the health of others. We will not refuse your visit unless the resident voices concern.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene. We discourage larger family gatherings during outbreak or high transmission. If you feel you must gather you will need to reserve your space ASAP. Families will be placed away from other residents and there must be enough space to accommodate physical distancing within your group. For Example: If a resident has family who wants to join him/her for Thanksgiving dinner the resident’s room could accommodate up to 5 people total (including the resident) and still allow for social distancing of 6ft.
Visitors must stay in resident rooms or the reserved space and not wander the halls/activity room etc. Visitors should avoid other residents and staff.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Visiting a resident who is positive is NOT recommended and is a risk to your health. If you must visit, please see a nurse first so infection control recommendations can be followed.
Visitors may now enter/exit at all regular entrances of the building. Masks must still be worn and have been placed by all doors and visitor guidelines been posted for you to review and uphold.

Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing

November 16^th, 2022 Residents, Staff and Families, We continue to complete outbreak testing for anyone with a high risk exposure, no additional cases have been discovered thus far. Testing for COVID-19 will be completed again Thursday November 17^th. We were able to identify high risk exposures for this case, so only residents and staff who have had a high risk exposure will need to be tested. If all tests are negative we will be done testing, if more cases are identified we will continue to test every 3-7 days for 14 days until no new positive cases are identified.

High risk exposure: close contact (within 6ft) with another person for greater than 15 minutes where only one or neither person was wearing a mask.

If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms (that are not explained my other health issues) should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Outbreak/High Transmission Rate During the Holidays Our facility continues to be in outbreak status and will remain there until Nov 25^th as long as no additional cases are identified. Renville County is also noted to be in High Transmission. With the holidays coming up we want to remind everyone of the visiting guidance during times of outbreak and high transmission.

Visiting is not encouraged during times of facility outbreak as it is a threat to the health of others. We will not refuse your visit unless the resident voices concern.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene. We discourage larger family gatherings during outbreak or high transmission. If you feel you must gather you will need to reserve your space ASAP. Families will be placed away from other residents and there must be enough space to accommodate physical distancing within your group. For Example: If a resident has family who wants to join him/her for Thanksgiving dinner the resident’s room could accommodate up to 5 people total (including the resident) and still allow for social distancing of 6ft.
Visitors must stay in resident rooms or the reserved space and not wander the halls/activity room ect. Visitors should avoid other residents and staff.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Visiting a resident who is positive is NOT recommended and is a risk to your health. If you must visit, please see a nurse first so infection control recommendations can be followed.

Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing

October 26^th, 2022 Residents, Staff, Families and Friends, We completed outbreak testing Monday and had no new positive cases. Our building is considered to be out of outbreak status. Weekly testing continues to be required for staff who are not “fully vaccinated”. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms (that are not explained by other health issues) should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Reminders:

ALL visitors are required to wear a mask in all public spaces of the facility. Visitors may remove their mask while in the room of a loved one, if the resident is comfortable and no other residents/staff are around. Visits should only occur in resident rooms or outside, weather permitting.
Residents must wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols. Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Nursing staff should be the only department entering the room of a positive resident, they will assist with bringing in meals, cleaning, and other duties as needed.

COVID-19 Booster Update: We administered COVID-19 boosters last week to all staff and residents who desired to receive their shot. If you missed the booster clinic, please look for your booster at your local clinic or pharmacy. BLHCC will host vaccination clinics as needed, nothing scheduled at this time. COVID-19 vaccination continues to be one of the best practices to keep yourself safe from severe COVID-19 or death from COVID-19. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing

October 19^th, 2022 Residents, Staff, Families and Friends, We completed outbreak testing yesterday and had no new positive cases. Our building continues to be in outbreak and all required infection control practices should continue to be used. Staff and residents will need to test on Monday, October 24^th. If all tests are negative, we will be done testing, if more cases are identified we will continue to test every 3-7 days for 14 days until no new positive cases are identified. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms (that are not explained my other health issues) should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols. Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Nursing staff should be the only department entering the room of a positive resident, they will assist with bringing in meals, cleaning, and other duties as needed.

COVID-19 continues to be a concern for all of us. Use caution while out and about, visit ONLY if you have NO symptoms, haven’t been exposed and are not COVID-19 positive. Being vaccinated and boosted continues to be one of the best tools to fight COVID-19. COVID-19 Booster Update: We administered COVID-19 boosters earlier this week to all staff and residents who desired to receive their shot. Our facility continues to maintain our 100% vaccination compliance for staff (all staff are vaccinated or have an approved exemption) as well as 98% of residents are fully vaccinated. We accredit this data to our currently healthy population. Although we have seen staff and residents who are up to date with the COVID-19 vaccine be diagnosed with COVID, they have healed quickly with recoverable symptoms. Vaccination continues to be the best defense against COVID-19 and its many variants. Other News: BLHCC is offering a specialized safety training for all staff on October 26^th. Sign up by the time clock. You will be paid for your time and refreshments will be provided. Stay Safe, Mark Rust Kendra Hiles Administrator Director of Nursing

October 12^th, 2022 Residents, Families and Friends, We identified a positive case of COVID-19 among our staff yesterday afternoon. This means our building continues to be in outbreak and all required infection control practices should continue to be used. ALL staff and residents will need to test for COVID-19 today, Friday October 14^th, Monday October 18^th, and October 24^th. If all tests are negative, we will be done testing, if more cases are identified we will continue to test every 3-7 days for 14 days until no new positive cases are identified. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms (that are not explained my other health issues) should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols. Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Nursing staff should be the only department entering the room of a positive resident, they will assist with bringing in meals, cleaning, and other duties as needed.
The COVID-19 vaccination clinic is currently on hold, waiting for vaccine supply to be delivered from the pharmacy. We will contact residents and all staff interested as soon as we have a date for the clinic.

The newest positive case reminds us that COVID-19 is still in our communities and our homes. It continues to spread invisibly and we are all at risk. Use caution while out and about, visit ONLY if you have no symptoms, haven’t been exposed and are not COVID-19 positive. Being vaccinated and boosted continues to be one of the best tools to fight COVID-19. Stay Safe, Mark Rust Kendra Hiles Administrator Director of Nursing

October 6^th, 2022 Residents, Families and Friends, We identified a positive case of COVID-19 among one of our residents this morning. The resident is being cared for with all recommended infection control precautions. Visiting a resident who is positive is NOT recommended and is a risk to your health. If you must visit, please see a nurse first so infection control recommendations can be followed. This single case of COVID-19 does put our facility back in OUTBREAK status. Per the newest CDC guidance and BLHCC facility policy; ALL staff and residents will need to test for COVID-19 this Friday October 7th, Monday October 10^th and on Wednesday October 12^th. If all tests are negative we will be done testing, if more cases are identified we will continue to test every 3-7 days for 14 days until no new positive cases are identified. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. Residents who are experiencing symptoms (that are not explained my other health issues) should be placed in quarantine until they receive 2 negative antigen COVID-19 tests 48 hours apart. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Preform good hand hygiene.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols. Staff caring for a positive resident are required to use a gown, gloves, face shield and an N95 mask. Nursing staff should be the only department entering the room of a positive resident, they will assist with bringing in meals, cleaning, and other duties as needed.
COVID-19 vaccination will be completed on October 11^th as originally planned.

We will send out another update next week. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing

October 5^th, 2022 Staff, Residents, Families and Friends, We have completed outbreak testing with no new cases identified. We are officially considered out of outbreak. There are a few changes to our infection control guidance that we will outline below. We recognize, for some, this is amazing news, a step closer to getting back to normal. This transition may also be scary and we invite anyone who has questions or concerns to reach out in person or phone: (320)-833-5364 to Kendra Hiles (Director Of Nursing ext. 14) or Shyann Topel (Safety Director ext. 30). Some of the newest guidance from the CDC released in September is dependent on the county transmission rate. Renville County continues to be at a “High” transmission rate which means there is NO change to the guidance around masking. Staff, Residents and Visitors continue to be required to wear a blue surgical mask as you have been (in patient care areas, during visits unless resident is comfortable with VISITOR taking mask off, and for residents, in hallways and during group activities). Everyone must continue to sanitize hands upon entering and exiting the facility and resident rooms. If your hands become visibly soiled, use soap and water to wash hands. Visits continue to be allowed in resident rooms only or outside – weather permitting. What HAS Changed? Staff and Visitor Screening: Staff and Visitors are required to monitor themselves for signs and symptoms of COVID-19 and should not enter the building if they are ill. Visitors should not visit if they are positive for COVID-19 or within 14 days after recovery. Visitors should also refrain from entering if they have been exposed to someone positive for COVID within the last 10 days. Staff should complete an antigen test for COVID-19 at the first sign of any symptoms and again 48 hours later. As before, staff should see the charge nurse before working if any symptoms are present, or if they have been exposed. Staff who test positive for COVID-19 will need to continue to follow the quarantine requirements. Active Symptom and Temperature Screening is NO LONGER REQUIRED for staff and visitors. Residents still need to have O2, Pulse and Temperature screening completed daily as we have been. Eye Protection: Eye protection provides a barrier between staff and the people they encounter to help stop the spread of COVID-19 and other infectious illnesses. Eye protection will remain available in the NE Wing Scheduling/Safety Director office for anyone who would like to use it. Eye protection is optional, and no longer required. Testing: Testing will continue to be required for staff and residents if a case of COVID-19 is identified in the building and if symptoms of COVID-19 are present. Staff or residents experiencing symptoms should test immediately and again 48 hours later. Weekly testing for staff who are NOT fully vaccinated* continues to be required but routine testing for staff who are NOT up to date* has been discontinued. *Fully vaccinated: a person has received all of the initial doses in a vaccine series. *Up to date: a person has received all the initial doses of the vaccine series and the latest recommended booster dose recommended for them. Care for COVID-19 Suspected or Confirmed Patients: Residents experiencing symptoms, with no other explanation or residents who are positive for COVID-19 will continue to be placed in quarantine. Staff who provide care for residents in quarantine will need to continue to wear gloves, gown, N95 masks, face shields and other PPE as deemed necessary. We continue to discouraged visits for anyone in quarantine. If you must visit, alert a nurse and training will be provided to you before you enter the room of your loved one. Vaccination: Vaccination continues to be one of the best tools to protect yourself and others from severe illness/death caused from COVID-19. We encourage everyone to get vaccinated and boosted as you are able. Staff members who are NOT fully vaccinated* or have an approved exemption will need to continue COVID-19 testing once per week, and will be required to complete vaccination education modules/in-services every year. Remember it is ok to change your mind, vaccines continue to be available at any time. Kendra or Shyann can assist you in finding a vaccination location. Vaccination Clinic at BLHCC: BLHCC will be holding a vaccine clinic for staff and residents to receive the most recent Bivalent booster on October 11^th. Any staff member who would like the vaccine should let Kendra or Shyann know so we can get you on the list. Residents will be vaccinated in the morning and staff will be vaccinated during their shift or Kendra/Shyann will be in contact with you for an appointment time. At this time, we encourage our volunteers to seek vaccination at local clinics/pharmacies. If you need assistance please let us know and we can help you find a vaccination location. As we continue to move forward in the fight against COVID-19 and other infectious diseases, let us never forget the lessons we’ve learned and may we never underestimate the power of comradery between our staff, residents, families and friends. We appreciate all of you! We are blessed to have your continued support. With Appreciation, Mark Rust Kendra Hiles Administrator Director of Nursing

September 21^st, 2022 Staff, Residents, Families and Friends, Weekly outbreak testing was completed on Monday, all resident and staff test results were negative at that time. We will complete facility wide testing again on September 26^th. If all test results are negative, we will commence outbreak testing. Another update will be sent next week. Anyone who has symptoms related to COVID-19 should complete a rapid test and speak with a nurse before clocking in to work. Residents should also be tested if presenting with any similar COVID-19 symptoms. Symptoms of COVID-19 include; shortness of breath, cough, loss of taste or smell, fever (a full list of symptoms can be found on the CDC website). Resident visitors are welcome in our facility. We ask that you wear a blue surgical mask for the entirety of your visits, sanitize your hands upon entering your loved ones room, and ONLY visit in the resident room or outside. Visits are NOT to occur during activities or in the common areas (dining room). Staff continue to be required to practice good infection control including; sanitizing your hands upon entering and exiting resident rooms, wearing your mask and eye protection and completing weekly/bi-weekly COVID-19 testing as required for outbreak testing and based on your vaccine status. Any staff member who is not up to date with the COVID-19 vaccine must test twice per week and is encouraged to speak with Kendra or Shyann for information about how to receive your initial or booster dose. Vaccination against COVID-19 continues to be effective in decreasing COVID-19 hospitalizations and death. Thank you! Mark Rust Kendra Hiles Administrator Director of Nursing

September 13^th, 2022 Staff, Residents, Families and Friends, Our weekly outbreak testing has been completed and NO positive resident cases were identified. However, we did discover a positive staff member this past weekend. That staff member had worked 48 hours prior to the positive test which means our facility continues to be in “outbreak” status. We will complete facility wide testing on September 19^thand 26^th. Weekly updates will continue until the outbreak has commenced. Anyone who has symptoms related to COVID-19 should complete a rapid test and speak with a nurse before clocking in to work. Residents should also be tested if presenting with any similar COVID-19 symptoms. Symptoms of COVID-19 include; shortness of breath, cough, loss of taste or smell, fever (a full list of symptoms can be found on the CDC website). Resident visitors are welcome in our facility. We ask that you wear a blue surgical mask for the entirety of your visits, sanitize your hands upon entering your loved ones room, and ONLY visit in the resident room or outside. Visits are NOT to occur during activities or in the common areas (dining room). Staff continue to be required to practice good infection control including; sanitizing your hands upon entering and exiting resident rooms, wearing your mask and eye protection and completing weekly/bi-weekly COVID-19 testing as required for outbreak testing and based on your vaccine status. Any staff member who is not up to date with the COVID-19 vaccine must test twice per week and is encouraged to speak with Kendra or Shyann for information about how to receive your initial or booster dose. Vaccination against COVID-19 continues to be effective in decreasing COVID-19 hospitalizations and death. Thank you! Mark Rust Kendra Hiles Administrator Director of Nursing

September 7^th, 2022 Staff, Residents, Families and Friends, The second round of COVID-19 testing was completed yesterday, Sept 6^th with no new cases identified. BLHCC continues to be in outbreak status 14 days after the last positive case identified (8/29/22). This means we will complete one more round of facility wide testing on September 13^th. If all test results are negative, we will cease outbreak testing. Staff who are not up to date will still be required to test based on the county transmission rate (currently HIGH = twice weekly testing). Anyone who has symptoms related to COVID-19 should complete a rapid test and speak with a nurse before clocking in to work. Residents should also be tested if presenting with any similar COVID-19 symptoms. Symptoms of COVID-19 include; shortness of breath, cough, loss of taste or smell, fever (a full list of symptoms can be found on the CDC website). COVID-19 Vaccine Update: A new booster has been approved by the CDC. This COVID-19 booster has been re-created to provide protection for the original COVID-19 virus as well as the newest variants of the virus that continue to spread rapidly. We are working closely with our in-house pharmacy to be able to offer this new booster when it becomes available. Any staff who are interested in receiving the newest booster should talk with Kendra or Shyann so we can put your name on the waiting list. According to the most recent update from the CDC: You are up to date with your COVID-19 vaccines if you have completed a COVID-19 vaccine primary series and received the most recent booster dose recommended for you by CDC. More COVID-19 Vaccine/Booster information can be found here: https://www.cdc.gov/coronavirus/2019-ncov/vaccines/stay-up-to-date.html Thank you! Mark Rust Kendra Hiles Administrator Director of Nursing

August 31^st, 2022 Staff, Residents, Families and Friends, We identified 4 additional positive staff since the beginning of the outbreak last week, some were identified during outbreak testing, and some because of symptom onset. The first staff has completed their quarantine and is able to return to work. We pray that all affected staff heal and recover without any complications. You are all missed! ALL staff and residents will test again on September 6^th and September 12^th for outbreak testing. Staff who are not scheduled to work on the 6^th or 12^th can come in and test on those dates, or may test during a shift prior too or after (as close to the testing date as possible). Staff who are not “up to date” with the COVID-19 vaccine also need to test a second time during the week. Anyone who has symptoms related to COVID-19 should complete a rapid test and speak with a nurse before clocking in to work. Residents should also be tested if presenting with any similar COVID-19 symptoms. Symptoms of COVID-19 include; shortness of breath, cough, loss of taste or smell, fever (a full list of symptoms can be found on the CDC website). The COVID-19 policy is located in the main nursing office and is available for reference if you have questions or concerns. We encourage you to reach out to Kendra Hiles, Director of Nursing or Shyann Topel, Safety Director for assistance with COVID-19 vaccination or other infection control concerns. Our staff work diligently every day to keep our residents safe, comfortable and happy. We are honored each of our staff has chosen BLHCC as their place of employment. Dietary, Environmental Services, Nursing, Maintenance, Activities, Office Staff; EVERYONE has an important role at BLHCC and we are thankful for everyone! Infection Control Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on.
Residents MUST wear their surgical masks when out of their rooms.
Staff must remain vigilant with all required infection control protocols, including the use of eye protection while in resident care areas.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe.

