Austen Riggs Center Admissions with Quarantine and COVID-19 Testing
The Austen Riggs Center has developed a version of our longstanding Inn Residential Program to allow us to resume admitting patients, while at the same time observing rigorous protocols to safeguard our community from the novel coronavirus. This level of care, called the Inn Residential Program – Nursing and Quarantine (IRP-NQ), uses quarantine and virus testing for new patients, while offering our highest degree of nursing support.
Upon arrival on campus, IRP-NQ patients enter a 14-day quarantine period and receive testing for the virus that causes COVID-19, while they begin intensive individual and group evaluation and treatment via remote access. This includes remote access 4 times weekly to intensive individual psychodynamic psychotherapy, nursing support, support groups, and remote access participation in the therapeutic community program. Once patients complete the quarantine period and have a confirmed negative test result for COVID-19, they enter the full residential treatment program at Riggs.
Please note: The quarantine period involves some direct contact with treatment providers in outdoor settings. Prospective patients are encouraged to discuss program details with our admissions office to determine if IRP-NQ matches the patient’s needs.
IRP-NQ Level of Care Frequently Asked Questions
Is it safe to come to Riggs?
We have had no COVID-19 cases among our patients. Two staff members have recovered from confirmed cases acquired outside Riggs. Their infections were caught early and did not spread the virus to our community. See our COVID-19 webpage for more information on our response to the outbreak.
How are you screening new patients for COVID-19?
In addition to usual medical information gathered during the preadmission process, new patients will be screened at intervals by Riggs staff, before and after they travel to the Center, including inquiry about the following:
- Travel within the previous 14 days
- Symptoms including:
- PRIMARY: New onset cough, fever (>100 degrees), or shortness of breath
- SECONDARY: Muscle pain, headache, sore throat, new onset loss of taste/smell
- Exposure to confirmed or suspected cases of COVID-19
What happens if I don’t pass the screening?
If a prospective patient’s temperature is 100 or above and/or there are symptoms suggestive of COVID-19 infection, consultation is rescheduled for when they have recovered.
How long will it take to be admitted?
Riggs admits up to three patients each week. We recommend calling as soon as possible to begin the admissions process. Once assessed, appropriate patients are put on a waiting list for a consultation scheduled on the day of admission. The total time from contact with Riggs to admission varies based on how quickly required information is provided to us, and the number of openings we have.
Are you conducting in-person campus tours for prospective patients and their families?
We are not presently conducting tours in person, but virtual tours are available to those in IRP-NQ.
What does the admission consultation involve?
The decision about whether to offer admission to Riggs is always made at an admissions consultation. Admissions consultations take place in the historic Corner House building, located on Main Street, approximately one block from the main campus. Riggs staff will screen patients, including checking for fever, prior to the consultation. Family members are encouraged to participate in the consultation, either in person or via video conferencing. Please see the full description of the process.
What happens during the first two weeks in IRP-NQ?
Upon admission, patients will stay in separate quarters for two weeks at the Inn, our primary on-campus residence. Nursing staff will provide medical and temperature tests twice a day. COVID-19 testing will be performed within the first few days of admission, and again approximately seven days after admission.
We have designed this period of time to include as many of our traditional treatment program offerings and services as possible, while maintaining the quarantine protocols. The majority of the work during this period will be conducted via Zoom video, though there will be limited in-person engagement with medical and nursing staff. Please see the full description of the first two weeks.
What happens after the quarantine period?
Upon verification from the Riggs Infection Control Physician that new patients have completed quarantine successfully and that they do not have COVID-19, they will be fully integrated into the Riggs treatment milieu. Patients will continue working with their treatment team and participate in full residential programming of the Inn Residential Program-Nursing (IRP-N) level of care. In addition, each patient will be assessed by their program manager to determine the most appropriate level of care post-quarantine, with possible step down to the version of the Inn Residential Program that emphasizes work in groups (IRP-G), if appropriate.
Is the cost for IRP-NQ different from Riggs’ usual fees?
Treatment rates for IRP-NQ are the same as for our other admission programs, which is $1,500 per day, all inclusive. The standard prepayment is due on the day of admission.
Insurance coverage varies depending on the patient’s carrier. Our specialist will work with you to do pre-certification and determine what level of support might be available.
Riggs has established a protocol for all patients (both current and newly admitted) who develop COVID-19. Such patients will enter isolation at Riggs and be treated by our nursing staff and consultant in internal medicine.
If necessary, our consultant in internal medicine could arrange transfer to a medical hospital for additional treatment.
What happens if a staff member has COVID-19?
Riggs has enacted policies aimed at the early detection of symptoms among our staff. Any personnel reporting COVID-like symptoms are placed in quarantine, which removes them from interaction with patients and other Riggs staff until their status is resolved as safe to return to work.
