April 1, 2020: Lynne Giacobbe on community-based services during a pandemic
April 2, 2020: Dennis Adams on serving low-income housing residents and protecting staff
April 3, 2020: Frank Soltys on FMLA and serving residents living with dementia during the pandemic
April 4, 2020: Aric Martin on legal liability for providers coping with the pandemic
April 4, 2020: Dave Gehm on serving COVID-19-positive residents, building trust, and testing
April 5, 2020: James Bernardo on lack of PPE, stress on staff, and communicating with families
April 6, 2020: Carla Rafferty on Coronavirus policies for assisted living, independent living, and skilled nursing
April 7, 2020: David Smart on how COVID-19 affects older adult housing, plus supporting staff
April 8, 2020: Elizabeth Weingast on coping with a large number of COVID-19-positive residents
April 10, 2020: Roger Myers on COVID-19-positive residents, philosophies driving crisis response, and protecting housing residents
April 13, 2020: Will Blackwell and Teresa Forney on their experiences with state surveys done remotely
April 14, 2020: David Hood on emergency preparedness plans and working with local and state emergency agencies
April 15, 2020: Dr. Samira Beckwith on PACE and hospice programs during the pandemic
April 16, 2020: Toby Halliday of HUD on guidance for housing providers coping with COVID-19
April 17, 2020: Dr. Danielle Doberman on advance care planning and coronavirus
April 18, 2020: Nesa Joseph on how hospice and other community-based services have adjusted to COVID-19
April 19, 2020: Michelle Norris on pandemic stresses for a multistate provider, plus planning and lessons learned for the future
April 20, 2020: Dave Isay on StoryCorps and its new partnership with LeadingAge
April 21, 2020: Carrie Chiusano on how the pandemic affects care for those living with dementia
April 22, 2020: Carol Silver-Elliott with a positive message for LeadingAge members
April 23, 2020: Dr. Nicole Lurie Offers Facts and Cautions About COVID-19 Testing
April 24, 2020: Carrie Hays McElroy on Adapting a PACE to Pandemic Restrictions
April 25, 2020: Ginny Helms on How Georgia is Opening Up and How it Affects Providers
April 26, 2020: Pat Tursi on Operating a Center for Medically Complex Children in the Age of Coronavirus
April 27, 2020: Justin Hinker on Planning for COVID-19 Cases in a Retirement Community
April 28, 2020: Jack Rollins on Issues of Concern to State Medicaid Programs
April 29, 2020: Karolee Alexander and Sue LaGrange on Emergency Staffing
April 30, 2020: Sharon Wilson-Geno on How VOA Pivots to Cope With COVID-19
May 1, 2020: Nancie-Ann Bodell on the Rural Housing Service at USDA
May 4, 2020: Dr. Paul Katz on Containing Outbreaks, Testing, and Workforce Challenges
May 5, 2020: Nick Yablon on Creating Time Capsules During the Pandemic
May 6, 2020: Andrea Lazarek-LaQuay on Helping Counties “Find the Virus”
May 7, 2020: Dr. Nimalie Stone on the Role of CDC and Difficulties That Face Aging Services Providers
May 8, 2020: Deborah Royster on Reconfiguring Services for Community-Based Customers
May 11, 2020: Neal Buddensiek, M.D., on a Multi-State Provider’s Pandemic Preparation, and Concerns About Testing
May 12, 2020: Michelle Just on Communication, Opening Up, and Handling Mixed Messages
May 12, 2020: Nick Uehlecke on How HHS Views Provider Relief Funds
May 13, 2020: Karen Hatfield on Hospice Services, Grief, and Help for Mental Health
May 14, 2020: Rob Lahammer on Tough Media Environment, Staff Engagement, and Opening Up
May 15, 2020: Carol Silver-Elliott on Fighting COVID-19 in the New Jersey Hotspot
May 18, 2020: Beth Kilgore-Robinson and Karina Barragan on the Mental Health of Residents and Staff
May 19, 2020: Robert Espinoza on Disparities in Communities of Color and Why We Must Better Support Low-Income Workers
May 20, 2020: Dr. Tom Frieden on the CDC and Thoughts on Reopening
May 21, 2020: Marvell Adams on Staff Stress, Scheduling, and Self-Care
May 22, 2020: Howard Gleckman on How COVID-19 Changes the Future of Long-Term Services and Supports
May 26, 2020: Kate Shepard on Recovered Residents, Maintaining Positivity, and Testing
May 27, 2020: Lee Ann Hubanks on Challenges Facing Her Affordable Housing Organization
May 28, 2020: Ami Schnauber on the Nightmare of Coronavirus in New York
May 29, 2020: Minnesota Testing Spotlight with Sharon Zehe, Karen Martin, and Diane Rydrych
June 1, 2020: Maureen Carland on Handling a Large Outbreak of COVID-19, and Why Planning for it is so Hard
June 2, 2020: Ralph Gaines on Affordable Housing in Pandemic, Thoughts on HUD Expectations
June 3, 2020: Lori McLaughlin on Overcoming Staff Fears and Poor Service from Public Health Services
June 4, 2020: Keith Knapp on COVID-19 in Kentucky and Positive State Responses
June 5, 2020: Karyne Jones on Overcoming Fear of Discussing Race in Aging Services
June 8, 2020: Jess Maurer on COVID in a Rural State With an Aged Population
June 9, 2020: Mario LeMay on Serving COVID-10-Positive Residents and Overcoming Staff Fear
June 10, 2020: Gus Keach-Longo on Testing, Tracing, and a “Soft Opening” in Elder Housing
June 11, 2020: Stuart Hartman on Protecting Residents and Staff in a Large National Organization
June 12, 2020: Nick Uehlecke of HHS on Provider Relief Funds
June 12, 2020: Col. Brian Kuhn on FEMA PPE Supplies
June 15, 2020: Rebekah Levit on Quickly Responding to an Early Outbreak, and Preparing to Reopen
June 16, 2020: Karen Sturchio on Preparing for Ending of Restrictions and Difficulties of a Rural Provider
June 17, 2020: Tina Sandri on Coping With COVID-19 Early, Plus Workforce and Testing Difficulties
June 18, 2020: Kristi Strawser and Kara Allread on how a Long-Standing Provider Partnership Faced the Pandemic
June 19, 2020: Capt. Joselito Ignacio of FEMA on Quality and Decontamination of PPE
June 22, 2020: Walter Ramos on Finishing Construction and Doing Move-Ins During the Pandemic
June 23, 2020: Michael Soccio on the Economics and Benefits of a Large Home Care/Hospice Program
June 24, 2020: Julie Thorson and Carol Silver Elliott on Leadership in a Time of Crisis
June 25, 2020: Kim Brooks on How HSL is Thinking Through Reopening
June 26, 2020: Mary Stompe on Keeping Housing Residents Engaged While Preparing for Reopening and Another Surge
June 29, 2020: Peter Sullivan on Protecting Residents in a Tourist-Heavy Town, Plus a Visitation Pilot Program
June 30, 2020: Katrina Gray on Procuring and Managing PPE
July 1, 2020: Deke Cateau on Morale, Testing, and Reopening
July 2, 2020: Phil Jacob on Transparency, His Own COVID-19 Infection, and Preparing for a Surge
July 6, 2020: Nancy Evans on How a Large Housing Provider Copes and Thinks About Reopening
July 7, 2020: Kassie South on Surging Cases in SC, Visitation Concerns, and PPE
July 8, 2020: Josh Bowman on Scavenging PPE, Visitation Plans, and Positive Media Coverage
July 9, 2020: Rola O'Meally on Shutting Down—and Then Reinventing—Adult Day Programs
July 10, 2020: Allison Salopeck on PPE, Testing, and Managing Outdoor Visitations
July 13, 2020: Bruce Dmytrow on the Insurance Market and the Effects of COVID-19
July 14, 2020: Dan Stewart on LGBTQ Elders, COVID-19, and How Aging Services Can Become More Inclusive
July 15, 2020: Marki Flannery on HCBS Services Hit Hard by COVID in NYC
July 16, 2020: Dorothy Davis on PPE, Testing, Telehealth Issues in HCBS
July 17, 2020: Steve Fleming on PACE and the Pandemic, Re-opening Adult Day and Dining, and Boosting Pay
July 20, 2020: Lisa Balster on Grief, Hospice in a Pandemic, and Ways Hospice Can Help Staff and Other Providers
July 21, 2020: Manny Ocasio on a “Just Culture” in a Large Multi-state Organization, Plus Testing Challenges