We wish you a safe Labor Day weekend! Mark Rust Kendra Hiles Administrator Director of Nursing

August 26^th, 2022 Residents, Families and Friends, We identified a second positive case of COVID-19 among our staff today. This staff member worked within 48 hours of symptom onset and worked in various areas of the building. ALL staff will need to test for COVID-19 today, Tuesday August 30^th and again on September 6th. Residents have already been tested today, all are negative. They will be tested again on August 30^th and September 6^th. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. COVID-19 continues to spread rapidly throughout our county. Staff who are not up to date with their COVID-19 vaccines continue to be required to test twice per week per CMS guidelines. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Complete the screening forms upon entrance, preform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe. Staff must continue to complete COVID-19 tests based on vaccine status as well as for outbreak status.

We will send out another update next week. Have a nice weekend, Mark Rust Kendra Hiles Administrator Director of Nursing

August 24^th, 2022 Residents, Families, and Friends, Our facility has identified a positive case of COVID-19 among our staff. This case of COVID-19 puts our facility in outbreak status, but because the case was isolated to a small number of exposures, only residents and staff with high-risk exposures will be required to test. Exposed resident(s) will be tested today and again on Monday, August 29th. As long as no more positive cases are identified further testing will not be required. If anyone, resident or staff, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. COVID-19 continues to spread rapidly throughout our county. Staff who are not up to date with their COVID-19 vaccines continue to be required to test twice per week per CMS guidelines. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Complete the screening forms upon entrance, perform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at-home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe. Staff must continue to complete COVID-19 tests based on vaccine status as well as for outbreak status.

We will send out weekly updates until the outbreak has ended. Outbreak time frame is defined as 14 days beyond the identification of the most recent positive case. Thank you for your continued support, Mark Rust Kendra Hiles Administrator Director of Nursing

August 3^rd, 2022 Residents, Families and Friends, We completed all required outbreak testing we are considered to be OUT OF OUTBREAK status. We did have one staff member who tested positive earlier in the week but has not been in the building for more than 48hours, this case does NOT require additional testing. We continue to encourage all staff and residents to test for COVID-19 if they are feeling ill. Most of the state of Minnesota continues to be high risk for transmission of COVID-19, please use caution while out and get vaccinated/boosted when you can. Reminders:

Visits must only occur in resident rooms, where everyone is recommended to keep their mask on. Complete the screening forms upon entrance, preform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe.

We are always hopeful that this will be the “last” outbreak, but we know that COVID-19 is now part of our normal routine. Thank you for your continued partnership in keeping yourself and others safe from COVID-19. Mark Rust Kendra Hiles Administrator Director of Nursing

July 28^th, 2022 Residents, Staff, Families and Friends, We completed outbreak testing for the second time this week and discovered one additional positive staff. This staff member had not been in the building 48 hours prior to testing positive. We continue to encourage all staff and residents to test for COVID-19 if they are feeling ill. Any staff member who has experience a high risk exposure outside of the facility is also asked to test on days 1,2,3, and 5-7 after exposure. We will conduct facility wide outbreak testing again on Monday August 1^st. Renville County continues to be a high transmission county. It is the season for large community gatherings, please be safe and remember to use good infection control while enjoying such activities. Staff who are not up to date with their COVID-19 vaccines continue to be required to test twice per week per CMS guidelines. Reminders:

Visits are not recommended during an outbreak, but if you must visit; ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Complete the screening forms upon entrance, preform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe. Staff must continue to complete COVID-19 tests based on vaccine status as well as for outbreak status.

We will send an additional next week. Thank you, Mark Rust Kendra Hiles Administrator Director of Nursing

July 21^th, 2022 Residents, Staff, Families and Friends, We discovered a COVID-19 positive staff member last evening. This staff person was in the building 48 hours before the positive test. Additional testing will be required. ALL staff and resident will need to complete outbreak testing on Friday July 22^nd, Monday July 25^th and Monday August 1^st. Outbreak testing will cease if no new cases are discovered. Let this be a reminder that COVID-19 continues to spread rapidly in our communities. Use precautions while out in the community, and follow ALL infection control protocols if you must visit our facility. If anyone, resident or staff member, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. COVID-19 is still spreading very rapidly throughout our county. Staff who are not up to date with their COVID-19 vaccines continue to be required to test twice per week per CMS guidelines. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Complete the screening forms upon entrance, preform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe. Staff must continue to complete COVID-19 tests based on vaccine status as well as for outbreak status.

Thank you for your continued support, Mark Rust Kendra Hiles Administrator Director of Nursing

July 20^th, 2022 Residents, Staff, Families and Friends, Our facility has completed two rounds of outbreak testing on the residents and staff who were a high risk exposure to the positive person. Everyone has tested negative for COVID-19. We will test again on Monday the 25^th. A second staff member tested positive today, however; this staff person was not in the building with in the last 48 hours prior to symptom on set, so no further testing is required. If anyone, resident or staff member, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. COVID-19 is still spreading very rapidly throughout our county. Staff who are not up to date with their COVID-19 vaccines continue to be required to test twice per week per CMS guidelines. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Complete the screening forms upon entrance, preform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe. Staff must continue to complete COVID-19 tests based on vaccine status as well as for outbreak status.

We will send another update next week. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

July 13^th, 2022 Residents, Staff, Families and Friends, Our facility has identified a positive case of COVID-19 among our staff. The staff person is suffering from mild symptoms and is out of work per quarantine guidance. This case of COVID-19 puts our facility in outbreak status, but because the case was isolated to a small number of exposures, only residents and staff with high risk exposures will be required to test. Testing for the exposed residents will be Thursday July 14^th, Monday July 18^th and Monday July 25^th. As long as no more positive cases are identified further testing will not be required. Exposed staff will also complete outbreak testing based on exposure guidance. If anyone, resident or staff member, becomes ill or develops symptoms similar to COVID-19, please complete a COVID test right away or alert a staff member for help with testing. COVID-19 is still spreading very rapidly throughout our county. Staff who are not up to date with their COVID-19 vaccines continue to be required to test twice per week per CMS guidelines. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Complete the screening forms upon entrance, preform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe. Staff must continue to complete COVID-19 tests based on vaccine status as well as for outbreak status.

We will send out weekly updates, until the outbreak has ended. Please let us know of any questions. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

July 1st, 2022 Residents, Staff, Families and Friends, We completed our last round of outbreak testing earlier this week. No new positive cases were identified. Our facility is out of “Outbreak” status. Weekly testing for residents and facility staff who are “up to date” will cease for now. Our county transmission rate remains “high” therefore; we continue to encourage everyone to follow safe practices to protect yourself and others from COVID-19. Some reminders are listed below. Reminders: 1) Visitors are required to wear a blue surgical mask at ALL TIMES while in the hallways or common areas of the building. 2) Visits must only occur in resident rooms, where everyone should keep their mask on. Complete the screening forms upon entrance, preform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation. 3) Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together. 4) Staff must remain vigilant with all required infection control protocols. 5) COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe. Staff must continue to complete COVID-19 tests based on country transmission rate and vaccination status. Anyone who is not “up to date” must test twice per week. A big thank you to our staff for everything you do day after day and thank you to those working over the long holiday weekend. Many of our staff have put in extra hours and continue to pick up extra shifts whenever possible. We recognize that right now is a difficult time to be working in healthcare, and we are so grateful for the amazing staff we have. We also appreciate our residents and their loves ones for your patience and understanding. As we continue to navigate everyday life as well as the COVID-19 protocols that have become a “new normal”, we couldn’t do our best work without your support. Happy Fourth of July! Stay Safe, Mark Rust Kendra Hiles Administrator Director of Nursing

June 23^rd, 2022 Residents, Staff, Families and Friends, Our most recent round of outbreak testing did not identify any additional COVID positive cases. We will continue with outbreak testing on Monday June 27^th for all staff and residents. Our facility is considered to be in “Outbreak” status, visits are permitted however the safest practice would be to wait to visit until the outbreak has ended. Listed below are a few additional reminders to help keep everyone safe from COVID-19. Reminders:

ALL visitors and staff are required to wear a mask anytime they are in the building.
Visits must only occur in resident rooms, where everyone should keep their mask on. Complete the screening forms upon entrance, preform good hand hygiene, and practice social distancing. Per MDH and CDC guidance visitors are encouraged to complete an at home COVID-19 test 2-3 days before visiting to ensure no one is ill. Testing it is not a requirement for visitation.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols.
COVID-19 vaccination and all recommended boosters are strongly encouraged to keep EVERYONE safe. Staff must continue to complete COVID-19 tests based on vaccine status as well as for outbreak status.

We will send out another update next week. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

June 15^th, 2022 Residents, Staff, Families and Friends, Our facility has identified a staff member positive for COVID-19. The employee is experiencing symptoms and was in the building 48 hours prior to testing positive. We are now considered to be in outbreak status. Outbreak means all staff and residents will complete COVID-19 testing on Friday June 17^th, and the following two Mondays. Additional testing will be completed as needed for any new cases identified and testing based on vaccine status. Reminders:

Visits must only occur in resident rooms, where everyone should keep their mask on, complete good hand hygiene, and practice social distancing.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff must remain vigilant with all required infection control protocols.

We will send out a weekly update with any necessary information for the duration of this outbreak. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

June 3^rd, 2022 Residents, Staff, Families and Friends, On Monday we completed our last round of outbreak testing with no new COVID-19 cases identified. This means we will only need to test residents based on exposure, symptoms, or upon admission. Staff who are not “up to date” will need to continue to test twice per week. Reminder: “Up to date” incudes everyone who has received all the recommended COVID-19 shots, initial dose(s) and all boosters. As of today, our facility is considered to be out of outbreak status however, we caution everyone to continue with the current infection control guidelines; masking, hand hygiene, social distancing and vaccination as recommended. Renville County continues to be in “High” transmission rate for COVID-19, therefore it is only a matter of time before we see another case with in our homes or work places. Please be safe whenever you are out and about. Staff Reminder: Anyone who is not “up to date” on their vaccine must test twice weekly. If you have symptoms of COVID-19 or are just not feeling well, please test for COVID-19 and alert the charge nurse – no matter your vaccine status. Resident Reminder: Please alert a staff member if you are not feeling well. Any resident experiencing symptoms will be tested as needed based on the nurse’s assessment. Residents should wear their mask when in common areas, when they have a visitor and while out of the building. Visitor Reminder: If you are experiencing any symptoms associated with COVID-19 please refrain from visiting until you are well. If you must visit during an outbreak; wear your blue surgical mask at all times, preform hand hygiene often, and practice social distancing. All visits must only occur IN RESIDENT ROOMS. Thank you to our staff and families for your continued support and patience. We understand how frustrating things can be. If anyone has any questions or concerns, feel free to reach out. To our residents – we are sorry that life in healthcare has changed drastically over the last two years. We know this is not how anyone imagined living, but we admire your resilience and tenacity with every mandate, every guideline, and every change in protocol. It’s not easy but we will continue to try to make things as accommodating as possible. **This pandemic seems unending, so is the emotional stress it imposes on us. If you notice you are struggling and need help; please reach out to a trusted friend, loved one, co-worker or mental health professional. Everyone one is needed and important, please take care of yourself. National Suicide Prevention Hotline: 800-273-8255 Woodland Center 24-hour crisis line: 800-992-1716 Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

May 26, 2022 Residents, Staff, Families and Friends, Outbreak testing was completed on Monday with zero new COVID-19 cases identified. We will complete one more round of outbreak testing on Monday May 30^thfor all staff and residents. If everyone is negative on the 30^th we can go back to routine testing based on county transmission level and vaccine status. BLHCC continues to be in outbreak status and we caution everyone who visits to use proper infection control. To alleviate the burden of receiving so many COVID-19 updates, we have updated our notification policy for “COVID-19 Outbreaks”. As of May 26^th: you will receive one notification within 12 hours of our facility identifying its first COVID positive case indicating outbreak status. After that, we will send out weekly updates to alert you of any new cases or changes in protocol. We will identify the end of outbreak status in the last letter sent. This process will start over when a new case is identified. Although we all want this pandemic to end, it seems we are being forced to learn to live with COVID-19 in all areas of our life. If you have any questions or concerns, please reach out at any time and we will do our best to provide information. Things continue to change frequently and we understand it’s hard to keep up with all the different expectations. Staff Reminder: ALL staff are required to test once per week for outbreak testing and anyone who is not “up to date” on their vaccine must test twice weekly. If you have symptoms of COVID-19 or are just not feeling well, please test for COVID-19 and alert the charge nurse. Resident Reminder: Please alert a staff member if you are not feeling well. Any resident experiencing symptoms will be tested as needed based on the nurse’s assessment. Residents should wear their mask when someone is in their room and while out of the building. Visitor Reminder: If you are experiencing any symptoms associated with COVID-19 please refrain from visiting until you are well. If you must visit during an outbreak; wear your blue surgical mask at all times, preform hand hygiene often, and practice social distancing. All visits must only occur IN RESIDENT ROOMS. As always, if you have not been vaccinated or have not had your recommended booster doses, do so as soon as possible. Vaccination continues to be the most effective way to prevent severe illness/death from COVID-19. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

May 19, 2022 Residents, Staff, Families and Friends, We identified one additional COVID-19 positive staff member this afternoon. The staff member is out of work on quarantine and we pray for a speedy recovery. All residents and staff will be tested again on Monday, May 23^rd. COVID-19 county transmission levels are increasing and we continue to monitor the situation in order to keep everyone safe. We will send additional updates as needed. Due to the positive cases of COVID-19, our facility remains in OUTBREAK status. We encourage everyone to wear a mask, use hand hygiene and practice social distancing. We also highly suggest that you get vaccinated and boosted when able. Thank you all for your support and encouragement as we continue to navigate through this pandemic! Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

May 18, 2022 Residents, Staff, Families and Friends, We identified one additional COVID-19 positive staff member this morning. The staff member is out of work on quarantine and we pray gets well soon. All residents and staff will be tested again on Monday May 23^rd. COVID-19 county transmission levels are increasing and we continue to monitor the situation in order to keep everyone safe. We will send additional updates as needed. Due to the positive cases of COVID-19 our facility remains in OUTBREAK status. We encourage everyone to wear a mask, use hand hygiene, practice social distancing and get vaccinated or boosted when you are able. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

May 16, 2022 Residents, Staff, Families and Friends, COVID-19 continues to be of great concern for our communities. We identified one positive staff member at the start of our outbreak testing this morning. All residents are negative. We will send out another update if there are any more positive cases identified in staff. We will test everyone again on Monday May 23^rd. With the new positive case, our facility remains in OUTBREAK status. We encourage everyone to read and follow the reminders below. Staff Reminder: If you have symptoms of COVID-19 or are just not feeling well, please test for COVID-19 and alert the charge nurse. Resident Reminder: Please alert a staff member if you are not feeling well. Any resident experiencing symptoms will be tested as needed based on the nurse’s assessment. Visitor Reminder: If you are experiencing any symptoms associated with COVID-19 please refrain from visiting until you are well. If you must visit during an outbreak; wear your blue surgical mask at all times, preform hand hygiene often, and practice social distancing. All visits must only occur IN RESIDNET ROOMS. As always, if you have not been vaccinated or have not had your recommended booster doses, do so as soon as possible. Vaccination continues to be the most effective way to prevent severe illness/death from COVID-19. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

May 9, 2022 Residents, Staff, Families and Friends, We completed our second round of outbreak testing today and have identified one additional staff member who is positive for COVID-19. This staff person has mild symptoms. Our staff who were previously positive are recovering. All residents tested this morning are negative for COVID-19. We will test everyone again on Monday 16^th. With this news, it means we continue to be in outbreak status and caution should be used if you are coming to visit. Staff Reminder: If you have symptoms of COVID-19 or are just not feeling well, please test for COVID-19 and alert the charge nurse. Resident Reminder: Please alert a staff member if you are not feeling well. Any resident experiencing symptoms will be tested as needed based on the nurse’s assessment. Visitor Reminder: If you are experiencing any symptoms associated with COVID-19 please refrain from visiting until you are well. If you must visit during an outbreak; wear your blue surgical mask at all times, preform hand hygiene often, and practice social distancing. All visits must only occur IN RESIDNET ROOMS. As always, if you have not been vaccinated or have not had your recommended booster doses, do so as soon as possible. Vaccination continues to be the most effective way to prevent severe illness/death from COVID-19. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

May 2, 2022 (2^nd Update) Residents, Staff, Families and Friends, From the outbreak testing that has been completed so far, we have identified one additional staff member who is positive for COVID-19. This staff person has mild symptoms. We wish both staff who are ill a fast recovery. All residents tested this morning are negative for COVID-19. We will test everyone again on Monday May 9^thfor the second round of outbreak testing. Staff Reminder: If you have symptoms of COVID-19 or are just not feeling well, please test for COVID-19 and alert the charge nurse. Resident Reminder: Please alert a staff member if you are not feeling well. Any resident experiencing symptoms will be tested as needed based on the nurse’s assessment. Visitor Reminder: If you are experiencing any symptoms associated with COVID-19 please refrain from visiting until you are well. If you must visit during an outbreak; wear your blue surgical mask at all times, preform hand hygiene often, and practice social distancing. All visits must only occur IN RESIDNET ROOMS. As always, if you have not been vaccinated or have not had your recommended booster doses, do so as soon as possible. Vaccination continues to be the most effective way to prevent severe illness/death from COVID-19. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update May 2, 2022 Residents, Staff, Families and Friends, Our facility has identified a staff member positive for COVID-19. The employee is experiencing symptoms and was in the building 48 hours prior to testing positive. For this reason, we must increase our infection control practices to keep everyone safe, we are now considered to be in outbreak status. The changes include:

Visits must only occur in resident rooms, where everyone should keep their mask on and practice social distancing.
Residents MUST wear their surgical masks when out of their rooms. This includes in activities and throughout the common areas. Residents are still allowed to eat together.
Staff are recommended to once again wear eye protection for all resident care encounters. (This could become mandatory again if our county numbers continue to go up).
Outbreak testing for all staff and residents will be completed today and again on May 9^th. Additional testing will be based upon testing results.