Prior to traveling to Riggs:
Patients on the waitlist, who are candidates for Riggs treatment that includes an initial period of quarantine (with its associated limits in access to direct contact with treaters), are offered consultation with possible admission to the IRP-NQ level of care (per our usual waitlist protocol, and barring any issues regarding travel restrictions).
Patients are screened by an admissions staff person once a consultation with possible admission is offered and as close as possible to patients’ time of travel for:
- All travel within the past 14 days
- Symptoms including:
- PRIMARY: New onset cough, fever (>100 degrees), or shortness of breath.
- SECONDARY: Muscle pain, headache, sore throat, new onset loss of taste/smell.
- Exposure to confirmed or suspected cases of individuals with COVID-19.
- **Affirmation of any of the above will require assessment of the situation by the Infection Control Physician to proceed.**
Patients are oriented to the expectations of quarantine, and integration into the full residential community after quarantine and a negative COVID-19 test result.
Upon arriving at Riggs:
Patients are formally offered admission to IRP-NQ only after an admission consultation:
Patients are screened again and their temperature is taken prior to the start of the consultation at 48 Main Street (the Corner House) by the on-site admissions staff person (temp must be 99.9 degrees F or lower). If the temperature is 100 or above and/or there are symptoms suggestive of COVID-19 infection, the consultation will be rescheduled for when patients have recovered.
The admissions consultation will be performed by an Admissions Officer via video conference (Zoom).
Patients will participate in the consultation from the 48 Main Street Corner House building (first floor access only, separate entrance from staff, separate bathroom facilities), facilitated by an on-site admissions staff person.
- Family may accompany patients to the Corner House for the consultation, but will not be permitted on the main campus (patients will be encouraged to come alone, if possible).
If offered admission, patients will complete paperwork digitally via the patient portal, have a box lunch provided by the Riggs kitchen at the Corner House, and participate in a lunch Zoom session with the patient sponsor.
Following lunch, patients will meet with business office staff via Zoom from the Corner House; paperwork to be provided via the patient/family portal and any physical payment will be collected by on-site an admissions staff person.
Patients will be given a schedule for the next 14 days and transitioned to their quarantine residence. An on-site admissions staff person will facilitate the move.
IRP-NQ Week 1
- Patients enter 14-day quarantine at the Inn – room accommodations to include a designated bathroom to prevent cross-contamination.
- Patients are tested for COVID-19 within 1 to 3 days of admission.
- Patients begin a variation of the Inn Residential Program-Nursing (IRP-N) Riggs treatment program that utilizes remote access to services, including assignment to a team and individual evaluation and treatment with a therapist, psychiatrist (if non-MD therapist), social worker, substance use counselor, dietitian, nursing, and therapeutic community staff.
- Medical health is assessed by telemedicine – medical history and current health status assessment are gathered utilizing remote access via Zoom; physical assessment and lab tests will occur after release from quarantine.
- Medications are prescribed by a Riggs psychiatrist and distributed by nursing staff as meets each individual patient’s needs.
- Patients have access to twice daily check-ins with their assigned treatment team Nursing Care Coordinator (NCC), covering team nurse, and/or with Community Nurse Karen Kalish, RN, as permitted by staff schedules.
- Patients have access to daily IRP-NQ program meeting/group led by Therapeutic Community Program (TCP) staff.
- Patients have access to the following established groups/meetings by Zoom: Community Meeting (CM) daily (Monday-Friday), Riggs 101, Substance Use group, Coping Skills group, and Transitions group.
- Patients meet via Zoom with the following departments/services for orientation: Inn Program Manager, Director of TCP, Substance Use Services, Nutrition Services, Fitness/Wellness Services, and Activities Department.
- Patients have access to virtual wellness options, including meditation.
- Patients will have scheduled time to go outside 3x/day for 30 to 60 minutes.
- Emergency services are provided remotely by the TCP and NCC staff assigned to the individual patients, backed up by first and second doctors on call (DOCs).
- Failure to remain in quarantine and/or follow established guidelines for safety are grounds for administrative discharge.
IRP-NQ Week 2
Same as week 1, and in addition:
- Patients are tested a second time for COVID-19, ~7 days after admission.
- Patients are seen remotely by their treatment team. (This may occur during week one, depending on scheduling.)
- An Early Planning Conference (EPC) is held.
- Remote psychological testing begins (if scheduling permits).
- Pre-Case Conference Family meeting held remotely. (If scheduling permits, this may occur any time between weeks 2-5, as clinically indicated.)
- Patients continue to be monitored for any emergence of COVID-19 symptoms.
IRP-NQ Week 3 – Full Integration
- In the first part of the week, patients that were quarantined are screened by the Infection Control Physician to verify that they have completed quarantine successfully and that they are COVID-19 negative.
- Patients continue with their treatment team, are integrated fully into the milieu, and are able to participate in full residential programming at IRP-N level of care.
- Patients are to be assessed by the program manager for level of care post-quarantine, and may possibly step down to the version of the Inn Residential Program that emphasizes work in groups (IRP-G), if appropriate.