July 22, 2020: Don Blose on Preparing for Pandemics, Keeping Staff and Residents Busy and Loved
July 23, 2020: Dr. Noah Marco on Letting Residents Decide Their Own Risk Tolerance; Plus Testing
July 24, 2020: Hank Lovvorn on In-Person Advocacy with HHS Deputy Secretary
July 27, 2020: Sondra Norder on Taking in Residents Displaced by Fire, and St. Paul’s New Documentary
July 28, 2020: Andrew Banoff on Getting Through the Worst of the Crisis, Plus Good Interaction with Lawmakers
July 29, 2020: Colleen Frankenfield on Early Problems, Motivating and Supporting Staff and Residents
July 30, 2020: Shelly Griffith on the Pandemic, PPE, and Community Support in a Rural County
July 31, 2020: Terri Cunliffe on Multi-State Rapid Hiring Process & Re-Opening
August 3, 2020: Dr. Ashish Jha on Testing and Likely Length of the Pandemic
August 5, 2020: Dave Sanford on White House Supply Chain Task Force and PPE Shipments
August 5, 2020: Derrick DeWitt on Baltimore NH with Zero COVID-19, Health Disparities for POC
August 10, 2020: Dawn Barker on Helping Staff With Stress, Childcare
August 12, 2020: Stacey Johnson on Quality Control and Communication
August 17, 2020: Dr. David Grabowski on Supporting Staff, Public Policy re PPE, and Testing
August 19, 2020: Mitzi Epperson on Visiting With Dr. Deborah Birx
August 24, 2020: Dr. Monica Gandhi on Infectiousness of the Coronavirus, Mask Wearing, and Testing
August 26, 2020: Brian King on Managing Weekly Testing for All
April 1, 2020: Lynne Giacobbe, executive director, Kendal at Home
Topics: The challenges of community-based clients who are unwilling to allow caregivers into their homes; supporting staff and minimizing caseloads; how telehealth has improved for some members; keeping clients socially connected; and praise for staff resilience. Length: 12:04.
April 2, 2020: Dennis Adams, CEO, Christopher Homes
Topics: How visitor restrictions are working in affordable housing, including residents who resist the restrictions; challenges in screening essential visitors for an organization without clinical staff; increasing employee compensation and challenges faced by staff; dealing with multiple COVID-19-positive residents; how to help residents buy supplies when they can’t leave home. Length: 14:53.
April 3, 2020: Frank Soltys, president & CEO, Felician Village
Topics: Felician Village’s process for deciding which positions to exempt from FMLA provisions, and evaluating how policies affect staff; and infection control processes and contingency planning for COVID-19 cases in memory care units. Length: 8:25.
April 4, 2020: Aric Martin, managing partner, Rolf Goffman Martin Lang LLC
Topics: Intro by Cory Kallheim of LeadingAge, on seeking clarity on PREP Act provisions for immunity for liability for providers. Aric Martin on: providers acting as “quasi-governmental agents,” and deserving immunity; the danger of legal battles down the road, even if providers have strong defenses; PREP act coverage for testing or treatment choices; why all-encompassing federal immunity, or strong state immunity, are necessary; situation in various states—why are some practitioners given protection while those in other states are not; and why LeadingAge should form coalitions with other entities. Length: 18:44.
April 4, 2020: Dave Gehm, president and CEO, Wellspring Lutheran Services
Topics: How to serve residents living with dementia who are COVID-19-positive; on communication with staff, and dealing with staff fear; offering testing to all residents and staff, and how it builds trust and confidence; making a new type of decisions in the face of legal and regulatory liability; and why leaders must ask the right questions and be transparent to empower people with knowledge. Length: 16:12.
April 5, 2020: James Bernardo, president and CEO, Presbyterian Senior Living
Topics: Coping with a lack of PPE; proactive policies by state of Pennsylvania; stress on staff, and supporting them; and helping family understand the severity of the problem in the early days. Length: 13:41.
April 6, 2020: Carla Rafferty, administrator, assisted living, Asbury Place Maryville
Topics: The challenge of setting guidelines for independent living residents who are free to come and go; why the organization is implementing the same rules in assisted living that are used in skilled nursing, to maintain consistency; challenges of guidance on masks and physical distancing for memory care residents who may not comply; an assisted living resident’s creation of customized cloth masks; contingencies for handling a COVID-19-positive resident in assisted living. Length: 13:18.
April 7, 2020: David Smart, president and CEO, Eaton Senior Communities
Topics: How the jobs of service coordinators and wellness coordinators have changed; creating new procedures to remain within guidelines; why it’s especially important for people to move into older adult housing during the pandemic; how emergency preparedness has helped; using operating funds for purchase of PPE; incentives to staff during the pandemic—reduced hours but full-time pay, plus bonuses to exempt staff; and the best way to get in an argument (talk about masks). Length: 12:51.
April 8, 2020: Elizabeth Weingast, vice president, clinical excellence, The New Jewish Home
Topics: Going from one COVID-19-positive residents to more than 140; why advance directives must be a part of planning for coronavirus cases; the variety of symptoms among positive people; why cluster units are necessary; the most typical grouping of symptoms; planning for inevitable illness among staff, typically 10-14 days in duration; financial incentives for staff; dealing with backups at mortuaries; why the organization hired a nurse practitioner to serve staff who are out sick; who to contact re testing options; educating new staff; and why you should never allow communication and transparency to diminish. Length: 22:19.
April 10, 2020: Roger Myers, president and CEO, Presbyterian Villages of Michigan
Topics: How PVM is doing (32 confirmed positive residents, 14 deaths; 14 confirmed positive staff, 1 death as of 4/10/2020); why it’s important to “live the mission,” and project calm, confidence, and reassurance; why PVM prioritizes factual information, capturing positive stories, and looking for innovation opportunities; how technology department is using its 3-D printer to make 150 face shields per day; coping with COVID in affordable housing; and things PVM wishes it had known earlier—importance of PPE, need to rethink some contingency plans; and policies put in place to keep virus out of affordable housing while allowing critical services to come in. Length: 18:13.
April 13, 2020: Will Blackwell, VP of health services, Westminster Canterbury Richmond, and Teresa Forney, executive director, Thornwald Home
Topics: Both members’ experiences with recent surveys, performed by phone; how advance planning for the pandemic was time well-spent; value of ongoing recording of changes as they occur for future reference and future surveys; importance of daily meetings; and questions about PPE fit tests. Length: 14:17.
April 14, 2020: David Hood, Principal and Director of Operations–Healthcare, RPA
Topics: Adapting existing emergency preparedness plans for a pandemic; why all providers must engage with their local offices of emergency management, which can be very helpful in supporting providers; why staffing issues are one of the biggest problems for providers during this episode; a review of some “staff reduction mitigation options” and resources he has observed. Length: 16:49.