Use caution while you are in the facility and while you are out. Residents who are not “up to date” are asked to stay in their rooms when possible. If you must leave, practice social distancing of 6 feet, wear your mask and remember good hand hygiene. Any staff or residents that are interested in getting the COVID vaccine or booster contact Shyann or your supervisor as soon as possible. Thank you for your ongoing support. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update March 31, 2022 Residents, Staff, Families and Friends, We are pleased to announce a few changes in our COVID-19 protocols. Based on the Renville County COVID-19 Transmission rate (Moderate Transmission), we can adjust a few of our rules for staff, residents, and visitors. Please note that if the transmission rate moves back into Substantial/High levels, we will have to re-implement more strict protocols. Per CDC guidance – County Transmission Level (Moderate/Low): Resident Mask Usage – It remains the safest practice to wear a mask when out in the hallway, during activities and while visiting in your rooms. However, residents who are “up to date” on their COVID-19 vaccines may choose whether to wear there mask or leave it off while out of their room. Visitor Changes – Visits must only occur in resident rooms. No visits in the dining area or activity room.

When you visit; enter at door number 1, screen in, answering all of the questions, take your temperature, wear a blue surgical mask at all times during your visit. If both the visitor and the resident are “up to date” on their COVID-19 vaccines and the resident is comfortable; masks may be removed while in the resident room (you may eat/drink with your loved one in their room, not in the dining room with others present).

Staff Eye Protection –Staff are NOT required to wear eye protection during patient care. COVID-19 testing for BLHCC staff:

If you have any symptoms consistent with COVID-19 please test immediately.
Staff who are “up to date on COVID-19 vaccines” do not need to test for COVID-19 on a routine basis.
Staff who are unvaccinated or who are NOT up to date on COVID-19 vaccines will be required to test twice per week (Monday/Thursday).
If you miss testing on Monday/Thursday you need to test prior to working your next shift.
Staff = payroll staff, volunteers and contracted workers
If you have received your booster dose of COVID-19 vaccine and have not submitted this information to the facility, please bring your updated vaccine card to your supervisor.

Definition of “Up to Date” – To be considered up to date you must be fully vaccinated and have received a booster dose as recommended. *If you are fully vaccinated but have not reached the recommended time frame to receive a booster dose, you are considered to be up to date. If you are past the time frame to receive a booster dose and have chosen not to be boosted, you are NOT considered up to date. COVID-19 Vaccine Update: People age 50 years or older have been approved for a second booster dose of Pfizer or Moderna brand COVID-19 vaccine. This news was just released on Tuesday and we are working to gather all the necessary information. Despite the lightened restrictions, COVID-19 is still a threat to all of us. Please continue to wash your hands, stay home while ill, and if you have not received your COVID-19 vaccine and booster, do so as soon as possible. It has been a long road to this relief of COVID-19 restrictions. Work force shortages and stringent COVID-19 protocols have not been easy to maneuver over the last two years (BLHCC First Shut Down to Visitors on March 9^th 2020). It is because of our staff, residents, families and community that we continue to be able to serve this beautiful rural community. We know it hasn’t been easy for anyone, but we are so gracious to you for sticking with us. As we look towards Easter, we thank all of you for your support and compassion. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update February 19, 2022 Residents, Staff, Families and Friends, We completed outbreak testing Thursday as planned. All staff and residents were negative for COVID-19. Because we have not identified any positives cases, we can return to routine testing of staff. Residents will only be tested if symptomatic or possibly exposed. See Routine testing changes below. Per CDC guidance: Routine testing for BLHCC staff:

Staff who are “up to date on COVID-19 vaccines” will need to test once per week (Mondays) as a mitigation effort to combat COVID-19.
Staff who are unvaccinated or who are NOT up to date on COVID-19 vaccines will be required to test twice per week (Monday/Thursday).
Staff = pay roll staff, volunteers and contracted workers

Definition of “Up to Date” – To be considered up to date staff must be fully vaccinated and have received their booster dose as recommended. *If you are fully vaccinated but have not reached the recommended time frame to receive a booster dose, you are considered to be up to date. If you are past the time frame to receive a booster dose and have chosen not to be boosted, you are NOT considered up to date. If you have received your booster dose of COVID-19 vaccine and have not submitted this information to the facility, please bring your updated vaccine card to your supervisor as soon as possible so your COVID-19 vaccine records can be updated. If you miss testing on Monday/Thursday you will need to test prior to working your next scheduled shift. If you have any symptoms consistent with COVID-19 please test immediately. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update February 11th , 2022 Residents, Staff, Families and Friends, We completed outbreak testing yesterday as planned. All staff and residents were negative for COVID-19 during that round of testing. However, we had one staff test positive today. We will test ALL staff and residents on Monday Feb. 14^th and Thursday Feb. 17^th. This means we continue to be in outbreak status and caution everyone who is visiting, in person, to take all the necessary precautions. If you feel you must visit in person please practice good infection control procedures posted throughout the building. Other avenues for visiting are available upon request. Please call to set up a video chat or phone call. Ask for Lyn (320)-833-5364 ext. 36 or sign up at BLHCC Virtual Visit. Staff/Volunteer Reminder: If you have received your booster dose of COVID-19 vaccine and have not submitted this information to the facility, please bring your updated vaccine card to your supervisor as soon as possible so your COVID-19 vaccine records can be updated. If you have any symptoms consistent with COVID-19 please test immediately. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update February 7th , 2022 Residents, Staff, Families and Friends, We completed outbreak testing today as planned. We discovered one positive staff. This staff member has not worked within the last 48 hours. All of the residents continue to test negative. Our next round of outbreak testing will be Thursday Feb 10^th. If everyone is negative after that round of testing we will go back to our routine testing. We continue to caution everyone who comes to visit at our facility as we are in outbreak status. You will see signs posted on the main entrance doors as well as in the main hall as you come in. These signs offer infection control education. Please practice all necessary infection control procedures while you are here. COVID-19 is easily spread from person to person. Getting the COVID-19 vaccine will greatly reduce your symptoms and chance of serious illness. We have seen the positive effect of having the vaccine in all of our vaccinated individuals who have contracted COVID-19. When you are able, please get vaccinated and boosted. FYI: The CDC has updated vaccine status definitions. Individuals are considered to be “Up to Date” on their COVID-19 vaccine if they are fully vaccinated and have received a booster dose as recommended. Anyone who is unvaccinated, fully vaccinated but not yet boosted as recommended, are considered to be “NOT Up to Date”. Routine testing changes will be coming for our staff (Staff includes: facility staff, volunteers and contracted staff). If you have received your booster dose of vaccine and have not submitted this information to the facility, please bring your updated vaccine card to your supervisor as soon as possible so your COVID-19 vaccine records can be updated. If you have questions or concerns please reach out to (320)-833-5364 to our Director of Nursing ext. 14 or Safety Director ext. 30. Thank you! Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update February 5th , 2022 Residents, Staff, Families and Friends, One of our staff tested positive for COVID-19 this morning. We will complete outbreak testing for ALL staff and residents Monday Feb. 7^th and Thursday Feb. 10^th. Thank you to all of our staff who work tirelessly to keep our residents cared for and safe. Many of you have worked extra hours on weekends, holidays and during regular hours. You all do an amazing job day in and out. Thank you for being here. Anyone visiting today or in the near future should continue to use hand sanitizer frequently, keep your blue surgical mask on at all times, and do not join your friend or loved one in activities or in the dining room. Visiting during an outbreak is a risk to your health, please keep yourself and our residents and staff safe while you are here. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update February 3rd, 2022 Residents, Staff, Families and Friends, We wanted to let you know that we discovered three additional COVID-19 positive staff yesterday during our outbreak testing. No positive residents at this time. We will need to complete outbreak testing for ALL staff and residents Monday Feb. 7^th and Thursday Feb. 10^th. We are hopeful that soon we will start to see a decline in the transmission rate of COVID-19 but for now we remain cautious and wish all of our ill staff the best. So far, everyone is doing well with mild cold like symptoms. If you are feeling ill we encourage you to stay home, quarantine and get tested for COVID-19. Thank you for your continued support, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update February 2nd, 2022 Residents, Staff, Families and Friends, We wanted to let you know that we discovered one COVID-19 positive staff member today. This staff member does have symptoms and was in the building 48 hours before the symptoms started. We will need to complete outbreak testing for ALL staff and residents tomorrow, Feb. 3^rd and Monday Feb. 7^th. We continue to caution everyone to use good infection control practices when out and about. Also, please get your COVID-19 vaccine and get boosted when you are able. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update February 1st, 2022 Residents, Staff, Families and Friends, Our facility completed two rounds of outbreak testing with no new positive staff or resident cases discovered. We currently have one resident in quarantine, they are doing well with no symptoms at this time. We will resume our routine testing schedule of all staff one time per week and unvaccinated staff twice per week. At this time residents will not be tested unless symptomatic or we identify a new staff case of COVID-19. We are happy that no new cases have been detected but we are hesitant to celebrate. We know that COVID-19, specifically the omicron variant, is spreading rapidly. The transmission rate for Renville County continues to be “High”. We continue to encourage everyone to get vaccinated and boosted. When you are in our building you must; practice good hand hygiene, wear a blue surgical mask at all times, and practice social distancing from other staff and residents. If you are here during meal times or afternoon coffee, we encourage you remain masked and refrain from eating with your loved one. If you feel you must stay during meals or coffee time, you are required to stay in the resident’s room. You may only remove your mask in the residents room if you are fully vaccinated and you’re loved one is comfortable with you not wearing your mask. At this time: No visitors are allowed in the dining area or activity room. As this year plunges forward we look for brighter, healthier times, but right now the reality remains; COVID-19 is still a danger to everyone. Please continue to help us keep staff and residents safe by following all of our COVID-19 protocols. As always we appreciate your ongoing support and understanding. Staff….we cannot say THANK YOU enough, we have seen countless staff step into roles that are not their preferred role. We thank you! The residents thank you! Without our outstanding TEAM at BLHCC we could not provide the exceptional care our resident deserve. THANK YOU! Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update January 26th, 2022 Residents, Staff, Families and Friends, Our facility completed outbreak testing on all staff and residents as planned on January 24^th. We discovered one positive staff and one positive resident. The staff member is doing ok with mild cold like symptoms and the resident has no symptoms at this time. We will need to complete outbreak testing for all residents and staff on Thursday Jan 27^th and Monday January 31^st, both days will be rapid tests. Once we complete two rounds of COVID-19 testing with NO new positive cases identified we can resume our regular testing of only staff as required by CMS. COVID-19 seems to be everywhere these days and even people who are vaccinated are testing positive. However, studies continue to show that the vaccine keeps people from becoming severely ill or dying. If you have not been vaccinated please do so, and if you have not had your COVID-19 vaccine booster shot, we recommend that you get it as soon as you are able. We caution everyone who comes to visit our residents. Please do not visit if you are experiencing any symptoms associated with COVID-19, have tested positive for COVID within the last 14 days or have been exposed to someone with COVID. If you feel you must visit; sanitize your hands before and after visiting, wear your blue surgical mask during your entire visit, and practice social distancing from residents and staff. If you are having symptoms of COVID-19 please stay home and get tested. The CDC has posted a link for everyone to be able to order 4 at home COVID-19 test kits for free. It’s a simple form to fill out on the U.S Postal Service Website: https://special.usps.com/testkits?ACSTrackingID=USCDC_2067-DM74062&ACSTrackingLabel=Free%20At-Home%20COVID-19%20Tests%20%20%7C%20COVID-19&deliveryName=USCDC_2067-DM74062 Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

January 20, 2022 Residents, Staff, Families and Friends, Our facility completed outbreak testing today as planned. We identified two additional staff cases, both with symptoms. These staff were tested before having resident contact. We also discovered one positive resident. This resident is having mild symptoms and is doing fine at the moment. The previous staff and residents who are positive continue to get better. Again a reminder to our visitors: If you are experiencing any symptoms of COVID-19, or the common cold, refrain from visiting until your symptoms are gone and you feel better. Anyone with symptoms should get tested for COVID-19 as soon as possible, to avoid spreading the disease further. If you feel you must visit; we ask that you use caution when you enter the facility. Keep your blue surgical mask on for your entire visit, sanitize your hands often (before and after entering or exiting a resident room) and practice social distancing. We will complete outbreak testing for all staff and residents on Monday Jan. 24^th (Mayo tests). A big thank you to all of our staff who are giving up their personal time and time with families and loved ones to help us get through this COVID outbreak! We also appreciate all of our families and visitors for their understanding and patience! Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update January 19th, 2022 Residents, Staff, Families and Friends, On January 18^th we identified one additional staff member positive for COVID-19. We are wishing all of our ill staff and residents well. So far everyone is experiencing mild symptoms. We will complete outbreak testing for all staff and residents this week on Thursday (Rapid tests) and on Monday January 24^th (Mayo tests). Thank you for your patience and understanding. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update January 17th, 2022 Residents, Staff, Families and Friends, We want to inform you that we identified three positive residents and three more positive staff today during our outbreak testing. All staff and residents are doing well. Most are experiencing cold like symptoms. We encourage everyone to wear there surgical mask at all times while in the facility. We are asking all residents to wear there mask for the entire time they are out of their room or apartment, this includes in the activity room. Communal dining is still open, but we encourage those who can to eat in their room. Visitors, if you are experiencing any symptoms of COVID-19, or the common cold, refrain from visiting until your symptoms are gone and you feel better. Anyone with symptoms should get tested for COVID-19 as soon as possible to avoid spreading the disease further. If you feel you must visit; we ask that you use caution when you enter the facility. Keep your blue surgical mask on for your entire visit, sanitize your hands often (before and after entering or exiting a resident room) and practice social distancing. A phone call might be more appropriate if that is an option for your loved one. We will complete outbreak testing for all staff and residents again on Thursday (Rapid tests) and on Monday next week (Mayo tests). Please continue to take all the necessary precautions to keep yourself and others safe. Wear a mask, practice social distancing, get vaccinated and boosted, and stay home if you are feeling ill. Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update January 15th, 2022 Residents, Staff, Families and Friends, We discovered one COVID-19 positive staff today. All of our COVID positive staff are doing ok and experiencing mild symptoms. We will complete outbreak testing for all staff and residents on Monday and Thursday next week. Please continue to take all the necessary precautions to keep yourself and others safe. Wear a mask, practice social distancing, get vaccinated and boosted, and stay home if you are feeling ill. Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update January 14th, 2022 Residents, Staff, Families and Friends, We discovered one COVID-19 positive staff today during our routine testing. We will complete outbreak testing for all staff and residents on Monday and Thursday next week. We encourage any staff member who may be experiencing symptoms consistent with those of COVID-19 to please complete a rapid test immediately. A reminder for visitors who enter our building; a BLUE SURGICAL mask is required to be worn throughout the facility when visiting. Our facility in outbreak status we encourage everyone to stay masked and practice social distancing during your entire visit. Thank you for all you continue to do to keep our residents and staff safe. Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update January 11th, 2022 Residents, Staff, Families and Friends, We wanted to let you know that we discovered two COVID-19 positive staff yesterday during our routine testing and an additional staff self-reported being positive after taking an at home test. All three staff members had not been in the facility 48 hours prior to testing positive so no outbreak testing will be needed. We wanted to share this information with you as a cautionary statement; please wear your mask, use good hand hygiene and get vaccinated or boosted at your next availability. Thank you for your ongoing support. Mark Rust Kendra Hiles Administrator Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update December 30, 2021 ALL Families/ResidentS/Tenant/staff UPDATE: This update is to let everyone know that we identified one positive staff case of COVID-19 today (December 30th). The positive staff was in the building within 48 hours prior to testing positive and has no symptoms. We are considered to be in outbreak status, however, this staff had no contact with residents and we will only be testing all staff per our routine testing on Monday, January 3rd with rapid tests. Feel free to contact us with any questions. It is best to email us at khiles@blhcc.org or mrust@blhcc.org. Mark Rust, Administrator Kendra Hiles, Director of Nursing

Greetings Residents, Staff, Families, Friends; There have been a few changes to the visitor screening upon entry to our facility. Visitors are now able to screen themselves into the building. Upon entry you will still need to put on a surgical mask, fill out a screening form and take your temperature just like you have in the past. The doors will open whenever you are ready to enter, you will no longer have to ring the doorbell unless you are visiting after hours. Visits are still only allowed in a resident’s room or tenant’s apartment. Also new, residents may have visitors at their choosing even during times of quarantine or isolation. Please note that if you choose to visit a resident while they are in quarantine/isolation due to COVID that this is a great threat to your own health. You will also be expected to wear the proper PPE to keep you safe. Nursing staff will guide you through this process. COVID-19 is a contagious virus that has proven to be detrimental to people from all ages, backgrounds and health statuses. The best way to protect yourself and others is to become vaccinated and get your COVID-19 booster doses, wear your mask, practice social distancing and stay home if you are sick or have been exposed to anyone who is positive for COVID-19. If face to face visitation isn’t possible we have a few other options available. You can sign up for a virtual visit at https://www.signupgenius.com/go/904044AA9AF22A4F94-blhcc1 or go to our website at https://blhcc.org/, scroll down and you will see a link to sign up for our virtual visit. If you need assistance with signing up or need a different time and date that is not listed on our sign up, please call Lyn at 320-833-5364 ext. 36 or e-mail: atotenhagen@blhcc.org and we will try out best to set it up for you and your loved one.

COVID-19 Update: A positive case of COVID-19 has been identified in a facility staff member. ALL residents and staff will be COVID tested with rapid tests on Thursday Dec. 16^th 2021 and Mayo tests on Monday Dec. 20^th. If no new cases are identified, we will return to our regular staff testing schedule..

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 1, 2021 ALL Families/Residents/Tenant/staff UPDATE: This update is to let everyone know that we identified one positive staff case of COVID-19 today (December 1^st). The positive staff was in the building within 48 hours prior to symptom onset during the infectious period. We are considered to be in outbreak status and have tested all residents and staff on Monday November 28^th and will test everyone again Friday December 3^rd with PCR tests and Monday December 6^th with rapid tests. We want to continue to encourage everyone to get vaccinated and if eligible to get your booster dose as soon as you are able. Feel free to contact us with any questions. It is best to email us at khiles@blhcc.org or mrust@blhcc.org Mark Rust, Administrator Kendra Hiles, Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant/Staff COVID-19 Update July 21, 2021 ALL Families/Residents/Tenant/staff UPDATE: We wanted to update you on the results of our outbreak testing that was completed after a positive case was identified on July 6^th. Our test results from our last round of outbreak testing was completed on Monday. All results are in and EVERYONE IS NEGATIVE! This means we are no longer considered to be in outbreak status. The current county positivity rate in Renville County is very low at 0.7%. This is great news, but we are watching the states and counties around us closely. There are various strains of the COVID-19 virus still out there and making their way into the southern counties in our state. They are impacting people in different ways. Research is ongoing in the effectiveness of our current vaccines against the multiple strains of COVID-19. So far, vaccines have proven to be effective, protecting those who are fully vaccinated against severe illness, hospitalization and death. We want to continue to encourage everyone to get vaccinated. Vaccination, along with social distancing, mask usage per recommendations, and hand hygiene are the best tools we have at fighting this virus. Attached at the end of this letter you will find a document we have put together with links to find out where and how you can get vaccinated. It’s not too late! Thank you for all your continued support! Sincerely, Mark Rust, Administrator Kendra Hiles, Director of Nursing How Can I Get My COVID Vaccine? Call Your Local Clinic – Clinics are receiving allotments of vaccine. They receive a specific number of doses each week, vaccine brand may vary. They will schedule you or add you to a waitlist. Go to https://mn.gov/covid19/vaccine/connector/ or google search MN vaccine connector you will fill out a form to include your location, employment category and medical information. Visit www.vaccinefinder.org on this website, you can select a specific vaccine you are looking for (Johnson & Johnson, Moderna, Pfizer). It will give you all the pharmacies within your search area that can help you get vaccinated. You can then call that pharmacy and schedule an appointment. Sign up on the Thrifty White website: https://www.thriftywhite.com/covid19vaccine . Visit the MDH website https://mn.gov/covid19/vaccine/index.jsp Call Shyann Topel – Safety Director for the Buffalo Lake Healthcare Center – She can assist you in finding a vaccine clinic closest to you. (320)-833-5364 ext 30

July 6th, 2021 This morning, we were notified of a positive COVID-19 case in a staff member. COVID-19 rapid tests are being completed facility wide for all residents and staff. At this time, we have not identified any further cases. We are open for all visitors. Per MDH and CDC guidelines, we will test all residents and staff weekly for two weeks. If no further cases are identified, we will no longer be considered to be in “outbreak” mode and will return to routine monthly testing of staff. Please feel free to contact Mark, Kendra, Shyann or Michelle if you have any questions or concerns at 320-833-5364.

BLHCC and Westview Estates Family/Resident/Tenant COVID-19 Update May 12, 2021

ALL FAMILIES/RESIDENTS/TENANT UPDATE:

As we reflect back on this last year we remember how hard it was when the pandemic began. There was fear, anxiety, disbelief and even anger. We are once again in a position where all of those emotions come into play. We are officially in the “recovery” mode of this pandemic and now we feel the same emotions as we move forward and try to re-build a new normal in all our lives. MDH, CDC, and CMS have laid out new guidance once again to further help our residents, staff and their families move forward. We’ve broken out the new guidance below. Visiting Guidance Changes: All Visitors Must:

Visitors must be asked if they have received their vaccine on their screening form upon entry. Those who are unvaccinated or those who do not want to disclose this information should be treated as unvaccinated people.
Visitors must continue to wear surgical masks upon entry and throughout the facility, in hallways and common areas.
BLHCC no longer needs to enforce 3 people per room or limit the number of people in the facility at any one time.
Visitors under Age 16 must continue to wear a mask. Those under the age of 2 are still prohibited from entrance because of inability to wear a mask, you may visit outside.

– Fully Vaccinated Visitors:

Vaccinated visitors may visit and/or eat with their loved one in the resident’s room unmasked if the resident is also fully vaccinated.

– Unvaccinated Visitors:

· Must continue to wear a mask during their entire visit and may not eat or drink while in the facility.
· Must continue to practice 6 foot social distancing while visiting if the resident is unvaccinated.

Resident Activity and Dining Changes:

– Fully vaccinated Residents may sit next to each other without masks for dining and activities.
· If an unvaccinated resident enters the room, the unvaccinated resident must stay 6 feet from others and everyone in the room must wear their mask (unless eating).
– All Residents must continue to wear masks in the hallways while going to/from another part of the facility.

Staff:

– We are to take the visitors word for their vaccination status and we are trusting visitors to follow guidance based on their vaccination status. As visitors enter they will be reminded of the visiting (PPE) guidelines. There will be cards to give visitors at the front door related to visiting guidelines.
– Staff PPE requirements have NOT changed. All staff must wear surgical mask and eye protection at all times in resident care areas. Eating should continue to only take place in the break room.
– If a visitor or another resident asks about a resident’s vaccination status encourage them to ask the resident directly, if the resident cannot respond assume they are unvaccinated.

We continue to be extremely proud of our staff for the hard work they put in each day to keep everyone safe. We also are so thankful for the patience and grace we have received from our families, residents and friends. This past year has not been easy but we cannot emphasis enough how much you all mean to us. Thank you for your support! Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing

BLHCC and Westview Estates Family/Resident/Tenant COVID-19 Update May 10, 2021 ALL FAMILIES/RESIDENTS/TENANT UPDATE: Today we identified a positive case of COVID-19 in one of our staff. Due to this case all visits had to be temporarily suspended until testing on everyone (staff and residents was complete). All staff and residents have since been tested with rapid testing and no further cases have been identified. This means in facility visits may resume. This one case does place us in outbreak status and we are therefore required to test everyone again every 3-7 days for 2 weeks. We will be testing this week again on Thursday. Next week we will test everyone on Monday 5/17 and Thursday 5/20. If there are no positive cases identified we will return to routine testing of the required staff per the county positivity rate. If you have any questions, do not hesitate to contact us at 320-833-5364 or khiles@blhcc.org. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update April 1st, 2021 ALL FAMILIES/RESIDENTS/TENANT UPDATE: Our test results from this week Monday are in and everyone is negative. We completed outbreak testing this week which means we tested all residents/tenants and staff. We will do this again on Monday 4/5/21 and if everyone is again negative we will go back to only testing staff weekly, due to our county positivity rate being higher than 5%. Please be aware that we may need to block off visiting for sections of the building if there is a positive case of COVID identified. We want to continue to encourage everyone to get vaccinated. COVID -19 is not going away and getting vaccinated is the best way to protect yourself, your family and our residents. Attached at the end of this letter you will find a document we have put together with links to find out where and how you can get vaccinated. We are now allowed to have anyone visit that can follow the following guidelines:

1) Pass the screening: no signs/symptoms of COVID and no contact with someone with COVID in last 14 days

2) Wear a mask that covers the face and nose at all times – Surgical mask provided at the door (no cloth masks)

Children that cannot follow this will not be allowed to visit at this time. Unfortunately this means no babies.

3) Social distance of at least 6 feet

4) Use proper infection control guidelines and hand hygiene.

5) You are not allowed to remove your mask, so NO eating or drinking while visiting and residents/tenants and you will need to also wear a mask during the entire visit. The resident or tenant should also wear a mask for your visit, even in their room or apartment.

Visiting: We are asking that all visitors come to our front door off Yellowstone Trail. You will come in the front sliding door and before the second door ring the door bells (2 of them). This will alert staff that there is a visitor at the door. Between the hours of 2pm and 5pm there will be someone at the door and you will not have to wait to be screened. During other hours you can ring the door bell, begin to complete the screening form at the door, apply a surgical mask and wait for someone to screen you face to face to let you into the building. We cannot have more than 3 people visiting one person at a time. Just so that you are aware, we are not allowing more than 36 visitors in the building at a time. If this number is met you may have to wait to be allowed in for a visit. If you have not done so watch this video to see the visiting plan in action: https://www.youtube.com/watch?v=ZuBKWgY7vsA Outings: Easter is upon us. If you are planning to take your loved one out for Easter please call ahead so that we can prepare by getting medications ready ahead of time. Those that are fully vaccinated may go out for Easter. Fully vaccinated (2 weeks post both shots if a 2 shot series, or 2 weeks post the one shot if the Johnson and Johnson shot). Remember to follow the infection control protocols- wear a mask at all times, socially distance as much as possible, wash hands. Those that are fully vaccinated do not have to quarantine upon return unless they spend 15minutes or more in a 24 hour period within 6 feet of someone who has COVID-19. For those that are fully vaccinated and wish to leave for non- medically necessary reasons it is recommended to follow these steps: · Residents who are fully vaccinated may gather indoors or outdoors with other people who are fully vaccinated. · Residents who are fully vaccinated can visit indoors or outdoors with unvaccinated people from a single household who are at low risk for severe COVID-19 infection. · If the resident is fully vaccinated, they can choose to have close contact (including touch) with the persons they are visiting. · Indoor and outdoor visits should be conducted following good infection control practices, such as wearing well-fitting masks that cover the mouth and nose, staying 6 feet from others (social distancing) when practical, and using good hand hygiene to reduce risk of infection. · If a resident who is fully vaccinated chooses to attend a place of worship or other group event, or to shop or eat in public establishments, the resident should follow the core principles of COVID-19 infection prevention. MDH strongly encourages attending places of worship or other group events only when the 14-day county percent positivity rate is below 5%. The positivity rate is the percentage of people who test positive for COVID-19 among all the people in the county who are tested. ***Our county is currently greater than 5% so this outing is not recommended and participating in this type of outing will mean we are obligated to place this resident in quarantine upon return for the health and safety of everyone in our setting. · If you have visited our facility or had contact with our residents/tenants and develop symptoms of COVID-19 or receive a confirmed diagnosis of COVID-19 within 24-48 hours of the visit, please call the facility so we can take precautions as necessary. If it becomes known that a resident had a high risk exposure we are obligated to protect the health and safety of everyone here and place that resident in a 14 day quarantine. As a reminder a high risk exposure is being out with more than one family that is not vaccinated. Thank you for your understanding of the guidelines we must follow. If you have any questions, do not hesitate to contact us at 320-833-5364 or khiles@blhcc.org. Have a very blessed Easter! Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing

How Can I Get My COVID Vaccine?

Call Your Local Clinic – Clinics are receiving allotments of vaccine. They receive a specific number of doses each week, vaccine brand may vary. They will schedule you or add you to a waitlist. Go to https://mn.gov/covid19/vaccine/connector/ or google search MN vaccine connector. Here you can get on a waitlist for anywhere in the state that has the vaccine available. You will fill out a form to include your location, employment category and medical information. When vaccine becomes available you will receive an email or phone call. Visit www.vaccinefinder.org on this website, you can select a specific vaccine you are looking for (Johnson & Johnson, Moderna, Pfizer). It will give you all the pharmacies within your search area that can help you get vaccinated. You can then call that pharmacy and get on their list. Sign up on the Thrifty White website: https://www.thriftywhite.com/covid19vaccine . You can sign up to get on a waitlist for a thrift white in your area. They will call you when they have an opening for you. Vaccine brand may vary. Visit the MDH website https://mn.gov/covid19/vaccine/index.jsp Staff once you have received your vaccine please show your vaccine card to Kendra, Michelle, Marty or Shyann. It is important for us to have this information!

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update March 26th, 2021

In Person Visits are able to resume effective immediately

Results from Monday, March 22nd staff testing are in: At this time we have one staff that was identified with COVID-19 on our routine testing this week, this staff is not exhibiting any symptoms and had been fully vaccinated. This is an example of the vaccine doing its job to decrease symptoms and illness related to COVID. All staff and residents were tested again on Wednesday and Thursday March 23/24th and no new cases were identified. Per CMS and MDH guidance visitors are allowed to come into the building as the first round of outbreak testing is complete. Please enter through Door #1 (the main entrance). If you come between the hours of 2pm and 5pm there will be someone at the door, use the door bells in the entrance at other times. All staff and residents will be tested again on the next two Monday’s, if there are any positive tests we have to cease visiting until we can determine if we have a large scale outbreak. Please see previous notices as to the visitation and outing guidelines at BLHCC.

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update March 24th, 2021

In Person Visits are temporarily suspended, we are experiencing an outbreak of COVID-19.

“Outbreak” – one or more cases of COVID-19 in a staff or resident. Essential caregivers and compassionate caregivers are still allowed entrance through Door #13 (Church Ave). Outing and quarantine guidance are not affected by the outbreak. We are still awaiting the rest of results from Monday, March 22nd staff testing and will send out a letter when all results are in. At this time we have one staff that was identified with routine testing this week. All residents and staff will be tested today and next two Monday’s to ensure this outbreak is not wide spread. If all tests come back negative today visitors will be allowed back in the building per CMS and MDH guidance. Please watch our notices for further direction.

In addition to our previous announcements about visiting, we need to also remind you no one under 2 years of age, and others who are not able to properly wear their mask and adhere to appropriate hand hygiene, will be allowed to enter the facility. Although it pains us to continue to have this precaution in place, it is our responsibility to keep our residents and tenants safe as well as everyone who enters our doors Thank you for your understanding.