April 15, 2020: Dr. Samira Beckwith, president and CEO, Hope Healthcare
Topics: Operating a PACE when the PACE center must be closed, and finding ways to visit clients one-on-one using the PACE buses; reassigning staff; offering more education for family caregivers; launching virtual classes and activities for clients; connecting clients with technology; using consistent staffing; why we need to continue to enroll new hospice patients; possibilities for virtual or socially distanced hospice visits; consistent information for staff re PPE use and other issues related to COVID-19 and their work; how Hope Healthcare works with nursing homes; and how we can be an “and.” Length: 15:58.
April 16, 2020: Toby Halliday, Director of HUD Multifamily Housing’s Office of Asset Management and Portfolio Oversight
Topics: How to find guidance re treatment of stimulus payments under the CARES Act; guidance re rights and responsibilities for tenants, including re eviction moratoriums; guidance re forbearance for owners; service coordination funds; HUD deferring to public health officials re handling COVID-19-positive residents; guidance on move-ins/move-outs; and guidance for owners re COVID-19-related expenses. Length: 15:30.
April 17, 2020: Dr. Danielle Doberman, Assistant Professor, Johns Hopkins School of Medicine, and Medical Director of Palliative Medicine at Johns Hopkins Hospital
Topics: Definition of advance care planning (ACP); why people at any stage of life should be planning; how independent living elders can access resources and create advance directives; how COVID-19 affects ACP, and why we must do direct education; do-not-transport options; what should be re-assessed in the light of COVID-19; and trying to envision the illness process in the case of COVID-19. Link to Dr. Doberman’s presentation. Link to Serious Illness Communication and ACP Resources on LeadingAge.org. Length: 15:54.
April 18, 2020: Nesa Joseph, president & CEO, Visiting Nurse Association of Greater St. Louis
Topics: Anxiety from clients and family members re hospice workers and Advanced Illness Management (AIM) workers in their homes; safety measures instituted to help reduce anxiety from clients and staff—“getting used to doing business as unusual”; no staff layoffs so far, despite business down 15-20%; and a new telehealth initiative involving Tapcloud, rolled out just before the lockdowns began. Length: 17:59.
April 19, 2020: Michelle Norris, executive vice president, National Church Residences
Topics: Effects of COVID-19 in a 25-state organization; preparing for reopening in stages, and keeping clients and staff safe; managing norms in different states; strategic concerns on many levels for the future; supporting frontline staff holistically; the PARRT regional testing program for SNF or assisted living communities; testing and PPE lacking in all senior living communities; adding service coordinators to buildings without them; how LTC is the overlooked player in the health care system; and lessons learned for future crises (weakness of paper-based systems, telework, ways to keep staff in many states up to date, and the bigger the crisis, the bigger the heart—great response from employees and volunteers). Length: 25:30.
April 20, 2020: Dave Isay, founder and president, StoryCorps
Topics: The history of StoryCorps; the launch of StoryCorps Connect using a digital platform; now is a critical moment of urgency to connect with a loved one; how it can help prevent social isolation; why a partnership with LeadingAge is a natural opportunity; website is storycorpsconnect.org; and information about a simple toolkit for LeadingAge members. Length: 15:41.
April 21, 2020: Carrie Chiusano, executive director, Dementia Care Center for Excellence, Presbyterian SeniorCare Network
Topics: Keeping up with teams in multiple sites; making it a priority to keep residents and family members in contact; residents with advanced dementia respond to video calls; ways to emphasize resident engagement while maintaining distancing; ways to communicate about COVID-19, and altering body language, with residents; families going to great lengths to interact with loved ones; offering more support to family caregivers; and memory cafes becoming virtual. Length: 15:25.
April 22, 2020: Carol Silver-Elliott, president and CEO, The Jewish Home Family
Topics: A message from the LeadingAge Chair on celebrating our successes; counteracting the inaccurate, negative picture that the media paints of our field; and the importance of staying focused, positive, and together. Length: 2:45.
April 23, 2020: Dr. Nicole Lurie, COVID incident management team leader, Coalition for Epidemic Preparedness Initiatives (CEPI)
Topics: Facts about tests to detect current infections; the limitations of day-to-day fever screening; why tests do not tell us as much as we might expect; facts about tests to detect antibodies; why many of the available antibody tests are questionable; and the effects of poor leadership, and of good leadership. Read this article on LeadingAge.org, based on Dr. Lurie’s presentation. Length: 23:54.
April 24, 2020: Carrie Hays McElroy, VP, clinical operations/CNO, Trinity Health PACE
Topics: Outline of how a PACE (Program of All-Inclusive Care for the Elderly) works; revising care plans to deal with closure of the PACE center; reassigning employees to offer support in clients’ homes; how family support has increased, allowing reduced workloads for staff; weekly staff meetings for PACE employees in multiple states; organized prayer calls; activity packets delivered to clients’ homes; daily check-in phone calls; PPE supplies (adequate due to affiliation with health system), and conservation strategies; serving the few COVID-19-positive clients; confidentiality issues in remote interactions with clients; and challenges for staff who go into clients’ homes. Length: 18:54.
April 25, 2020: Ginny Helms, president and CEO, LeadingAge Georgia
Topics: Experience of Georgia’s phased reopening; how reopening makes providers hypervigilant; members investigating infection control systems; independent living residents are pushing for reopening in many places; life plan communities not doing move-ins, but planning for how to balance quality of life and safety in the future; how adult day providers are adapting, and preparing for limited reopening; and need for funding of adult day providers. Length: 17:47.
April 26, 2020: Pat Tursi, CEO, Elizabeth Seton Children's Center, and Resident Stephanie Gabaud
Topics: Aggressive infection control has kept COVID-19 out; protecting kids who had to go to hospitals; 5% of staff tested positive, most have returned to work; dealing with staff concerns; sharing information and stories with community and media; how to tell families they could not visit with their children; heartbreaking stories of small children whose parents aren’t allowed to visit; comments from Stephanie Gabaud, long-time resident; and the importance of smiling and having fun. Length: 22:16.
April 27, 2020: Justin Hinker, administrator, Avera Prince of Peace Retirement Community
Topics: Avera’s experience with COVID-19 positive residents; connection to Avera health system helps with planning and PPE; creating a COVID-19 wing in anticipation of May peak; financial help to staff, including covering health insurance; creating a “virtual town hall” for family members and planning to keep doing it indefinitely. Length: 16:58.
April 28, 2020: Jack Rollins, program director for federal policy, National Assn. of Medicaid Directors
Topics: Dramatic increase in telemedicine, occurring much more quickly than we thought possible; lots of modifications to reimbursement policy; NAMD wants more state involvement in distributing provider relief funds; Medicaid providers not being prioritized; wants more granular provider-specific funding award information to make better decisions on how to help providers at state level; concerned about “financially fragile” providers (in many fields) that may not be able to remain open, including those who provide non-COVID related care; creation of COVID-19-specific LTC facilities; some states doing higher rates for COVID-19 services; a lot of newly unemployed people likely to end up on Medicaid, and ways to prepare for that, including a higher match rate; and how good data is what policymakers need most to better understand pressure on LTSS providers. Length: 18:12.
April 29, 2020: Karolee Alexander, director of reimbursement and clinical consulting, and Sue LaGrange, education director, Pathway Health
Topics: Providers need to have emergency staffing policies, preferably with addendums re COVID, with focus on different phases; planning for leadership backup; accounting for factors outside of work life that affect staff; fear caused by staff who have frail relatives at home; consider reducing medications management workloads for staff; why memory care units are sites of high transmissibility; good acuity-based staffing tools don’t exist, but PBJ numbers could be a source of data; communicating altered standards of care; trying to reduce non-direct care subtasks from nurses and CNAs by training other staff; hiring new staff; delegation to volunteers; finding ways for staff to build camaraderie; sources of new staff—including hospital nurses, nursing students, and idled cafeteria workers; and a toolkit for emergency staffing and policies. Length: 20:42.
April 30, 2020: Sharon Wilson-Geno, EVP, chief operating officer national services, VOA
Topics: Why VOA staff stays on-site in housing communities; keeping residents active and engaged; operating in multiple states, and dealing with outbreaks in 3 states; how state governments’ views on the virus differ; coping with different reopening plans and communicating with residents; testing—if you look for it, you will find the virus; the validity of tests; why housing and health care, and their funding streams, need to be thought of together; thinking about the people we don’t serve; and how to determine what staff must be tested, and how. Length: 19:04.
May 1, 2020: Nancie-Ann Bodell, deputy administrator for multi-family housing with the Rural Housing Service at USDA
Topics: Intro to USDA multi-family housing; 68% of Section 515 USDA affordable multi-family housing are elderly or disabled; 14,000 units total, 13,000 of them Section 515 rural rental housing; USDA to begin including service coordination within the Sec. 515 portfolio; have heard anecdotes about COVID-19-positive residents, and deferring to CDC and health department recommendations; seeing many interim recertifications due to wage loss; interim certifications being provided to adjust income even for non-wage earners, which may include elderly; what’s unique about rural needs; and impactful job losses. Length: 15:22.
May 4, 2020: Paul Katz, M.D., Chair, Dept. of Geriatrics, Florida State U. College of Medicine
Topics: Difficulty of containing a small outbreak in a nursing home or assisted living; does the acute-care sector understand what skilled nursing faces? Thoughts on mandatory testing and contact tracing for all residents and staff; why hospitals should test everyone who comes in; the acute-care sector misunderstands the LTC workforce; will changes in physician staffing be required in LTC? Comments on team care and telehealth. Length: 19:28.
May 5, 2020: Nick Yablon, associate professor of history, University of Iowa
Topics: An introduction to time capsules; the value of creating time capsules during a difficult time such as this pandemic; how senior living communities can make their mark with time capsules; advice for providers wanting to do time capsules for their residents and staff (and why they should not be buried). Length: 14:35.
May 6, 2020: Andrea Lazarek-LaQuay, Chief Clinical Officer, Nascentia Health
Topics: Home health clients choosing to reduce face-to-face visits; increasing use of telehealth units as a substitute; working with different counties, each with its own emergency management system; connecting with a federally qualified health center (FQHC) in Syracuse, NY; how Nascentia worked with counties to go and “find the virus” in individuals’ homes; Nascentia staff visiting “hotspots” in senior living communities in Onondaga County to do testing; working with providers to allow entry into their facilities; over 1,200 people tested; how to leverage resources in your own community; identifying a limited number of staff as a “target team” to deal with COVID-19 cases; why nasal pharyngeal swabs are still the most effective tests; why this would work in affordable housing. Length: 15:56.
May 7, 2020: Dr. Nimalie Stone, medical epidemiologist, CDC
Topics: How CDC supports providers and health departments; praise for how LTC providers have performed; how providers are vilified; roles of CDC and CMS and how they differ; a snapshot of differences between state agencies—survey agencies vs. health departments; facts about NHSN, and streamlining of reporting during the pandemic; concerns about difficulties with duplicative reporting; and CDC recommendations re masking. Length: 31:31.
May 8, 2020: Deborah Royster, CEO, Seabury Resources for Aging
Topics: Changing services to serve elders sheltering in place; dramatically boosting meal deliveries; great stories of staff going the extra mile to serve; racial disparities in effects of COVID-19; underscoring the importance of protocols and emphasizing it to customers; preparing for Mother’s Day—giving out roses and chocolates, a special meal, window visits, remote family connections; and bringing remote activities, classes, and religious services to residents. Length: 18:19.
May 11, 2020: Neal Buddensiek, M.D., chief medical officer, Benedictine
Topics: A grant 2 years ago allowed creation of an infection tracking system and infection documentation in EMR system as part of our pandemic preparation; a large COVID-19 task force has met every day across the organization; how Benedictine’s “virtual strike team” helps walk individual communities through COVID-19-positive cases, using data; a system that allows us to track infections and data across states; how a system that operates in 5 states can work across all; possibility of turning some COVID-19 units into hospice units; concerns about the logistics and consequences of mass testing of staff and residents. Length: 23:23.
May 12, 2020: Michelle Just, president and CEO, Beatitudes Campus
Topics: Quick adjustments by staff to lockdown of campus; keeping residents engaged—a daily theme for education and resident contact; daily updates for residents by CEO or senior VP; ways to encourage resident questions and comments; thoughts about opening up; how Beatitudes handles marketing, sales, and move-ins; and reminding staff of duty for safety while the state opens up. Length: 14:01.
May 12, 2020: Nick Uehlecke, advisor, HHS
Topics: HHS wants better data on who’s providing care and what it looks like; encourages members to submit to the portal for funding; working to make sure rural and Indian tribe providers get funding; HHS wants to identify individual communities that haven’t received any funding; working on a SNF tranche (including those that are 100% Medicaid) and concerned about relief re PPE as well; advice re how to track spending to come; HHS wants questions to be sent in (via LeadingAge or directly); advice re a multi-continuum provider using funds in various levels of care; question re using donated funds vs. provider relief funds; and questions about deadlines. Length: 19:54.
May 13, 2020: Karen Hatfield, team leader for counseling services, Hospice of the Western Reserve
Topics: None of the team is personally visiting patients; having to pay attention to all losses people experience, and how that affects grief; trying to figure out contingencies for future services the rest of the year; why staff sometimes feel their grief is disenfranchised; why we encourage staff to acknowledge their own grief; grief doesn’t always look like what you expect; the need to recognize delayed grief and validate grief; how we might have to alter services; where to go for counseling and support; we’re now reaching people who didn’t have access to us pre-COVID; new practices that might last beyond the pandemic—some virtual services, etc.; and working with visitor restrictions at LTC providers. Length: 22:31.
May 14, 2020: Rob Lahammer, VP of engagement and advocacy, Presbyterian Homes & Services
Topics: No part of the organization that hasn’t been impacted; value of early lockdown; the transitional care business dropped but we were able to reassign staff; 16 COVID-19 deaths so far; how to maintain a strong communications process; a centrally stored PPE supply; value of transparency; how one standalone transitional care site was converted into a COVID-19 site; in Minnesota, 81% of deaths were in LTC—press has been very hard on providers; difficulties with testing; unengaged employees are leaving, but others sticking, and employee engagement actually going up; dealing with a variety of resident attitudes in independent living; small drop in census; initial plans re relaxing restrictions; and difficulty recruiting new staff. Length: 20:20.
May 15, 2020: Carol Silver-Elliott, president and CEO, The Jewish Home Family
Topics: COVID-19 experiences in the center of a hotspot; turning management staff into dining assistants; this part of NJ was hit hard early on and local hospitals were overwhelmed early; decision to keep COVID-19-positives in-house; how JHF adopted hospital practices, and pushed physicians to be more aggressive; importance of turning and repositioning teams, hydration teams, and high-flow oxygen; praise for staff and others who supported the work; “parking lot guy” and many others that have helped get PPE; JHF has reopened to admissions, including some people in recovery; “You cannot let down your guard even though things are stable”; making full PPE a requirement to any family coming in; testing all new admissions 48 hours before entry; testing mandated in NJ for residents and staff, and how JHF has begun implementing; issues involving payment for testing and sequencing; why leaders and managers must always be positive even in bad situations; and why we hold celebrations for residents who recover. Length: 23:32.
May 18, 2020: Beth Kilgore-Robinson, member services coordinator, Goodwin House, and Karina Barragan, director of resident services programs, TELACU
Topics: Acknowledging grief; finding ways to look for the positive; incorporating mindfulness; organizing virtual services to keep residents and clients engaged; fighting isolation among affordable housing residents; dealing with PTSD, alcohol abuse, noncompliance with stay at home orders, reduced family connections, and hoarding; staff responding well to frequent policy changes; daily checks on resident well-being; and recognizing the need to focus on mental health. Length: 21:08.