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update March 22, 2021 ALL FAMILIES/RESIDENTS/TENANT UPDATE: We apologize in advance for the length of this update, there are many changes in this week. All of the updates are good for our residents!!! We have been doing staff testing every Monday for the last 4 weeks due to our county positivity rate for COVID-19 being greater than 5%. This will continue for at least the next month due to regulations that we must follow based on the county rate. All staff have tested negative so far with the testing that has been done. We also do testing for any symptomatic staff or residents as needed and have had no positive cases of COVID since January 10, 2021. If one staff or resident were to test positive this is considered an “outbreak” and we would need to follow more stringent regulations for visiting and outings. We are happy to share that we completed our third vaccination clinic on March 10th. We want to continue to encourage everyone to get vaccinated. COVID -19 is not going away and getting vaccinated is the best way to protect yourself, your family and our residents. We continue to work with the Minnesota Department of Health to find ways to get COVID-19 vaccines for any residents or staff that wish to receive the vaccine and have not already done so. The COVID -19 vaccines have proved to be safe and very effective. Nationwide, the number of positive cases and deaths in Care Centers and Assisted Livings has dropped by 90% over the last two months. As a result, the CDC and Health Department have revised a number of COVID-19 precautions. Late last week CMS released some new guidance on visiting. We are now allowed to have anyone visit that can follow the following guidelines: 1) Pass the screening: no signs/symptoms of COVID and no contact with someone with COVID in last 14 days 2) Wear a mask that covers the face and nose at all times – Surgical mask provided at the door (no cloth masks) 3) Social distance of at least 6 feet 4) Use proper infection control guidelines and hand hygiene. We will begin to allow visits for anyone on Tuesday March 23rd. This is so exciting!! Visiting: We are asking that all visitors come to our front door off Yellowstone Trail. You will come in the front sliding door and before the second door ring the door bells (2 of them). This will alert staff that there is a visitor at the door. Between the hours of 2pm and 5pm there will be someone at the door and you will not have to wait to be screened. During other hours you can ring the door bell, begin to complete the screening form at the door, apply a surgical mask and wait for someone to screen you face to face to let you into the building. We cannot have more than 3 people visiting one person at a time. Please be aware that we may need to block off visiting for sections of the building if there is a positive case of COVID identified. You are not allowed to remove your mask, so NO eating or drinking while visiting and residents/tenants and you will need to also wear a mask during the entire visit. The resident or tenant should also wear a mask for your visit, even in their room or apartment. Watch this video to see the visiting plan in action: https://www.youtube.com/watch?v=ZuBKWgY7vsA Outings: Several residents have voiced that they are ready to “get out of here”. Now they can! If they are fully vaccinated (2 weeks post both shots if a 2 shot series, or 2 weeks post the one shot if the Johnson and Johnson shot) they can go out, following the infection control protocols- wear a mask at all times, socially distance as much as possible, wash hands. Those that are fully vaccinated do not have to quarantine upon return unless they spend 15minutes or more in a 24 hour period within 6 feet of someone who has COVID-19. For those that are fully vaccinated and wish to leave for non- medically necessary reasons it is recommended to follow these steps: · Residents who are fully vaccinated may gather indoors or outdoors with other people who are fully vaccinated. · Residents who are fully vaccinated can visit indoors or outdoors with unvaccinated people from a single household who are at low risk for severe COVID-19 infection. · If the resident is fully vaccinated, they can choose to have close contact (including touch) with the persons they are visiting. · Indoor and outdoor visits should be conducted following good infection control practices, such as wearing well-fitting masks that cover the mouth and nose, staying 6 feet from others (social distancing) when practical, and using good hand hygiene to reduce risk of infection. · If a resident who is fully vaccinated chooses to attend a place of worship or other group event, or to shop or eat in public establishments, the resident should follow the core principles of COVID-19 infection prevention. MDH strongly encourages attending places of worship or other group events only when the 14-day county percent positivity rate is below 5%. The positivity rate is the percentage of people who test positive for COVID-19 among all the people in the county who are tested. ***Our county is currently greater than 5% so this outing is not recommended. · If you have visited our facility or had contact with our residents/tenants and develop symptoms of COVID-19 or receive a confirmed diagnosis of COVID-19 within 24-48 hours of the visit, please call the facility so we can take precautions as necessary. Fully vaccinated residents should continue to: · Take steps to prevent contact with COVID-19 in public settings. Examples include wearing a well-fitted mask over their mouth and nose, and physical distancing. · Follow infection control practices, such as wearing masks, practicing social distancing, and perform hand hygiene to lower their risk when visiting with unvaccinated people who are at higher risk for severe COVID-19 disease or who have a household member who is at increased risk for severe COVID-19 disease and is not vaccinated. · Wear masks, practice social distancing, and perform hand hygiene to lower their risk when visiting with people from multiple households who are not vaccinated. · Comply with any current state mandates or restrictions on group size at the time of the outing. https://www.leg.mn.gov/archive/execorders/21-11.pdf · Get tested if they have CDC: Symptoms of Coronavirus https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html · Follow CDC and health department travel requirements and recommendations. Residents/tenants that are not fully vaccinated are required to follow the quarantine guidelines for non-medically necessary outings. New news: Beginning on Monday March 15, 2021 we started having residents who choose come to their main dining room for the noon meal. The Assisted Living tenant can choose to come to their dining areas at their ends of the building and the Care Center residents come to the main dining area if they choose. Residents are socially distanced at the meals and wear a mask to and from the dining area as well as complete hand hygiene. This has been going very well. We also have had group activities going on with residents. Residents are socially distanced and wearing masks for these events. This is all very exciting news! We are excited to welcome visitors back! At the same time please be respectful of our staff and practice socially distancing from the staff. We are getting closer to more “normal” living but precautions must remain for this process to continue and be successful. If you have any questions, do not hesitate to contact us at 320-833-5364 or khiles@blhcc.org. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update February 25th, 2021 ALL FAMILIES/RESIDENTS/TENANT UPDATE: We completed our staff testing on Monday 2/22/21. Many staff resumed testing this week since it has been 90days since their positive case of COVID. All the results are in and all staff tested negative this week. Unfortunately the case positivity rate for our county has gone up. It is now at 6.0% and we are required to resume weekly testing for all staff if we are above 5%. Residents do not need to be tested unless we have one positive case. We are happy to share that we have completed our second vaccination clinic on February 10th. Getting vaccinated against COVID-19 is one of the best ways to protect long-term care residents and caregivers from COVID-19. This vaccine gives us hope for the future. A successful vaccination program is a huge step forward in beating the COVID-19 pandemic. To date we have had 94% of our residents and tenants, and 52% of our staff that have chosen to receive the COVID-19 vaccine. These are good numbers but we want to continue to encourage everyone to get vaccinated. COVID -19 is not going away and getting vaccinated is the best way to protect yourself, your family and our residents. In facility visits have been going now for a couple of weeks and the residents are enjoying these. You can sign up for these visits on our website at www.blhcc.org these visits are for anyone wanting to see a resident. Indoor visits or virtual visits are on Tues, Thursday or Sunday’s. The indoor visits are supervised in our new community room and are for those that are not approved as essential caregiver visitor in the building. Visitors enter through the main entrance at their scheduled time and are supervised from a distance for proper mask use and social distancing. Children that can be controlled are allowed, and these visits are for anyone, not just family, and last ½ hour. Essential caregiver visits in the building continue per the approved list. These visitors need to wear a surgical mask and eye protection during visits. These are visits that can take place once you have been approved for in building visits, to be approved set up a meeting with Michelle by calling 320-833-5364 ext 12. During these visits you must remain in the resident room, must wear a mask for the entire visit and must use the eye protection you have been or will be given. Please remember to call ahead for these visits if you do not have a regularly scheduled day and time for visiting. Several residents have voiced that they are ready to “get out of here” once they are 2 weeks post their vaccination. As a reminder the vaccination is considered 95% effective and receiving the vaccination at this time does not change our regulations from MDH and CDC related to quarantine. If someone is out of the building for a non-essential appointment we have to follow quarantine criteria, this is resident situation dependent and usually means a 14 day quarantine period following the outing. For more information see the MDH guidelines at: https://www.health.state.mn.us/diseases/coronavirus/hcp/ltceoguide.pdf While vaccination is a momentous occasion that marks the next chapter in our fight against the virus, it is just the beginning of a conversation about reopening long-term care settings. We have not received word from State and Federal regulators about any updated guidance or changes to the current safety protocols. At this time, the CDC recommends that we continue to follow all current infection prevention and control recommendations, regardless of vaccination status, as they continue to gather additional information about the vaccine’s effectiveness in preventing and transmitting COVID-19. Until we receive updated guidance from State and Federal regulators, infection control practices and the safety protocols must remain in place. In the meantime, we ask that everyone, even those not connected directly with long-term care settings, continue to wear a mask, wash your hands, don’t touch your face when you’re out, and stay home if you’re feeling sick. These measures will help keep the positivity rates low and allow long-term care settings to employ safe and socially distanced visitation for residents. We ask for your patience as we continue do all we can to ensure residents and staff remain healthy in our settings. We encourage you to review the options for safe and socially distanced visitation between residents and their loved ones. If you have any questions, do not hesitate to contact us at 320-833-5364 or khiles@blhcc.org. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update January 27th, 2021 ALL STAFF/FAMILIES/RESIDENT ALERT: We are excited to announce that we have no new positive cases at BLHCC in the last 2 weeks. This means we are moving out of outbreak testing for residents and staff. We will continue to test staff per our county positivity rates but will not need to test residents unless they are showing symptoms or we discover a positive case. This week our county positivity rate is at the lowest level in a very long time at 1.5%. The counties around us remain at 5% or greater. Our facility has decided to follow the recommendations of the Minnesota Department of Health and CMS (Centers for Medicare and Medicaid Services) and move to monthly testing for staff. Our next planned testing day will be February 22, 2021. We know that for some this testing frequency may not seem like enough. We will continue to test any symptomatic persons using our rapid testing process and monitor the county positivity rates to determine if we need to increase testing frequency. We are concerned about the new strains of COVID that have now entered Minnesota and are predicted to be easier to spread. We are happy to hear that the vaccine is also working against the new strains. COVID will be something as a society we will be dealing with for a long time yet, and future waves of outbreaks are predicted. Our only defense is to vaccinate as many as possible as quickly as possible. We highly encourage everyone to get vaccinated as they are able. This vaccination process will take time and we need to continue be very cautious with our community activity. With that being said we are welcoming back indoor visits on a scheduled basis. You can sign up for an indoor visit on our website at www.blhcc.org or contact the activity department at 320-833-5364 ext 36 for assistance. These visits are for anyone, you do not have to be family to visit someone at our facility. When you arrive for a visit come in through our new main entrance on Yellowstone Trail. You should arrive no more than 5 minutes before your assigned time and you will be screened prior to your visit. You will need to wear a proper mask and must maintain social distancing for the visit. The visit will then take place in our new community room with indirect supervision to ensure proper mask wearing and social distancing. Thank you for complying with the requirements to make these visits possible for our residents! We are preparing for our next COVID-19 vaccine clinic on February 10th. You will be notified of what time to come that day for your vaccine. This will be the second shot in the series for many of our staff and residents. Any staff or residents that have not started the series are welcomed to do so on Feb 10th. Staff, it is essential that we know by February 1st if you planning to start the vaccination process. At this time you will not be able begin the vaccine series on March 10th, this date will only be for those needing the second shot. Please let Kendra, Michelle or Shyann know if you plan to receive the vaccine and fill out the consent form as soon as possible. The end is at last in sight, but we will all need to work together to get there. Our society as a whole needs everyone possible to receive this vaccine and achieve herd immunity to return to any kind of “normal”. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing 1 27 2020 BLHCC Postive COVID Letter To Families Residents ___________________________________________________________________ BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update January 9th, 2020 ALL STAFF/Families/Resident ALERT: We are delighted to notify everyone that no new cases of COVID-19 were identified with this week’s testing. We will test all staff/residents/tenants again on Monday. We currently have one resident on COVID precautions and those precautions will be lifted on Monday. We will only be testing weekly this week as we have seen a drop in our county rates. Weekly testing will only take place on Monday and as needed based on symptoms. We are thrilled to announce that our first COVID-19 vaccine clinic will be on Wednesday January 13, 2021 from 11am-5pm. We will use the main entrance that day and vaccination will take place in the new Community Room/Activity Room. Please watch for a text with your assigned time and get your consents turned in by Monday January 11^th. Our second vaccine day will be February 10^th and a third date has been set for March 10^th. If you miss the 13^th for some reason you can begin your series on February 10^th. The vaccine clinic day will be a joyous day, but you may have questions about what to expect. We encourage you to review the CDC’s resource What to Expect at Your Appointment to Get Vaccinated for COVID-19. We are pleased that those most at-risk of COVID-19, vulnerable seniors and professional caregivers, have been prioritized to receive the vaccine. Getting vaccinated against COVID-19 is the best ways to protect long-term care residents and caregivers from COVID-19. This vaccine gives us hope for the next chapter in our fight against COVID-19. We want everyone in our communities who wants a vaccine to get it as soon as possible. However, we cannot mandate that staff/residents or tenants accept the COVID-19 vaccine. Therefore, it will continue to be important for senior living communities to follow safety protocols to protect seniors who we know are most at risk for serious consequences of COVID-19. The COVID-19 vaccine is a ray of hope for many older adults who have been so cut off from their family and friends over these past months. A successful vaccination program is a huge step forward in beating COVID. While this is a momentous occasion that marks the next chapter in our fight against the virus, it is just the beginning of a conversation about reopening long-term care settings. We have not received word of any updated guidance from the State about visitation in our settings. As soon as we start to successfully administer the vaccine throughout Minnesota and positivity rates begin fall, we hope we can begin to discuss what’s next for our community and for long-term care communities across our state. Long term care facilities will not be able to return to normal visitation routines until a vaccine is administered to most residents and staff. Even then, experts are saying that most of the population will have to be vaccinated before we can return to normal. Please be patient about changes in safety protocols as vaccinations roll out across Minnesota. Even though the vaccine is here, the virus is still being transmitted throughout our state and we need to continue to be cautious to protect the health and well-being of residents and staff. Until we receive updated guidance from the State, we ask that everyone, even those not connected directly with long-term care settings, continue infection prevention and control practices—Wear a mask, wash your hands, don’t touch your face when you’re out, stay home if you’re feeling sick— These measures will help keep the positivity rate low and allow long-term care settings to employ safe and socially distanced visitation for residents. Consent form preview: https://info.omnicare.com/rs/095-VIX-581/images/COVID%2019%20Vaccine%20Intake%20Consent%20Form.pdf Moderna COVID-19 Vaccine Fact Sheet: https://www.modernatx.com/covid19vaccine-eua/eua-fact-sheet-recipients.pdf COVID 19 Vaccination Frequently Asked Questions: https://info.omnicare.com/rs/095-VIX-581/images/COVID-19%20Vaccination%20FAQs_V2.pdf CDC’s Questions about New COVID-19 Vaccines: https://www.cdc.gov/vaccines/covid-19/downloads/hcp-employees-general-faqs.pdf Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing BLHCC Postive COVID Letter To Families Residents 1 9 2021

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update January 3rd, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: This notice is to let everyone know that we have received the results of testing that was done on Thursday 12/31/20. We tested all staff and residents that day and have identified 1 new positive resident. No new staff cases were identified. We will test all staff again tomorrow, and all residents and staff on Thursday this week. As we continue to fight this virus we will welcome the vaccine that is coming our way on January 13th. The rest of this notice is unchanged. Please be aware we will be calling this week to obtain verbal consent for those that cannot provide their own consent. The COVID-19 vaccine has been approved and the vaccination is coming! At this time we have been given the date of January 13th from 11am-5pm. We have confirmation from CVS pharmacy. What we know at this time is that CVS will come out to vaccinate all of our staff and residents. They will receive the Moderna vaccine, a series of 2 shots, 28 days apart. We are including a couple of documents for your reference to educate yourself related to the vaccine. Also attached is the 2 page consent that will need to be completed for each person to be vaccinated. It will be essential that we get everyone’s new insurance cards. We will need their pharmacy/prescription cards as well as new insurance cards ASAP, there will be no cost of the vaccine to anyone but insurance will be billed by the pharmacy for the cost of administration. What we will need: · A completed consent form, these will be available the day of testing: We will be contacting resident representatives as needed to obtain consents. Please review the consent form at the link below. · Copies of everyone insurance cards: Most people have gotten or will be getting new cards at the 1st of the year. WE WILL NEED A COPY OF THE NEW CARD, FRONT and BACK Consent form preview: https://info.omnicare.com/rs/095-VIX-581/images/COVID%2019%20Vaccine%20Intake%20Consent%20Form.pdf Moderna COVID-19 Vaccine Fact Sheet: https://www.modernatx.com/covid19vaccine-eua/eua-fact-sheet-recipients.pdf COVID 19 Vaccination Frequently Asked Questions: https://info.omnicare.com/rs/095-VIX-581/images/COVID-19%20Vaccination%20FAQs_V2.pdf CDC’s Questions about New COVID-19 Vaccines: https://www.cdc.gov/vaccines/covid-19/downloads/hcp-employees-general-faqs.pdf We know that we have people on both sides of the fence for receiving the vaccine. We cannot make anyone receive the vaccine but it will be essential to our community to have everyone receive the vaccine. We need to protect each other, our residents/tenants and our families. It is our hope that if everyone were to receive the vaccine by the spring we will have created a safe environment for our residents to return to a more “normal” way of living, maybe even mask free in our building. If you have questions related to the vaccine, please do not hesitate to ask. I am including my personal e-mail and will do my best to provide you with the best resource possible to find your answers to any questions or concerns. khiles@blhcc.org As we look forward to 2021 we do so with HOPE. Everyone is ready for this year to be over, turning the page on the calendar won’t magically erase all the hardship 2020 has brought, but it will provide us with HOPE that the days ahead will be brighter, better, and provide us with options to move ahead. For our residents/tenants and staff the vaccine is our best option. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 29th, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: This notice is to let everyone know that we have received the results of testing that was done on Thursday 12/24/20. We are proud to announce NO NEW CASES with this round of testing. Staff were all tested last Monday and staff and resident/tenants on Wednesday/Thursday. Yesterday (12/28/2020) we tested all of the staff again with no new cases of COVID-19 identified. This means that currently we have no positive residents, no one that remains in precautions, and all staff have returned to work. This news is the best Christmas present ever! The COVID-19 vaccine has been approved and the vaccination is coming! At this time we have been given a tentative vaccination date of January 13th from 11am-5pm. We are awaiting confirmation of this date from CVS pharmacy. What we know at this time is that CVS will come out to vaccinate all of our staff and residents. They will receive the Moderna vaccine, a series of 2 shots, 28 days apart. We are including a couple of documents for your reference to educate yourself related to the vaccine. Also attached is the 2 page consent that will need to be completed for each person to be vaccinated. It will be essential that we get everyone’s new insurance cards. We will need their pharmacy/prescription cards as well as new insurance cards ASAP, there will be no cost of the vaccine to anyone but insurance will be billed by the pharmacy for the cost of administration. What we will need: · A completed consent form, these will be available the day of testing: We will be contacting resident representatives as needed to obtain consents. Please review the consent form at the link below. · Copies of everyone insurance cards: Most people have gotten or will be getting new cards at the 1st of the year. WE WILL NEED A COPY OF THE NEW CARD, FRONT and BACK Consent form preview: https://info.omnicare.com/rs/095-VIX-581/images/COVID%2019%20Vaccine%20Intake%20Consent%20Form.pdf Moderna COVID-19 Vaccine Fact Sheet: https://www.modernatx.com/covid19vaccine-eua/eua-fact-sheet-recipients.pdf COVID 19 Vaccination Frequently Asked Questions: https://info.omnicare.com/rs/095-VIX-581/images/COVID-19%20Vaccination%20FAQs_V2.pdf CDC’s Questions about New COVID-19 Vaccines: https://www.cdc.gov/vaccines/covid-19/downloads/hcp-employees-general-faqs.pdf We know that we have people on both sides of the fence for receiving the vaccine. We cannot make anyone receive the vaccine but it will be essential to our community to have everyone receive the vaccine. We need to protect each other, our residents/tenants and our families. It is our hope that if everyone were to receive the vaccine by the spring we will have created a safe environment for our residents to return to a more “normal” way of living, maybe even mask free in our building. If you have questions related to the vaccine, please do not hesitate to ask. I am including my personal e-mail and will do my best to provide you with the best resource possible to find your answers to any questions or concerns. khiles@blhcc.org As we look forward to 2021 we do so with HOPE. Everyone is ready for this year to be over, turning the page on the calendar won’t magically erase all the hardship 2020 has brought, but it will provide us with HOPE that the days ahead will be brighter, better, and provide us with options to move ahead. For our residents/tenants and staff the vaccine is our best option. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing 12 24 2020 BLHCC Postive COVID Letter To Families Residents