May 19, 2020: Robert Espinoza, VP of policy, PHI
Topics: Coronavirus’ more negative effects on communities of color—highly overrepresented; direct care workers especially unable to weather the crisis and having greater difficulty with childcare and health access; why providers should be surveying communities of color re needs; tools to help develop a racial equity lens in our work; for home and community-based workers, why compensation must be improved; things employers can do to support these workers; policy wishes—improving compensation, sick leave, childcare, health coverage, provider compensation, pipelines for more workers into the HCBS sector; precarious lives of these workers creates impossible choices; getting technology to underserved communities; need for better training creates opportunities for both workers and employers; and value of connecting workers to community resources to support them. Length: 19:54.
May 20, 2020: Dr. Tom Frieden, president and CEO, Resolve to Save Lives, and former director, U.S. Centers for Disease Control
Topics: Role of the CDC, and optimism about beating the virus; what will a “new normal” look like; different risk levels for different areas; testing situation improving but does not meet needs yet; how providers should approach reopening; 2 false dichotomies (open vs. closed) and (health vs. economy); and 2 sites of interest (preventepidemics.org and covidexitstrategy.org). Length: 15:00.
May 21, 2020: Marvell Adams, COO, The Kendal Corporation
Topics: Understanding and alleviating stress on staff, both at work and in personal life; encouraging staff to use vacation, and have “staycations”; staff embracing mass testing; switching to 12-hr. shifts; keeping staff in consistent, separate teams, and general benefits of that model; simplifying menu plans to deal with diminished dining staff; encouraging staff to practice self-care; and lessons learned from a children’s book. Length: 16:13.
May 22, 2020: Howard Gleckman, Senior Fellow, Urban Institute
Topics: Disappointing absence of guidance on testing for providers; pandemic was a tragedy waiting to happen; broad recognition of an unsustainable LTC system; why paying for value can be a useful concept going forward; LTC becoming even less attractive to low-wage workers; labor and capital costs will go up; danger of focusing only on infection control; question of where will the money come from; providers understand delivery reform better than anyone; why the goal should be to build a system from scratch; financing LTC through Medicaid is unsustainable; benefits of a public insurance program; the biggest stumbling block is the money; can a shift toward better LTSS really reduce health spending? Length: 21:08.
May 26, 2020: Kate Shepard, executive director, Reformed Church Home
Topics: Things improving somewhat; thinking about opening up, and offering outdoor activities; update on testing challenges; positive media coverage re 2 residents in their 90s who have recovered from COVID-19; details about a separate unit for residents who have tested positive; using live TV system for communication and engagement; creating an employee appreciation fund; frequency and costs of testing for staff; and pay incentives for all staff, and for staff on the COVID-19 wing. Length: 18:47.
May 27, 2020: Lee Ann Hubanks, president, Plano Community Home
Topics: Service coordinators doing excellent work; no coronavirus cases so far; unable to get tests so far; weekly memos to all stakeholders with updates; revenue losses due to lack of move-ins; PPE costs and additional payroll costs; still reluctant to begin opening up; securing a PPP loan; move-in logistics; and struggles to find PPE. Length: 13:22.
May 28, 2020: Ami Schnauber, VP, advocacy and public policy, LeadingAge New York
Topics: Members have significant challenges with decreased census, partially due to lack of post-acute rehab; hazard pay and testing costs created a huge financial hole; state changing rules and issuing frequent survey questions; tremendous unaffordable costs involved in state-mandated staff testing—total estimate for members at $44 million per week; lab capacity inadequate; how NY State makes the pandemic more difficult for providers; no clear communication from DOH re resident testing, and suddenly changing rules; DOH staff doing testing are not themselves tested, and training is spotty; we want testing, but the volume required is unworkable, unaffordable, and threatens livelihoods of staff; rules for testing of staff who work at multiple communities; and how testing rules may create new staffing shortages. Length: 25:09.
May 29, 2020: Minnesota Testing Spotlight: Sharon Zehe, Mayo Clinic, and Karen Martin and Diane Rydrych, MN Dept. of Health
Topics: the “Minnesota Moonshot”; huge financial, legal, and cultural challenges of doing comprehensive testing; problems of unreimbursed costs; legal issues where facilities do not have medical directors; how mass protests and riots will effect disease statistics and first responders; who pays—insurance companies with state as a backup; additional issues raised by a testing program; identifying asymptomatic workers; reasons for early hesitance by providers; why testing must be an ongoing process; role of Mayo Clinic Labs; working to make home-testing workable in the short term; still questions re infectiousness of asymptomatics; situation of highest-risk residents or staff; and comments re payment for testing. Length: 27:43.
June 1, 2020: Maureen Carland, administrator, Maine Veterans' Homes
Topics: Despite detailed preparation for coronavirus, the first case occurred in an unexpected way; ultimately 34 residents tested positive, 17 passed away, 14 of them directly from COVID-19; why you’re not prepared even if you think you are; why attention to the minutia of infection control is so important; half of staff assigned to that unit also got coronavirus; scheduled Zoom calls with families and staff; delivering meals to sick staff’s homes; many staff lived in a nearby hotel; social workers and chaplains doing regular staff support calls; dealing with social isolation, esp. on the COVID-19 unit; wandering minstrels, bikers, and antique cars coming to visit outside the building; setting up BBQs outside to produce smells for residents (also popcorn, other comfort foods); if doing it again, review how people enter the unit and creating a clean zone; being careful of the language you use; attention to detail in using PPE; thinking about ways to honor residents who die; determining what constitutes “recovered”; and criteria for doing universal testing, and lack of a plan in Maine. Length: 21:49.
June 2, 2020: Ralph Gaines, CEO, Embrace Living
Topics: Challenging environment in EL housing communities, but organization has had only 15 total cases, including employees; some difficulty with PPE supply, but was able to secure sanitizer from distilleries and masks; resident interactions and activities; importance of Wi-Fi access in affordable housing; workforce motivation ideas—staying in close contact in any way possible, a flexible telework policy, “appreciation bags” for employees; and this former HUD employee’s view on how this affects housing policy. Length: 20:37.
June 3, 2020: Lori McLaughlin, managing member, WestShore LLC
Topics: Dealing with panic from nurses when the first positive case occurred; reassuring residents and staff facing fear; used large amounts of PPE; still don’t know what costs will be; state-provided strike teams inadequate; poor response from public health departments; and logistics of testing employees. Length: 15:36.
June 4, 2020: Keith Knapp, senior advisor on adult programs, State of Kentucky
Topics: KY Long-Term Care Advisory Task Force—a group to advise state government re COVID-19 and long-term care; working on protocols on big-picture issues and smaller operational issues; state issued “guidances,” not “directives,” re admission of COVID-19 cases; KY moving away from traditional approach to surveys, has been collaborative and people have been surprised about how good the outcomes have been; KY has been early adapter in universal staff testing, now halfway through; KY has orchestrated wraparound services re different contingencies in testing; creating staff strike teams for bad situations; KY has contracted with a lab and is paying for all testing. Lessons learned: Hope it is the end of semiprivate rooms; hopeful we can pay staff more permanently; we must think through the imposition of isolation, hard issues involved; value of a call center. Length: 22:00.
June 5, 2020: Karyne Jones, CEO, The National Caucus and Center on Black Aged
Topics: Introduction to NCBA; learning about racial denial; disparities in pandemic’s impact on people of color; how social determinants affect health; aging services is segregated; bringing POC into leadership of aging services organizations; LeadingAge needs to do more; a shared responsibility for people of all races; learning to be comfortable talking about race, and stop being afraid of each other; culturally appropriate activities in multiracial communities; actively bringing POC into leadership-track career opportunities in our field; reaching out to POC in marketing for all LeadingAge communities. Length: 30:29.