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 19th, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: This notice is to let everyone know that we have received the results of our testing that was done on Thursday 12/17/20. We are proud to announce there are no new resident cases with this round of testing. We did identify one new staff case of COVID-19. We will test all staff again on Monday 12/21/20 and all staff and residents on 12/24/20. This means that currently we have 5 positive residents and 6 positive staff. All of the residents and staff are doing well. We would consider the symptoms we are seeing as mild at this time. 3 of the residents will come off of precautions in the next 2 days as long as there is no change in their symptoms. 3 of the staff will also be allowed to come back to work as long as their symptom status does not change. As per guidelines from the CDC and Minnesota Department of Health each case is evaluated case by case and their precautions continue based on their symptoms if needed. This notice is short and to the point today. We hope each and everyone of you are staying safe! We head into our week ahead with HOPE for a vaccine to soon be heading our way. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 18th, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: We would like to let you know that we have identified one new positive case of COVID-19 in a staff yesterday. At this time we have 5 residents that remain in isolation and 5 staff that are out of work due to COVID-19. We have 2 more staff that are out due to high risk exposures. This week we removed all other residents from isolation precautions. We will get the results of our Thursday testing over the weekend and will update you as we know more of what this round of testing shows. We’re excited to announce that we’re gearing up to distribute the Moderna COVID-19 vaccine very soon. We expect to start residents and staff vaccinations shortly, hopefully in the next couple of weeks, no date is set at this time. The Centers for Disease Control and Prevention (CDC) and the Minnesota Department of Health have decided that residents in long-term care are in the highest priority group and they will get the vaccine first—along with all of our staff. From what we know today, resident families and other people in the general community will have to wait for vaccinations until later in the year, when the supply of vaccines is larger. Here are the details of our Vaccination Plan: · There will be no cost to you for the shots. · You’ll need two shots with 4 weeks (28 days) in between for it to be effective. · If you’ve had COVID-19, you should still get the shots. · Some people have had a sore arm, mild aches and fever after getting the shot, but you cannot be infected with COVID-19 through the shot. These types of side-effects are more common with the first injection but not as common with the second injection. It’s important you receive both shots. We have prepared a Frequently Asked Questions to help you understand more about why the vaccine is so important in defeating COVID-19. If you have other concerns, please contact Kendra or place them in the box by the time clock. Getting vaccinated against COVID-19 is one of the best ways to protect yourself and everyone around you, particularly those who are at increased risk for severe illness. Wearing masks and social distancing help reduce your chance of being exposed to the virus or spreading it to others, but these measures are not enough. Vaccines will work with your immune system, so it is ready to fight the virus if you are exposed. Getting these shots will not only protect you from being infected; it will help us take a big step towards ending this pandemic. The news of a vaccine gives us hope for a new chapter to our fight against this virus. We are so appreciative of the support and cooperation that all have given during these past nine tough months. Together, we’re moving toward a COVID-free future. Sincerely, Mark Rust, Administrator Kendra Hiles, Director of Nursing

Why should I get vaccinated?

Getting vaccinated against COVID-19 is one of the best ways to protect yourself and everyone around you, particularly those who are at increased risk for severe illness. Wearing masks and social distancing help reduce your chance of being exposed to the virus or spreading it to others, but these measures are not enough. Vaccines will work with your immune system, so it is ready to fight the virus if you are exposed. Getting these shots will not only protect you from being infected; it will help us take a big step towards ending this pandemic. When will the COVID-19 vaccination be available? Soon, hopefully in the next couple of weeks. Why is it important for long-term care staff and residents to receive the vaccination first? The average age of residents in long term care facilities is 85 and almost every one of them has an underlying health condition, and some have multiple chronic conditions. According to CDC data, the risk of mortality in this age group is 630 times higher than those 18-29 years old. While many industries can stay open or partially open with safety measures, long term care communities will not be able to return to normal until there is a vaccine. How will we receive the vaccine? We have partnered with CVS Pharmacy to come out and administer to Moderna vaccine. The Moderna vaccine is given in two steps, 28 days apart. CVS Pharmacy will require an informed consent to administer the vaccine. We have not received this form yet. Is there are risk that I can get COVID-19 from the vaccination? No, there is no risk of getting COVID-19 from the vaccination. This vaccination contains no actual COVID-19 virus. You may experience some side effects from the vaccine such as a sore arm, mild aches, or fever. This is your immune system responding to the vaccine and is expected. This does not mean you are getting sick with COVID-19. We need the vaccine to trigger this immune response to produce the immunity you need against COVID-19. How do we know it’s safe since it was developed so quickly? Scientists have worked on coronavirus research for decades starting with the original SARS outbreak and influenza. Scientists only needed to isolate certain things about COVID-19 to begin creating a vaccine because we already know so much about the type of virus. Due to the public health crisis created by the pandemic, many private, government and independent groups came together and cooperated on a vaccine. This scale of cooperation is not typical, and the partnership created resources and information sharing to develop the vaccine faster. What are the side effects of the vaccine? Are there long-term effects? There may be side-effects from the COVID-19 vaccination such as a sore arm, mild, generalized aches, headache, and fever. These side effects are more common after the first injection and not as common after the second injection. This vaccine will not make you sick with COVID-19; the side-effects are a result of your body’s immune system working to understand and create a response to the virus which is needed for your immunity. The long-term effects are still being studied. The first two months show no severe side effects. As with all vaccinations, long-term effects are monitored for up to 10 years. Should / can I still get a flu shot? It is important you still receive a flu shot. However, it is not recommended to have a flu shot within one month of the COVID-19 vaccine. If you have not already received your flu shot, speak with your supervisor or your doctor about the best plan for receiving flu vaccine and COVID-19 vaccine. Will I have to pay for it? No, there will be no cost to you for the vaccine. How many shots will I need and when? The vaccine includes two injections. The second injection will 28-days after the first injection. How long is the vaccine effective? We don’t know. Because the vaccine is new, the length of immunity is unknown. There are some vaccines that do not require additional shots and there are other vaccines, such as the tetanus vaccine, that require periodic boosters. The vaccine will continue to be studied over time and if additional boosters are needed that information will be released when it is known. Is it better to get natural immunity for COVID by getting the virus instead of the vaccine? In many cases, the way to develop natural immunity to a pathogen is to become sick, have our immune systems respond, and then our immune system “remembers” the pathogen to keep us from getting sick again. However, our immune systems cannot always “remember” the pathogen; or, it cannot always fight off the virus. Right now, we don’t know if becoming sick with COVID-19 actually causes you to be immune to re-infection with the virus or not. We believe the vaccination does provide immunity to the disease. Additionally, there is no way to predict whether or not someone with COVID-19 will develop severe disease and suffer significant health complications or not; becoming sick is a risk and there is no way to predict the outcome of illness. You will not become sick from the COVID-19 vaccine. Will I be able to work after getting the shot? Yes, you will be able to work after receiving the vaccination. You will still need to follow infection prevention and control practices such as wearing a mask, social distancing, and good hand hygiene. What happens when long-term care residents are vaccinated? Can we begin to reopen our community? Long term care facilities will not be able to return to normal until a vaccine is administered to most residents and staff. As soon as we start to successfully administer the vaccine in our communities, we hope can begin to discuss what’s next for our community and for long-term care communities across our state. Until that time, please continue your infection prevention and control practices and follow the most current visitation guidance, even after you start vaccinations. Vaccination Letter 12 18 20

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 15th, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: On Monday, December 14, 2020, we completed rapid testing on all of our residents/tenants/staff. This testing round identified 2 residents, 1 staff member and 1 contract staff person as positive for COVID-19. At this time, we have 7 residents of long term care in isolation precautions. 2 residents from previous reporting came off of precautions yesterday. We currently have a total of 6 staff out of work due to testing COVID positive and 2 staff out due to high risk exposures. All staff are doing well and recovering at home. Although these results are difficult to hear, we are so very grateful for all of our amazing staff who come to work every day with a caring and compassionate attitude to brighten the days of our residents. Each department at BLHCC has stepped up to the challenge of caring for residents during a pandemic and although this is new territory for everyone, they have done a fantastic job in the face of adversity! Even though there are days that we leave feeling defeated, especially with residents and staff continuing to test positive, we are also feeling blessed with residents and families who support us and a great team at BLHCC who care for one another, our residents, and tenants. We can also feel the support and prayers from our communities. We are grateful for those who sent Christmas cards, donated presents and treats for both the residents and staff and let us know they are thinking of us. Thank you! News of a vaccine gives us hope. In Minnesota, the Moderna vaccine is to be used for residents and staff in long term care. The Moderna vaccine is being reviewed this week by the FDA. Hopefully this process will be completed this week so distribution can begin shortly. The Moderna vaccine is given in two steps, 28 days apart. CVS Pharmacy will be coming out and administering the vaccine. We will be providing more information about the vaccine process as we get further instructions. BLHCC Activity Department has been extra busy getting our home ready for the holidays! There are trees up in many of the common areas and our Activity Staff has been decorating individual rooms as well! Our new Activity Room is a flurry of gifts, decorations and plans to make Christmas 2020 at BLHCC the best that it can be. The thought of residents and families missing each other during this special season weighs heavily on all of us. If you would like to call, Facetime or Zoom with your loved one, please use Sign Up Genius on our website, www.blhcc.org or contact the Activity Department to set up a time. We have hired an additional Activity Staff just for helping with keeping residents and families connected in this manner and have a full day of calls planned for Christmas day, please sign up now to reserve your time. We have also been so grateful for the ability to have live entertainment and worship services in our home with the ability to broadcast the event live over our BLHCC In House channel. If you have a special talent you would like to share, please let us know and we will get you on the schedule. In closing, we would like to add that while this holiday season may look different than previous ones, there will still be many blessings, especially if you are looking for them. You can choose to find new blessings amongst the restrictions, rather than focusing on the negative. Some blessings will be expected, and others unanticipated. Please know that we consider each of you reading this a blessing! Sincerely, Mark Rust, Administrator 12 15 2020 BLHCC Postive COVID Letter To Families Residents 12 15 2020

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 13th, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: We have received all of the testing result from Thursday 12/10/2020. There were 2 new cases of COVID-19 identified in residents. At this time we have 7 residents of long term care in isolation precautions. The COVID Care Team has been implemented to work with only these residents and is doing an amazing job doing what they have trained to do. We also have one new positive staff case of COVID-19. This means we have 5 staff that are out of work due to testing positive for COVID-19. All residents/tenants and staff will be tested again on Monday. We are currently conducting testing twice per week. This is a challenging time for everyone. Our staff have been pulling together and your putting your best efforts forward to contain the spread of this virus. Please see our previous updates earlier this week for more details of what is happening at BLHCC. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 10th, 2020 ALL STAFF/Families/Resident ALERT: We want to make everyone aware that we have identified two additional staff cases of COVID-19. Both staff were tested with the rapid antigen testing due to the symptoms they were experiencing. We are very proud of the staff for monitoring for any changes in their health and protecting the health of others around them by getting tested. We have also identified another positive resident case of COVID-19. This means that currently we have 5 positive residents and 4 positive staff. All of the residents and staff are doing well. We would consider the symptoms we are seeing as mild at this time, and pray that is how things continue. We have completed contact tracing related to our positive cases and have identified two high risk exposures of a staff. STAFF anytime you are outside of work or near anyone outside of your direct living situation you need to wear a mask. We need all of you all! At this time all of the positive resident cases being cared for by specific “COVID Care Staff”. These staff do not have contact with other staff or residents. Thank you to our COVID Care Team for your dedication to these residents! At this time the Buffalo Lake Healthcare Center is allowing essential caregivers to visit residents/tenants. PLEASE call ahead if you do not have an established visit time. We ask that you please use extreme caution and careful thought before coming for a visit. Even if you are feeling “congested” do not come. For many COVID-19 positive cases they have felt like they have, or are getting a “head cold” as their first symptoms. Residents and tenants are being asked to wear a mask for any visits from staff, family or essential caregivers. Staff, please assist residents to apply masks if they are receiving a visitor for any reason. As we look ahead, Activities has set up live entertainment that will come into our new entry and broadcast over the TV channels to resident/tenant rooms. The residents/tenants really enjoy this. We will also be having our resident Christmas Party Day on December 21^st. Activity staff will go room to room with gifts, entertainment and community Christmas Cards that have been sent. Our Activity Department has also set up a Sign Up Genius to sign up for video calls. To sign up go to our website www.blhcc.org or, contact Lyn, or Activities, at 320-833-5364 ext. 36. There are specific staff set up to assist residents/tenants with this process. Many of the residents/tenants are enjoying these visits. If there is a special event that you would like to do a video visit with a resident/tenant you may contact Activities and they will set this up with you. With the Holidays quickly approaching we are not expecting there to be a change in status compared to Thanksgiving. We will once again be asking that residents do not leave the building. Anyone who does go out is putting everyone else at increased risk and will need to be placed in a 14 day quarantine upon return. Please sign up now to get your desired time for a video visit on Christmas. A safe and effective vaccine is on the way. We know that we will be working with CVS Pharmacy to vaccinate all of our residents/tenants and staff. This will be a two-step injection. The vaccine is 95% effective against COVID-19 with 4-10% of those receiving the vaccine having mild reactions (muscle soreness and fatigue are the most common). The vaccine is our only chance to fight this awful virus and we will need at least 80% of the population to receive the vaccine to be effective. If you are researching information about the vaccine please be sure you are looking at credible sources. Do not depend on social media for your information. The Minnesota Department of Health and the CDC are recommended credible sites for information. In the weeks ahead we will be reaching out to obtain consent for administering the vaccine. Please do your research. We are all in this together! “Nothing in life is to be feared; it is only to be understood. Now is the time to understand more, so that we may fear less.”- Marie Curie Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing 12 10 2020 BLHCC Postive COVID Letter To Families Residents

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 7th, 2020 ALL STAFF/Families/Resident ALERT: How fast things can change in this world of COVID-19. Yesterday we received our results from our facility wide testing done on 12/3/2020. With that came the news that we had 3 positive residents on one wing of long term care. We also identified a fourth resident with symptoms. That resident was tested with our rapid testing ability and results were positive. No new positive staff identified on the 12/3/20 testing. On 12/6/20 one staff reported symptoms prior to coming to work, they were tested with the rapid testing process, and determined to be positive. Today we also identified another staff that has not been in the building for 1 month with symptoms and is also positive. This means that currently we have 4 positive residents and 2 positive staff. We have completed contact tracing and have not identified any high risk exposures. At this time all of the positive cases are in one wing of the building and are all being cared for by specific “COVID Care Staff”. These staff do not have contact with other staff or residents. Yesterday we tested all residents on the wing with the positive residents and did not identify any unknown cases of COVID-19. Today we have tested all residents/tenants and staff with the rapid testing process and have 1 staff case of COVID-19. We continue to monitor all staff and residents closely and cannot emphasize enough to everyone the importance of using proper infection control practices to contain the spread of this virus. No staff should be eating anywhere in the building except in the employee breakroom. If you are outside in your cars you should be by yourself. Masks must stay in place during your shift and residents should also be wearing a mask when you are in their room, the only exception to this is during cares where a mask would not allow proper care to be completed, i.e. Washing up, feeding, brushing teeth, shaving, etc. All of you are essential and we need you, please follow these guidelines. At this time the Buffalo Lake Healthcare Center is allowing essential caregivers to visit residents/tenants. PLEASE call ahead if you do not have an established visit time. We ask that you please use extreme caution and careful thought before coming for a visit. Even if you are feeling “congested” do not come. For many COVID-19 positive cases they have felt like they have, or are getting a “head cold” as their first symptoms. Residents and tenants are being asked to wear a mask for any visits from staff, family or essential caregivers. Staff, please assist residents to apply masks if they are receiving a visitor for any reason. We have prepared for this……our plan has been put into place. We pray that symptoms remain mild for the COVID positive cases and a higher level of care is not needed for anyone. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing 12 7 2020 BLHCC Positive COVID Letter To Families Residents