June 8, 2020: Jess Maurer, executive director, Maine Council on Aging
Topics: Maine is oldest and most rural state, already struggling with a direct care workforce shortage; coronavirus exacerbated the problems; most volunteers are elders who dropped out; coping with the problem—member and partner conversations, direct advocacy; have gotten a lot of help from legislators and others; good ad-hoc partnerships; getting insurers to pay for home-delivered meals; concern about the likely failure of small nonprofits in northern New England; and helping service coordinators cope with pandemic demands. Length: 22:14.
June 9, 2020: Mario LeMay, director, organizational effectiveness, San Francisco Campus for Jewish Living
Topics: SF came through COVID-19 relatively well; preparing to serve coronavirus-positive patients, logistically and otherwise; preparing staff and dealing with employees’ fear; unit was never more than half full; how LeadingAge Leadership Academy experience helped him work through the crisis; and experience of baseline testing for residents and staff and dealing with resistance. Length: 16:59.
June 10, 2020: Gus Keach-Longo, CEO, The Towers at Tower Lane
Topics: Interesting story of the origin of The Towers; “fluid” levels of care offered to residents; 8 coronavirus cases, all contracted outside the building; testing program for all residents and staff, as a pilot; leadership took their tests on camera and broadcast throughout building; doing contact tracing for residents who may have had contact; closed to visitors but not service providers—and how those visitors are tested and screened; overcoming resident/family anger over restrictions; keeping community regularly informed; trying to figure out a “soft open” strategy because isolation is so dangerous; and how expenses of testing and meals are covered. Length: 24:21.
June 11, 2020: Stuart Hartman, SVP of operations, acquisitions, and development, Retirement Housing Foundation
Topics: Limiting interactions between residents and staff and the outside world; 80% of the corporate workforce working at home, and furloughed some staff; nationwide, 122 COVID-19 positives in 35 communities, 66 recovered, and 20 deaths; most facilities had zero cases; lessons learned from initial Washington state nursing home cases—especially involving staff working multiple jobs; enabling those employees to stop working multiple jobs; how RHF is planning ahead for the fall; distinguishing between cases of COVID-19 and influenza; scenarios for staff returning to work in various settings; and policies re vacationing staff. Length: 19:00.
June 12, 2020: Nick Uehlecke, Advisor, Office of U.S. Secretary of HHS
Topics: Questions re Provider Relief Funds—those who bill Medicaid managed care plans are eligible; providers, such as adult day, who had to close their physical space, are eligible; clarification of deadline for applications, will be July 20; status of payments to Medicaid-only SNFs; status of guidance on reporting; policy on “paying to the upper TIN”; what’s next for remaining funds; how provider relief funds affect PACE providers; and eligibility of LPCs, guidance to come. Length: 18:12.
June 12, 2020: Col. Brian Kuhn, White House Supply Chain Task Force, FEMA
Topics: Description of task forces re PPE; Hanes cloth facemasks—not designed for medical settings, intended for visitors; FEMA packages, 2 rounds with a 1-week supply each time; the “blue tarps”—level 3 nonsurgical isolation gowns; details re the next shipment; explaining the tracking and reporting system; “Project America Strong” is the Hanes facemask shipments; how to deal with defective materials; and AL eligibility. Length: 19:03.
June 15, 2020: Rebekah Levit, executive director, Rogerson House
Topics: An assisted living dedicated exclusively to residents living with dementia, plus a social day program; had one of the first COVID-19 deaths in the state; needed to put systems in place immediately; eliminating staff crossover within the neighborhoods; figuring out how to quarantine residents safely; paying close attention to all symptoms; changing the closed day program into the “COVID floor”; continuing to serve residents who cannot socially distance; responding to Governor’s recent announcement that visitation could resume (outdoors only); details about how these visits are managed; which type of visits residents and families like the most; and dealing with PPE needs. Length: 16:44.
June 16, 2020: Karen Sturchio, CEO, Kansas Christian Home
Topics: Reopening guidance in Kansas; alarmed that nursing homes to be opened without restriction in late June; managers wear a lot of hats; state not requiring baseline testing; testing was difficult but getting easier; if county lets emergency declaration expire, we can’t get FEMA reimbursement funds and it would cost about $750K over a year; managing balance between safety and social isolation; sustaining budgeting for a provider with a lot of Medicaid, lose money on every Medicaid resident; and operating on a tight budget and with no margin for error. Length: 25:01.
June 17, 2020: Tina Sandri, CEO, Forest Hills of DC
Topics: The logistics of testing at her previous employer, early in the pandemic; staff challenges early on; at Forest Hills, lining up additional staffing before testing; testing done by public health lab nurses; still a challenge to get staff tested weekly; tremendous cost of testing; majority of cases found have been asymptomatic; covering workforce holes with staff out; dept. of health survey results; and questions re workforce policies. Length: 14:33.
June 18, 2020: Kristi Strawser, executive director, State of the Heart Care, and Kara Allread, SVP, Brethren Retirement Community
Topics: The 40-year partnership between Brethren Retirement and State of the Heart Care (hospice provider); how the partnership helped in coping with the pandemic; some staff work for both organizations; how established good communications helped in working through risks and exposures, without eliminating the hospice’s access; aspects of good partnerships—not becoming complacent, keeping regular contact between leadership and clinical teams; encouraging staff to make “caring choices”; working with LeadingAge Ohio to create a “travel and social gathering risk mitigation tool”; daily alerts using OnShift to remind staff about careful choices made at work and outside; recognizing COVID fatigue; cooperating in staff recognition and support; and policies re staff who work for both organizations. Length: 19:05.
June 19, 2020: Capt. Joselito Ignacio, lead, Supply Preservation Support Team, FEMA
Topics: Quality of PPE, including fraudulent PPE; evaluating unsolicited offers of PPE and respirators; PPE preservation; reducing, reusing, and repurposing PPE; using barrier controls, when possible, to limit using PPE; extended use of PPE; and decontamination systems in hospitals being used on PPE. Length: 20:05.
June 22, 2020: Walter Ramos, president and CEO, Rogerson Communities
Topics: Boston area hit early by the pandemic, had to learn fast; completing a construction project during pandemic; new residents hesitant to move into the new community; move-ins have picked up in recent weeks; setting up many safety protocols for move-ins; great communication and transparency helped the process; no residents have objected to move-ins, and how trust was built among residents; thinking about how to get our residents first in line for getting a vaccine if one is found; financial impact of residents delaying their move-in to the new community; and move-ins to be a challenge going forward as well. Length: 18:21.
June 23, 2020: Michael Soccio, VP of clinical operations, Trinity Health At Home
Topics: Up to 1,500 home care + hospice patients per day in census; “Home Care Connect” program, created to lower costs, reduce in-home visits, and monitor people 24 hrs. per day; clients can launch remote visits at any time, round the clock; many calls after midnight involve anxiety and isolation; many clients in their late 90s who do really well with the technology; “Getting Better and Getting Different” is the mantra—always looking to meet the triple aim; heavily invested in remote monitoring platform; saw during COVID-19 that many patients had no insurance, so we decided to place the technology with all patients who tested positive or who we suspected having it; monitoring remotely is a way to conserve PPE and also reduce exposure of staff; had about 250 COVID-19-positive patients on monitor, and could create a COVID-19 pathway in the Home Care Connect product so device would gather vital signs every 4 hours, with slight changes recorded and assessed; our virtual care center becomes a call center during overnight hours; interesting story about a client with a clogged PIC line; why ER nurses are such experts at triage; why remote monitoring should be 24/7; a business case built on reducing expenses by reducing home visits; patients give positive feedback about the telehealth helping them feel less isolated; thoughts about getting signed orders for services from physicians; and comments about Vivify technology. Length: 25:46.