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update December 4th, 2020 ALL STAFF/Families/Resident ALERT: This week at the Buffalo Lake Healthcare Center began our new testing plan. We completed our first week of twice per week testing for all staff. On Monday November 30^th we tested all staff with the rapid testing process and had no new cases of COVID-19 identified. Yesterday, December 3^rd we tested all staff and residents with the PCR tests that get sent to Mayo Clinic Labs. We will not have those results for a couple of days. At this time, we have one staff out due to a positive COVID-19 case, and 2 staff that remain on a 14 day quarantine due to high risk exposures. We celebrate the no new cases of COVID-19 this week with caution. The community transmission levels of COVID-19 hit new records every day. Our current county positivity rate is the highest it has ever been, at 15.5%, making us a “red county”. This means we continue to test staff twice per week and residents on the weekly testing schedule. This week our staff took time to prepare BLHCC for Christmas. They have set up trees in common areas, decorated nursing stations, decorated individual resident/tenant rooms and helped to create a positive atmosphere. We enjoyed hearing the Christmas carols being played on our in house channel while being broadcast from our entry way of the building. Residents/tenants continue to enjoy a variety of ways to play Bingo, relax with a manicure, participate in Religious Services, and spend 1:1 time doing Zoom calls with family members, coloring, crosswords, work searches, letters and cards. If you would like to send a card or message to any of our residents/tenants please send to: Buffalo Lake Healthcare Center Attention: Christmas PO BOX 368 Buffalo Lake, MN 55314 Our staff also enjoyed their version of Human Bingo by getting to know co-workers better to complete their Bingo card for prizes and indulged in meat and cheese trays from the Employee Council. There were also new guidelines put out by the Minnesota Department of Health related to travel. The State of Minnesota Emergency Executive Order 20-99 states that Minnesotans should refrain from non-essential travel out of state unless they meet certain exemptions. If non-essential travel does occur, they should enter a 14-day quarantine upon their return. This recommendation does not apply to individuals who must cross state or country borders for work, study, medical care, or personal safety and security. This means that any staff that travel out of the state for non-essential reasons will be required to enter a 14 day quarantine. This will not fall under the COVID pay policy for illness as this was travel for a non-essential reasons. This order went into effect on November 20^th and remains in place until December 18, 2020. At this time the Buffalo Lake Healthcare Center is allowing essential caregivers to visit residents/tenants. PLEASE call ahead if you do not have an established visit time. We ask that you please use extreme caution and careful thought before coming for a visit. Even if you are feeling “congested” do not come. For many COVID-19 positive cases they have felt like they have, or are getting a “head cold” as their first symptoms. We are trying to limit the number of people in our building to keep our residents as safe and healthy as possible. Residents and tenants are being asked to wear a mask for any visits from staff, family or essential caregivers. Staff, please assist residents to apply masks if they are receiving a visitor for any reason. We want to take this as an opportunity to thank everyone!! From our resident/tenant families that have sacrificed time and physical connections, to our residents/tenants for your unending resilience and desire to protect each other, your families, and the staff. A special thank you to our staff for the countless hours and dedication you have shown to our residents/tenants and your co-workers. Most of all we thank our own families that have allowed us to do what we were put here to do: to Care….. Please take a moment enjoy this video. (You may have to skip an ad to see the video). https://www.youtube.com/watch?v=NkDNp4ATCso Thank you!! Sincerely,Mark Rust Administrator Kendra Hiles Director of Nursing 12 4 2020 BLHCC Postive COVID Letter To Families Residents

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update November 27, 2020 ALL STAFF/Families/Resident ALERT: We are blessed and we are feeling Thankful! We have received all of our resident/tenant testing results for this week and have no new positive cases of COVID-19! The two assisted living tenants that were in quarantine due to previous positive test results have been taken off precautions today. What a glorious day! We continue to monitor all of our residents/tenants and test individuals with our rapid testing abilities as any symptoms arise. We will test all residents and tenants this coming week on Thursday. We have had 1 new positive staff since our last update. We feel blessed that the majority of our staff were able to return to work today and are doing well. At this time we have 3 staff out due to positive test results, one staff out due to a high risk exposure, two staff remain out past their quarantine period due to ongoing COVID-19 symptoms, and two staff with symptoms are awaiting test results. As you can see there is a lot to keep track of. At this time, staff will be testing twice per week on Monday’s and Thursday’s. The numbers in our area continue to soar and our hospitals are at or near capacity. Please, please, please do your part: mask up, socially distance, do not attend gatherings, and stay home. Stay safe everyone!! Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing BLHCC Postive COVID Letter To Families Residents 11 27 2020

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update November 23, 2020 ALL STAFF/Families/Resident ALERT: Today we are sending an update for the staff testing done yesterday. We identified 2 cases of COVID-19 with the rapid testing we did on staff. One of these staff had no symptoms and the other came to be tested in their car as they were experiencing minor symptoms. These tests were followed up with the PCR tests that go to Mayo and we do not have those results at this time. We are also waiting on the results from all of the resident/tenant tests completed yesterday. At this time we have a total of 12 staff out of work. Of those 12, 10 are COVID positive. Others have either a high risk exposure or symptoms and are awaiting results. We have 2 assisted living tenants that remain in isolation due to positive results last week. We are very happy to say they are not experiencing any symptoms or have mild symptoms at this time. Next week we will begin twice per week testing for staff. Staff will be testing on Monday’s and Thursday’s. Residents/tenants will be tested one time per week on Thursday’s. While essential care visits are allowed to continue per CMS guidelines, we are asking you to refrain from visiting. If you feel you need to visit at this time please call ahead to arrange a visit. Community transmission rates are higher than they have ever been and we ask that you find other ways to connect with your loved one. As we move through the weeks ahead we all need to do our part to slow the progression of this virus. We do not want anyone leaving this facility unless it is an absolute must. “This virus does not care that it is a holiday”. We do not take this lightly and want to protect everyone we care for. Eating and drinking around others without a face covering is a high risk activity. We also recommend staff do not get together with members outside of their immediate family setting. As per direction of the Minnesota Department of Health, if a resident or tenant goes out to a social gathering we will be placing them on a 14 day quarantine upon return. This means staff will need to wear full PPE to enter that room, the resident/tenant is not to leave their room/apartment for 14 days. We will then monitor them for any symptoms of COVID-19. This is a burden to our staff that is already stretched thin and causes increased social isolation for the resident/tenant. We go through a very large amount of PPE for anyone in a quarantine or isolation situation. It also places our whole facility at increased risk. With the potential for a safe and effective vaccine on the horizon, extra precautions are essential to protect our nursing home residents until a vaccine becomes available. Although many of us will not be celebrating as we traditionally would, we can still spend this holiday being thankful for the blessings that have helped us through this year. It is through these difficult times that is most important to give thanks for things in life we often take for granted. This year we give thanks for friends and family that we hold so dear, for the tireless dedication of healthcare heroes that have persevered throughout the pandemic, for those around us that have given us strength, and for the resilience that will get us through this challenging time and make us stronger than we were before. We wish you a safe, happy and memorable Thanksgiving. We will send out a notice as we get the resident/tenant results this week and we ask that you all say a special prayer for favorable results. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing BLHCC Postive COVID Letter To Families Residents 11 23 2020 ____________________________________________________________ BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update November 19, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: This week we send out our update with very heavy hearts. We have received the final results of our facility wide testing from Monday 11/16/20. We tested 126 residents/tenants and staff and have a total of eight positive staff this week, this number includes the staff that we have reported earlier this week. They are staff from almost every department and for this we are thankful. This means no staff is having to step into a role they are not familiar with. Our staff are jumping in to help each other and the teamwork we are witnessing is amazing, thank you for this! Most of the positive staff are asymptomatic (showing no symptoms or very mild symptoms) although, we are seeing staff develop symptoms after they are notified of their test results, yet they have been mild. We also have two positive assisted living tenants. At this time our assisted living tenants are showing no symptoms. We are monitoring them in house very closely and keeping them quarantined to their rooms. We pray for full recovery of our staff, the impacted tenants, and the numerous community members that are positive. May everyone find strength to fight this awful virus! We will continue to test all staff/residents and tenants. Today we did rapid tests on all the negative assisted living tenants and have no new positive tests. This week our county prevalence rate has jumped to 14.2%. This means we will begin twice a week testing on 11/30/2020. Our plan is once a week we will do a lab test on everyone. The staff will get tested a second time with the rapid antigen test. Testing of staff will be Monday’s and Thursday’s. Residents will be tested on Thursday’s. As we look ahead to the holidays please keep in mind that social gatherings are not recommended. We do not want anyone leaving this facility unless it is an absolute must. “This virus does not care that it is a holiday”. We do not take this lightly and want to protect everyone we care for. Eating and drinking around others without a face covering is a high risk activity. We also recommend staff do not get together with members outside of their immediate family setting. As per direction of the Minnesota Department of Health, if a resident or tenant goes out to a social gathering we will be placing them on a 14 day quarantine upon return. This means staff will need to wear full PPE to enter that room, the resident/tenant is not to leave their room/apartment for 14 days. We will then monitor them for any symptoms of COVID-19. This is a burden to our staff that is already stretched thin and causes increased social isolation for the resident/tenant. We go through a very large amount of PPE for anyone in a quarantine or isolation situation. It also places our whole facility at increased risk. With the potential for a safe and effective vaccine on the horizon, extra precautions are essential to protect our nursing home residents until a vaccine becomes available. The Activity staff is hard at work to come up with ideas of how you can still make your loved ones holidays a special time even if you are unable to be together physically. At this time if you could email a picture or video to Lyn at atotenhagen@blhcc.org saying “Happy Thanksgiving” by 11/23/20, she will work on putting them into a special collection to broadcast on our in house TV channel. You can also send cards/letters, make phone calls, or drop off a “care package”. While essential care visits are allowed to continue per CMS guidelines, we are asking you to refrain from visiting. If you feel you need to visit at this time please call ahead to arrange a visit. Community transmission rates are higher than they have ever been and we ask that you find other ways to connect with your loved one. As we move through the weeks ahead we all need to do our part to slow the progression of this virus. Window visits continue to be encouraged but we know the weather is against us again for these. If you wish to schedule a video visit we have set up a Sign Up Genius on our website www.blhcc.org for Zoom calls. The activity department will assist residents/tenants with these calls. This is a great way to connect with those you cannot see. If you have any questions about this process or need assistance, please contact Activities at 320-833-5364 ext. 36. We also encourage everyone to “Like” us on Facebook. This is a time of Thanksgiving. We are so very appreciative of all of our residents/tenants/staff/and families. Our team at BLHCC is committed to keeping you connected during this holiday season. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing November 19th Covid-19 Update

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update November 18, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: We have another staff member that has tested positive with COVID-19. This staff tested positive with the rapid test yesterday and is awaiting lab confirmation of the result. To summarize all the recent notices; at this time we have a total of 3 staff that are out of work due to testing positive, to date we have had a total of nine positive staff, one positive nursing home resident and three positive assisted living tenants. All of the assisted living cases as well as the nursing home case have made a great recovery, we have had no deaths related to COVID-19. All of our staff have also been able to recover from this virus. All of the cases, except for one, we feel are related to community spread, not facility spread. So what does this mean…it means everyone has to do their part to protect themselves while out in the community. The numbers in our area continue to soar and our hospitals are at or near capacity. Please, please, please do your part: mask up, socially distance, do not attend gatherings, stay home if you are sick. We will send out another update later in the week with the results of our facility wide testing from Monday 11/16/20. Stay safe everyone!! Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing Covid 19 Update November 18 _______________________________ BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update November 17, 2020 ALL STAFF/Families/Resident ALERT: We have received notice that another staff member has been confirmed positive with COVID-19. This staff last worked at the facility 11/12/20 and began to exhibit symptoms that day, they left work immediately. They were tested on 11/13/20 and the results are confirmed positive. They are home with symptoms and continuing to self-monitor through the quarantine period. We will be doing contact tracing throughout the day to identify if we have any high risk exposures. Thank you for your responsiveness to the calls for the contact tracing! This really helps us in the fight against this virus. We will send out another update later in the week with the results of our facility wide testing from Monday 11/16/20. Stay safe everyone!! Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing BLHCC Postive COVID Letter To Families Residents 11 17 2020 **************************************************************************************************** BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update November 14, 2020 ALL STAFF/FAMILIES/RESIDENT ALERT: We have received the final results of our facility wide testing from Monday 11/9/20. We tested 130 residents/tenants and staff and have one positive staff this week. That staff is asymptotic (showing no symptoms or very mild symptoms). As our county numbers soar, our state numbers skyrocket and we feel the direct impact of loved ones in our community that are struggling with positive results we are so very humbled by this news. We pray for full recovery of our staff and community members, may they find the strength to fight this awful virus. We will continue to test all staff/residents and tenants on weekly basis as we are still in outbreak testing. We need to all be negative for 2 weeks and then we will transition to staff only testing. This week our county prevalence is at 9.6%, if this number goes above 10% we will begin twice per week testing. Predications do not look good. As we look ahead to the holidays please keep in mind that social gatherings are not recommended. “This virus does not care it is a holiday”. Especially, gatherings of friends and loved ones that live in different households. Eating and drinking around others without a face covering is a high risk activity. We also recommend staff do not get together with members outside of their immediate family setting. As per direction of the Minnesota Department of Health, if a resident or tenant goes out to a social gathering we will be placing them on a 14 day quarantine upon return. This means staff will need to wear full PPE to enter that room, the resident/tenant is not to leave their room for 14 days, and we will monitor for any symptoms of COVID-19. Many of our staff have said they are willing to do this if it means residents/tenants can see their family for the holiday. We caution this thought process….not only is there undue burden placed on staff that are stretched thin, there is also a depletion of our precious PPE resources. We go through a very large amount of PPE for anyone in a quarantine or isolation situation. It also places our whole facility at increased risk of a large scale COVID-19 outbreak. At this time we have been able to contain the spread within our facility and hold on to hope that a vaccine is soon to come. The Activity staff is hard at work to come up with ideas of how you can still make your loved ones holidays a special time even if you are unable to be together physically. At this time if you could email a picture or video to Lyn at atotenhagen@blhcc.org saying “Happy Thanksgiving” by 11/23/20, she will work on putting them into a special collection to broadcast on our in house TV channel. If you are an essential caregiver and come for a visit over the holidays you can bring a meal for your loved one, but please refrain from eating with them. We also encourage you to set up virtual visits now for popular days like Thanksgiving. You can also send cards/letters, make phone calls, or drop off a “care package”. More ideas to follow. Essential care visits continue. We love to see you and so do the residents! If you have been approved as an essential caregiver in the past you are welcome to call and set up a time to return to visit your loved one. If you have not been approved and are wondering if you can visit please contact Michelle or Kendra at 320-833-5364. In order to be able to maintain these visits it is extremely important that everyone follow the safety guidelines. These include: scheduling the visit in advance, wearing the appropriate PPE at all times, entering door #13 and being screened, traveling straight to the resident’s room/apartment and exiting straight out door #13. Also be sure to sign out when you leave and have the resident/tenant you are visiting wear a mask during your visit. No eating during your visit please. Window visits continue to be encouraged but we know the weather is against us again for these. If you wish to schedule a video visit we have set up a Sign Up Genius on our website www.blhcc.org for Zoom calls. The activity department will assist residents/tenants with these calls. This is a great way to connect with those you cannot see. If you have any questions about this process or need assistance, please contact Lyn in Activities at 320-833-5364 ext. 36. We encourage everyone to “Like” us on Facebook. You will see on Facebook that life does go on at BLHCC. We are always trying to engage residents/tenants and promote quality of life to best extent possible. This past week the Veterans Meal was a huge success. We want to thank those that donated at The Broaster Cafe in Bird Island. 100% of Veterans meals were paid for, this was not expected, it was very heartwarming and appreciated. To our heroes, our warriors and our defenders we thank you for continuing to pull together and provide the best possible care to our residents. We need you! You are invaluable! To our residents/tenants there is no way to say how much we care about you and feel responsible for you. To our families….we miss you, we think of you and we thank you for entrusting us to care for your loved ones though this pandemic. The fight goes on…… Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing Weekly Update 11 14 20 ____________________________________________________________________________________________________________________________________________________________________________________________ BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update November 5, 2020 ALL STAFF/Families/Resident ALERT: We have received the final results of our facility wide testing from Monday 11/2/20. We have confirmed one positive staff person this week with our routine testing. That staff is having mild symptoms and home on quarantine. We are awaiting confirmation on the other staff that tested positive with the rapid test. At this time we treat them as a presumed positive case. That staff is asymptomatic (no symptoms) and is home monitoring for symptoms. The one staff that tested positive last week with no symptoms has not developed any symptoms and continues to remain home during the quarantine period. We have one staff from earlier testing that continues to seek treatment from the effects of COVID-19 including the cough, shortness of breath and fatigue. Prayers continue for a full recovery. The truly amazing news in all of this is that we have no positive resident/tenant cases again this week! Great job with PPE everyone!! We have been fighting this virus for eight months now and everyone is very tired, last week we described it as the snow storm that just does not end. Yet, staff continue to put every effort forward to pick up extra hours and provide the best possible care to our residents. Staff you are amazing! We cannot give up! We cannot let our guard down! We cannot think, “Our staff have recovered well, residents have recovered, we’re ok.” WE ARE NOT OK…..10 deaths have occurred in Renville County from COVID-19. Most COVID-19 transmission has been linked to the community and the activities we do outside of work. Please keep up with the best practices to fight this virus. We are blessed to have such a caring and dedicated team! Stay Safe……Mask up and social distance. We will continue to test all staff/residents and tenants on weekly basis as we are still in outbreak testing. We continue to be in contact with our health department and weekly updates on changes are ongoing. We train our staff continually, even fire drills now contain additional training on PPE use. We have also joined a collaborative called Project ECHO to meet with other facilities and share best practices in the management of COVID-19, we are excited to see what this has to offer. Essential care visits continue. We love to see you and so do the residents! If you have been approved as an essential caregiver in the past you are welcome to call and set up a time to return to visit your loved one. If you have not been approved and are wondering if you can visit please contact Michelle or Kendra at 320-833-5364. In order to be able to maintain these visits it is extremely important that everyone follow the safety guidelines. These include: scheduling the visit in advance, wearing the appropriate PPE at all times, entering door #13 and being screened, traveling straight to the resident’s room/apartment and exiting straight out door #13. Also be sure to sign out when you leave and have the resident/tenant you are visiting wear a mask during your visit. No eating during your visit please. Indoor visits remain on hold. We have a plan to begin these visits once we are all COVID-19 negative for 2 consecutive weeks. Window visits continue to be encouraged but we know the weather will be against us again. If you wish to schedule a video visit we are setting up a Sign Up Genius on our website www.blhcc.org for Zoom calls where the activity department can assist residents/tenants with these calls. This is a great way to connect with those you cannot see. If you have any questions about this process, please contact Lyn in Activities at 320-833-5364 ext. 36. We encourage everyone to “Like” us on Facebook. You will see on Facebook that life does go on at BLHCC. We are always trying to engage residents/tenants and promote quality of life to best extent possible. With Veteran’s Day next week our Veterans will enjoy a special meal being catered in from a local restaurant. We encourage you to post your pictures thanking our Veterans for us to share with them. They will receive a special Veterans mask and have a special thank you surprise entertainment…. The days are sometimes frustrating and the nights may be filled with worry or concern but as long as we all continue to work together we will make it! We are blessed to have the most amazing staff and residents at BLHCC!! Thank you! Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing Weekly Update 11 5 20 ************************************************************************************************ BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update November 4, 2020 ALL STAFF/Families/Resident ALERT: We have not received the final results of our facility wide testing from Monday 11/2/2020. However we have identified one positive staff person this week with our rapid test, we are awaiting confirmation of this test. Confirmation is obtained by doing a PCR lab test that can take up to 3-5 days to get the results. This staff is asymptomatic (no symptoms) and is now home monitoring for symptoms and off of work during the quarantine period. A more detailed letter will follow this week with the final results of our testing. It is a requirement that we update you within 24 hours that we are aware of a positive test and at this time all other staff and residents continue to be monitored with no symptoms identified. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing Weekly Update (short Version) 11 4 20