June 24, 2020: Julie Thorson, president and CEO, Friendship Haven, and Carol Silver Elliott, president and CEO, Jewish Home Family
Topics: Leaders that recognize their strengths; giving each other the grace when someone is “having a day”; relationships that sustain us; the anxiety caused by uncertainty, and learning to put it aside; staying positive despite difficulties; how a closed employee Facebook group has helped; how the Leadership Academy helped; creating a list to prepare for a second wave; and continuing ongoing communication with families. Length: 25:52.
June 25, 2020: Kim Brooks, COO for Senior Living, Hebrew SeniorLife
Topics: Hit hard at 2 sites early, despite being very aggressive in taking steps to protect residents; a “guiding principles document” for reopening planning; residents created educational video for other residents; purposely using different language than the state’s phasing language; risk assessment and mitigation planning tools; home care services picking up lately; trying to get baseline and surveillance testing in independent living; how contact tracing might work well among HSL residents; a relatively unrestricted approach to visitation in independent living; building trust and transparency with all groups; things we’ll keep after COVID—virtual programming opportunities, fitness via TV; and thinking through the return of volunteers. Length: 21:31.
June 26, 2020: Mary Stompe, executive director, PEP Housing
Topics: Starting to open up community rooms to small groups with masks; keeping resident managers and service coordinators working remotely; have had only 1 case; most volunteers are residents, so prevented vulnerable ones from participating, and used staff to take over food delivery and expand the program; the only positions hard to fill were in lower paid jobs like maintenance staff; appreciation pay; reduced hours in summer; flexibility re remote work; “Project Sunshine”—lots of communication with residents, cards, worked with Covia on “Happy Mail” program, bringing music to the properties; managing repairs and inspections; and thorny issues with testing of staff. Length: 20:38.
June 29, 2020: Peter Sullivan, executive director, Birch Bay
Topics: Protecting residents of a rural community with a lot of summer visitors—over 1 million per summer; effects of sheltering in place on residents, esp. those with dementia; “touching” and social supports decreased due to pandemic; pilot project in residential neighborhood, to allow visitation from loved ones with negative swab tests; pilot may extend to assisted living in the future; and staff showing support for the pilot. Length: 22:12.
June 30, 2020: Katrina Gray, compliance officer, Buckner Retirement Communities
Topics: Phased reopening of life plan communities’ independent living residents, have pulled back a little due to Texas surge; testing and isolation from residents coming in from outside; difficulties in procuring PPE; building up an emergency stock of PPE; paying up front for unknown quantity and quality of PPE; designating a “PPE Czar”; using Microsoft Teams to connect staff; planning stockpiles of PPE for the future; LeadingAge Texas sending out useful PPE alerts; and useful help from state and local health departments. Length: 20:54.
July 1, 2020: Deke Cateau, CEO, A.G. Rhodes
Topics: Previous emergence preparedness programs put us in a good place to deal with COVID-19; had 57 resident cases and 38 staff cases, and 9 resident deaths; went to zero cases by June 1 and now have 9 cases again; families misunderstood the governor’s opening order and thought they could visit; outdoor visits opened last week. Lessons learned from pandemic: COO and myself took over ordering supplies ourselves; put vendors on net zero payment terms, or pay in advance as needed; we delivered supplies to the homes ourselves; have strong supply vendors; required administrative staff to come into the workplace, for morale reasons, and it was successful; focused on resident testing early, but have been aggressive about employee testing; “business as unusual”—how to apply person-directed care to the pandemic; COVID-19 will set back the culture change movement; had to re-install barriers such as plexiglass walls at nursing stations after taking them down in the past; 14-day quarantines for new admissions, but tracing is still very difficult; hiring staff for person-directed care involves interviewing for “fit” by asking questions about scenarios; census has dropped to 70% occupancy; new admits push back against 14-day quarantines; finding labs to provide testing; and A.G. Rhodes has purchased 3 testing machines of its own. Length: 19:43.
July 2, 2020: Phil Jacob, associate executive director, The Buckingham
Topics: COVID came along just as a major expansion was completed; shut down admissions when first positive case came along; some staff tested as “positive” for 70 days or more; instituted frequent testing early in the pandemic; many difficult decisions re testing, staffing, etc., early on; transparency required to deal with frequent policy changes forced by the course of the pandemic; making questions asked of staff and new admits intelligible; what happened when I learned I was positive and continued working from home through the disease, and a bad 3 weeks followed by 5 more weeks before coming back to work; how the organization handled the financial hits of the pandemic; Houston undergoing a surge in cases in early July; and handling intra-level of care visits, resident-to-resident, only via remote technology. Length: 20:56.
July 6, 2020: Nancy Evans, CEO, CSI Support and Development
Topics: CSI has a unique cooperative management system for 60 apartment buildings with 6,300+ units in 4 states; coop model conflicts with the need for residents to shelter in place, so shifting our focus is the challenge; 76 confirmed positives in just a few properties in Massachusetts and Michigan, and 20 fatalities, probably have many more positives we don’t know about; going property-by-property to determine reopening strategies; some local health departments have been helpful in doing testing; results of testing are mainly negative, and lots of asymptomatic positives; our communication has never been better and we believe we have a much better handle on what’s going on; working remotely has worked out extremely well; coops are purchasing iPads for council members; stopped all move-ins, and have staff now doing most of the admissions work that was formerly done by member committees; properties are absorbing costs of unoccupied units, but maintenance costs have dropped as well; thoughts about how to handle repairs as things gradually open up; and sanitizing practices for repair jobs. Length: 17:19.
July 7, 2020: Kassie South, senior director of health services, Franke at Seaside
Topics: Huge increase in hospitalizations in Charleston, SC; having to manage downstream effects of hospitals being overwhelmed; increasing cases among staff; quarantine and testing policies for staff who go on vacation; changing staff scheduling to cope with staff shortages and to minimize the number of staff working in resident areas; anxiety re visitation changes, state requirements; floods of tourists coming into Charleston area; converted a 2-bedroom apartment as the PPE stockpile, access limited to only a few staff and stock closely tracked; strange and inadequate collection of PPE from FEMA; value of the Leadership Academy network in getting through the crisis; and concerns about outdoor visitations in hot weather. Length: 20:10.
July 8, 2020: Josh Bowman, administrator, Bethel Manor
Topics: Have not had any resident cases so far, and one asymptomatic staff member; ramping up PPE supplies in an unconventional ways; scavenging N95s from farm stores and paint stores; why I used my pop-up camper to live on-campus during the pandemic; doubled activities staff to boost resident engagement; added an app for family members to follow what their family members is doing during the day; window visitation; made a plexiglass structure outdoors for visitation; started indoor visitation this week, with restrictions; how we got positive local media coverage; advertising all of our infection control precautions; and what to preserve in the future—family connections and preparing for future emergencies. Length: 17:39.
July 9, 2020: Rola O'Meally, director for adult day services, St. Ann's Community
Topics: Adapting to the early closure of adult day programs; assessing the risk levels and needs of participants, then quickly finding ways to help the most high-risk individuals; remote activities, helping coordinate care, wellness, and medical appointments; adding a bilingual (Spanish) wellness coordinator for large number of Hispanic clients; telehealth is here to stay in adult day services; success in keeping hospitalizations down; funding—used some grant funding to help pay for adapted services; and meals and help with medical appointments were the most-requested. Length: 16:34.