**********************************

Resident Families

BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update October 29, 2020 ALL STAFF/Families/Resident ALERT: We have received the final results of our facility wide testing from Monday 10/26/20. We have confirmed one positive staff person this week. That staff is asymptomatic (no symptoms) and is now home monitoring for symptoms and off of work during the quarantine period. The two staff that were positive last week are doing well. One has returned to work already and one remains at home with mild symptoms and will be returning to work if all goes well next week. We are beyond happy to report no positive resident/tenant cases this week. We are following the Minnesota Health Department Guidelines for return to work criteria, if you are interested this is the link to those guidelines https://www.health.state.mn.us/diseases/coronavirus/hcp/hcwrecs.pdf Staff that are out of work during a COVID-19 illness or have symptoms of COVID-19 and are waiting test results are paid for the time they are out of work without having to use their vacation/sick time. We have had countless staff that have stepped up to fill in hours and make sure our residents receive the best care possible, thank you to all of you!!! We are blessed to have such a caring and dedicated team! We will continue to test all staff/residents and tenants on weekly basis as we are still in outbreak testing (even one case of COVID-19 is considered to be an outbreak) and need to have two consecutive weeks of all negative tests before we can stop testing residents weekly. Staff testing will depend on our county prevalence rate of COVID-19 cases. We also continue to require testing for any staff who show two or more symptoms of COVID-19, and place any residents that show symptoms are placed under transmission based precautions pending the determination of a diagnosis for their symptoms. We are excited to announce that we have resumed essential care visits and many residents have had visits this week. This means if you have been approved as an essential caregiver in the past you are welcome to call and set up a time to return to visit your loved one. If you have not been approved and are wondering if you can visit please contact Michelle or Kendra at 320-833-5364. In order to be able to maintain these visits it is extremely important that everyone follow the safety guidelines. These include: scheduling the visit in advance, wearing the appropriate PPE at all times, entering door #13 and being screened, traveling straight to the resident’s room/apartment and exiting straight out door #13. Also be sure to sign out when you leave and have the resident/tenant you are visiting wear a mask during your visit. No eating during your visit please. Indoor visits are on hold at this time. We have a plan to begin these visits once we are all COVID-19 negative for 2 consecutive weeks. These visits will be for anyone wishing to see a resident or tenant and will be set up though our website at www.blhcc.org. These visits will take place in our new community room. This room will have additional safety precautions, including added exhaust ventilation. These visits will be supervised from a distance to maintain infection control precautions. Window visits continue to be encouraged, at this time, the window should remain closed. If you wish to schedule a video visit, please contact Lyn in Activities at 320-833-5364 ext. 36. Just a reminder that we will be having a Scavenger Hunt outside of the building for kids on Halloween. This is a way that even though the kids cannot come into the building, the residents will still be able to see the little ones in their costumes. We will have individually packaged candy for the kids to pick up after they do the Scavenger Hunt on Saturday October 31^st from 5pm-6pm. Hopefully our weather cooperates. Watch our Facebook page for more details. This week we wished our longest employee of the Buffalo Lake Healthcare Center the best in her retirement. Paula Jakobitz retired after 43years at BLHCC. We thank everyone who came out to the Parade on 10/25/2020 in honor of Paula’s last day, sent her a card, greeting or wished her well from afar. She was overwhelmed to say the least. We will miss her in so many way: her dedication, the countless lives she has touched, her sense of humor and ability to inspire others will not be forgotten. Thank you Paula! Enjoy retirement!! Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing NEW Weekly Update 10 29 20 *********************************************************************************************** BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update October 23, 2020 ALL STAFF/Families/Resident ALERT: We have received the final results of our facility wide testing from Monday 10/19/20. These were delayed in coming from the lab this week, as many of you have heard labs are seeing increased testing numbers and are trying to keep up with the demand. We are currently using Mayo Clinic lab for all of our testing. We have two new confirmed cases of COVID-19. Both cases are staff members, no new resident/tenant cases. The staff have mild symptoms and are home in self quarantine spending some quality time with their families and being monitored daily by the healthcare worker monitoring team from the Minnesota Department of Health. We have no residents under precautions for symptoms of COVID-19 and all previous positive cases of COVID-19 have recovered and are doing well. We are extremely blessed to be able to say that no one suffered the severe symptoms of COVID-19, and even more blessed, to have experienced no loss of life related to this terrible illness. We will continue to test all staff/residents and tenants on weekly basis due to our county prevalence rate, and current outbreak status. We also continue to require testing for any staff who show two or more symptoms of COVID-19, and place any residents that show symptoms under transmission based precautions pending the determination of a diagnosis for their symptoms. Guidelines related to the Beauty Shop have changed. Our Beauty Shop is open and will remain open to all non COVID-19 positive residents/tenants. Anyone who shows any symptoms of COVID-19 will not be allowed in the Beauty Shop and will be placed on quarantine until they are confirmed COVID-19 negative. We are also resuming socially distanced group activities and following all the recommendations related to infection control for these events. We will be having a Scavenger Hunt outside of the building for kids on Halloween. This is a way that even though the kids cannot come in, the residents will still be able to see the little ones in their costumes. We will have individually packaged candy for the kids to pick up after they do the Scavenger Hunt on Saturday October 31^st from 5pm-6pm. Hopefully our weather cooperates. Watch our Facebook page for more details. We also continue to broadcast live entertainment, worship, devotions and movies over our facility wide TV channel (991) for residents that do not wish to be with the group. We are excited to announce that we will be resuming essential care visits. This means if you have been approved as an essential caregiver in the past you are welcome to call and set up a time to return to visit your loved one. If you have not been approved and are wondering if you can visit please contact Michelle or Kendra at 320-833-5364. In order to be able to maintain these visits it is extremely important that everyone follow the safety guidelines. These include: scheduling the visit in advance, wearing the appropriate PPE at all times, entering door #13 and being screened, traveling straight to the resident’s room/apartment and exiting straight out door #13. Also be sure to sign out when you leave and have the resident/tenant you are visiting wear a mask during your visit. No eating during your visit please. Indoor visits are on hold at this time. We have a plan to begin these visits once we are all COVID-19 negative for 2 consecutive weeks. These visits will be for anyone wishing to see a resident or tenant and will be set up though our website at www.blhcc.org. These visits will take place in our new community room. This room will have additional safety precautions, including added exhaust ventilation. These visits will be supervised from a distance to maintain infection control precautions. Window visits continue to be encouraged, at this time, the window should remain closed. If you wish to schedule a video visit, please contact Lyn in Activities at 320-833-5364 ext. 36. We deeply appreciate the sacrifices everyone has made to limit the impact of COVID-19 on our community and appreciate your patience. Our entire team looks forward to welcoming everyone back to BLHCC, when guidance allows. We continue to pray for health for all and healing for those affected. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing Weekly Update 10 23 20 (final Sent Out) ************************************************************************************************** BLHCC and Westview Estates Staff/Family/Resident/Tenant COVID-19 Update October 14, 2020 ALL STAFF/Families/Resident ALERT: We have received the final results of our facility wide testing from Monday 10/12/20. We are so humbled to report we have no new confirmed cases of COVID-19. We continue to monitor closely for symptoms, at this time, and test residents who show symptoms immediately using our rapid testing machine. The staff that tested positive has now returned to work and is doing well. We continue to monitor our positive residents/tenants, and if all goes well, they will also be off precautions by the end of the week. We also know that we are not free of concern related to this virus. COVID-19 has been known to show up in people up to 14 days after exposure. Please know that we are taking all precautions to stop the spread of this virus and continue to follow meticulous infection control measures. We will continue to test all staff/residents and tenants weekly at this time. After 2 rounds of all negatives we will convert back to testing only staff on a weekly basis. Per guidelines our beauty shop remains closed at this time and we are not doing any group activities. Activities that continue include: manicures, hallway Bingo, walks and 1:1 visits. We are also broadcasting live entertainment, worship, devotions and movies over our facility wide TV channel (991). At this time residents/tenants continue to eat in their rooms. Many families are enjoying time doing Zoom calls or video chats with their loved ones. If you wish to schedule a video visit, please contact Lyn in Activities at 320-833-5364 ext. 36 We are working with several teams from the Minnesota Department of Health and continue to follow their guidance and recommendations. At this time, we are slowly resuming essential care visits, and we will be contacting you to let you know if you are allowed to come for an in-person visit. In order to be able to maintain these visits it is extremely important that everyone follow the safety guidelines. These include: scheduling the visit in advance, wearing the appropriate PPE at all times, entering door #13 and be screened, traveling straight to the resident’s room/apartment and exiting straight out door #13. Also be sure to sign out when you leave and have the resident/tenant you are visiting wear a mask during your visit. We are working through new guidance from the Minnesota Department of Health related to indoor visits for anyone who wishes to schedule a visit. These visits will take place in our new community room. This room will have additional safety precautions, including added exhaust ventilation. For the indoor visits you will be entering the new front entry on Yellowstone Trail. You will be required to wear a blue surgical mask and then be screened in by a staff member. Please watch our website to sign up for these visits www.blhcc.org. Window visits continue to be encouraged, at this time, the window should remain closed. Also be sure to like us on Facebook for updates, photos and notifications. Thank you for your patience and understanding during this difficult time. We will continue to provide you with weekly updates and you will be notified directly if you or your loved one have tested positive. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing Weekly Update 10 14 20 ***************************************************************************************** BLHCC and Westview Estates Staff Covid-19 Update October 7, 2020 ALL STAFF/Families/Resident ALERT: The final results of our facility wide testing from Monday are in. We have 5 total confirmed cases of COVID-19. Three are assisted living tenants and one positive case in a nursing home resident, all of which we are monitoring closely at this time. We also have the one confirmed staff from last week that is home monitoring symptoms. We feel proud to say that all other staff have tested negative this week. Please know that we are taking all precautions to stop the spread of this virus. We are currently conducting contact tracing related to potential exposure. Please be sure to answer any calls you may receive from us or return our calls promptly. We continue to screen all staff at the beginning and end of shifts per guidelines and monitor all residents twice a day for any symptoms. We are working with several teams from the Minnesota Department of Health. Our priority is to keep everyone safe and healthy, and have open, honest communication about our status. Thank you for your patience and understanding during this difficult time. We will continue to provide you with weekly updates and you will be notified directly if you or your loved one have tested positive. Sincerely, Mark Rust Administrator Kendra Hiles Director of Nursing COVID Confirmed Staff Resident Letter 10 7 2020 ************************************************************************************************** BLHCC and Westview Estates Staff COVID-19 Update October 2, 2020 ALL STAFF/Families/Resident ALERT: We have been notified of a positive staff case of COVID-19 in our building, this is in addition to the presumptive positive resident case. Please know that we are taking all precautions to stop the spread of this virus. We are currently conducting contact tracing related to potential exposure and screening all staff at the beginning and end of shifts per guidelines. At this time our facility will now become a facility listed as an outbreak facility on the Minnesota Department of Health website. This information is updated weekly and you may not see our name on this list until next week. Our priority is to keep everyone safe and healthy and have open, honest communication about our status. We are working in collaboration with the Minnesota Department of Health to ensure we are taking all appropriate steps at this time. Thank you for your patience and understanding during this difficult time. Sincerely, Mark Rust and Kendra Hiles BLHCC Positive Staff COVID Staff Resident Letter 10 2 2020 ************************************************************************************************** Buffalo Lake Healthcare Center and Westview Estates COVID-19 Update October 2, 2020 Dear Resident, Family Member and Friends, We want to let you know that we have been notified of a presumptive positive case of COVID-19 in our building. The presumptive positive result was found by using our facility testing machine. Because our facility has had no cases of COVID-19 so far, the positive test is presumptive and we are seeking laboratory confirmation. Our priority is to keep everyone safe and healthy. Please know we are doing everything we can to stop the potential spread of this virus. We will be conducting facility wide testing on October 5^th. This will include testing all staff/residents/tenants. We continue aggressive infection control measures and screening procedures, which we believe will help us manage this situation as effectively as possible. We are working in collaboration with the Minnesota Department of Health to ensure we are taking all appropriate steps. In addition, we are following all recommended guidance from the Centers for Medicare & Medicaid Service and the Centers for Disease Control & Prevention to protect our residents and staff from this virus and will continue to take every action possible to prevent it from spreading in our setting. Because of our change in COVID-19 Status here are a few of the additional steps we are taking:

Closing our building to all visitors for everyone’s safety. All essential caregiver visits and outdoor/indoor visits have been suspended at this time pending facility wide testing. Window visits (with windows closed), virtual visits and phone calls are always welcome. If you have questions or concerns, please call Michelle Paulson (320)-833-5364 Ext. 12
Isolation: Any resident/tenant who would test positive or shows symptoms of COVID-19 is isolated to their room and placed on droplet precautions. These residents are assigned a dedicated staff team that will only serve isolated residents/tenants.
Contact Tracing: All residents/tenants and staff will be screened for possible exposure to positive patient(s).
Any staff member who tests positive will be placed on quarantine and will self-monitor all of their symptoms at home.
All residents will continue to eat in the rooms and at this time activities outside of resident rooms will cease.
Resident/tenants will no longer be able to physically go to the beauty shop.
We continue to monitor and screen all residents/tenants multiple times per day for any signs or symptoms of COVID-19.
Continuing to screen staff prior to work and upon leaving. Staff are not allowed in the building if they are ill. Any staff who exhibit symptoms are instructed to self-quarantine at home and get tested for COVID-19.

Communication is key, and we will continue to update you on any news, emerging issues, or additional changes in our operations via these letters and on our website. Your support means more to us than words could describe. We are working hard to have a variety of activities that engage our residents and are doing all we can to facilitate alternative means of communication between you and your loved one. If you have any issues or concerns, please let us know. (320)-833-5364 Sincerely, Mark Rust Kendra Hiles Administrator Director of Nursing BLHCC Presumptive Postive COVID Letter To Families Residents 10 2 2020