July 10, 2020: Allison Salopeck, president and CEO, Jennings
Topics: Lost 10 residents in May; restarting admissions; good success in short-term rehab; AL candidates holding off on move-ins, and many of them have more flexibility than those requiring skilled nursing; we have a tight-knit community of NP senior care providers, and have been able so far to get as many test kits as we’ve asked for; testing turnaround of 24-48 hours for the most part; National Guard has helped with testing; staffing has been one of the biggest struggles; have a number of staff who work in other places as well; tried to convince people to pick just one place to work; stopped job shadowing and went to online interviews, but are trying to get job shadowing back; part-time staff were encouraged to jump onto full time; outdoor visitation for AL and SNFs in Ohio; wanted a way to limit exposure of staff doing testing of visitors; came up with a “car-hop” where visitors stay in their cars and maintain social distancing while visiting relatives. Length: 19:48.
July 13, 2020: Bruce Dmytrow, Senior VP, CNA Insurance
Topics: Insurance market outlook before COVID-19; loss cost pre-COVID was trending at about 11%, and large jury awards were becoming more frequent; the claim severity has converged across all service levels and in all jurisdictions and in both NP and FP settings; beginning to see optimism until COVID-19 hit; in the senior living sector, there’s been a significant moratorium on new business by some of our competitors; pandemic, class action, and other exclusions shifting; have tried to take a measured approach among our long-term customers seeking renewals; most policies exclude business interruption coverage where there is no property damage; affects of federal and state immunity and executive orders; insurance landscape after COVID-19 is hard to predict because of constant change; if indemnity immunity is passed on the federal level things could look better; advice on being prepared for the future; keeping a timeline and documentation of events and challenges managed is a good idea for managing claims; insurability of health care isolation center to attract and care for COVID-positive people can be difficult—important to show how you’re operating from staffing, equipment, and infection control standpoints; “severity” refers to the average indemnity the company pays on claims; more about “timelines.” “Opportunities” presented by COVID-19: it has encouraged greater communication and collaboration among providers and families; new models of care being developed; increased telehealth; utilization of new technologies, including robotics and IoT; emphasis on home health options; more emphasis on social determinants; greater use of data; and greater attention to mental health. Length: 20:30.
July 14, 2020: Dan Stewart, Human Rights Campaign and LEI
Topics: Effects of COVID-19 on LGBTQ elders; greater risk for poor health conditions, chronic disease; higher risk for severe illness from COVID-19; 20% of LGBTQ elders are people of color; “fear of providers”; we’re just starting to learn about LGBTQ aging; a decreased social network LGBTQ elders can rely on; SAGE’s elder hotline 877-360-LGBT; the LEI (Long-Term Care Equality Index) is designed to help us care for LGBTQ elders, work with residential communities to provide tools, best practices, etc.; a “commitment to care pledge”; a self-assessment tool for providers; survey respondents can take a needs-based assessment; start by reviewing your non-discrimination policy; details of the self-assessment; making housing communities more inclusive; and strategies for non-inclusive residents. Length: 28:45.
July 15, 2020: Marki Flannery, President & CEO, VNSNY
Topics: VNSNY is largest nonprofit HCBS health care organization in the country; out business was significantly impacted by pandemic; HH business declined 25% in admissions in March, and 61% decline in April; very slight improvements by May; in hospice, saw increases in month over month volume in hospice; many people in end stage of COVID were served; average hospice length of stay went from 72 days to 19 days by March, predominantly because of lack of elective surgeries; huge impact on staff; biggest challenge was PPE access; for awhile, all PPE supplies were going to hospitals; we felt pressure from hospitals to accept patients with COVID, and we refused because of lack of PPE; they then offered to supply PPE to us and we agreed to take patients; many of our home-based clients were testing positive, and staff was being infected; 12 employees died; we don’t routinely test staff; only staff providing care are those working in nursing homes or AL where the communities require testing; home-care clients were declining care but that is improving; leadership lessons learned—stockpile as much PPE as possible, applied for lots of external funding, create a clinical emergency response team; I spent the majority of my time over-communicating—daily audio messages, written messages, weekly conference calls, regular video communications; and did advocacy to gain reimbursement for telehealth, but no relief has arrived so far. Length: 17:33.
July 16, 2020: Dorothy Davis, CEO, VNHS
Topics: Common theme has been employee safety, how our culture will get us through the crisis; providing PPE has been a priority; hit our high point for COVID-19 in April, seeing steady decline through May, June, and are seeing an increase in the last week; now preparing for our second wave; we now have 90 days of PPE; started testing our employees who had known exposure at work; today, testing a thermal scan as a screening tool, if test positive there, we move to a rapid antibody test, and if positive there, moving to nasal swabs. Have tested almost 3,000 people, most in senior living; have learned that those employees we have tested have had very few positive tests, so we continue to reinforce infection control and proper techniques; spent 6 figures on PPE, did a lot of due diligence to source it; went from 6 gowns a month to 300 gowns a week; we got provider relief funds and invested those dollars into PPE; hospice bereavement team has been available to our employees in wake of staff passing away; and staff surveys gave positive answers about communication, information, and level of transparency; we have not mandated our testing for staff unless they had a workplace exposure and we are requesting a 14-day quarantine; not all staff pleased with that; HH was our biggest revenue decline, partly due to shutdown of elective procedures in hospitals; we saw a growth in hospice revenues, almost 8% in the first 10 weeks; private duty had a revenue decline; our patients and even some staff struggled with telehealth technology; went back to phone calls in many cases; and telehealth did not have the impact we wanted. Length: 23:55.
July 17, 2020: Steve Fleming, president and CEO, The Well-Spring Group
Topics: Have been fortunate re positive cases; 2 positives on one campus in independent living; PACE has been hit due to the pandemic; physician office still open but other center operations shut down in late March; shifted to a home-based program for PACE, which made staff become home health aides and going into homes; 3 PACE participants in skilled nursing passed away; PACE is now open again as of July 1, very limited due to social distancing; averaging about 24 participants per day; families are hurting because the center wasn’t open for 3 months; our traditional adult day program has re-opened, because family caregivers need the help. Dining re-opening has seen about 10% of the population (40 people) coming to the dining room; dining area limited to 75 maximum; there are residents who say they’ll take the risk and really want to dine there; we have a conspicuous green-vested sanitizing person; a no-touch dining experience for residents and wait staff; staff received an early COVID bonus, and later a “longevity bonus”; testing costs about $105 per test; we estimate $250K - $500K in unanticipated expenses; details about no-touch serving; received some PPP money, and the state has continued to pay for PACE participants; have not had to furlough PACE staff; and has increased wages in general, competitive with acute care. Length: 22:33.
July 20, 2020: Lisa Balster, director of care, patient, and family support, Hospice of Dayton
Topics: “Loss of the assumptive world” as the loss of the world we assumed we would live in, and the way our life would be; Hospice of Dayton remains very busy; had to cut back on visitors; in-person visits limited to 2 people per day; bereavement is different under the pandemic—we are well-equipped to deal with it, but waiting for the other shoe to drop, people who don’t cope well with life in general are under even more stress now; how providers can promote healthy grieving; teaching people to not be alone as one small way to cope with grief, and giving them other resources; now there is “COVID stigma”; helping people acknowledge the pain of grief; services available from hospices—the hospice ethic is that every human in the community is our client; CDC website has a great resource list for grief and bereavement; and staying in contact with staff requires multiple layers (team meetings plus one-on-one touch-ins). Length: 17:38.
July 21, 2020: Manny Ocasio, chief HR and compliance officer, Asbury Communities
Topics: No positive cases in many communities, but outbreaks in some others, but as of today, no active COVID-19 cases in any SNFs; a “no regrets” strategy that focuses on trust, on commitment to mission, commitment to those closest to the process, and accountability; “a just culture” as a way to organize our thinking; implementing sophisticated screening device from 986labs.com; expanded a partnership to manage all of our call-outs and help us know where to make adjustments; how “just culture” articulates a principle in trusting and assuming good intentions when staff came to us with unusual requests; managing through a framework of trust and compassion; simple things providers can do to implement something like this; handling wait times for testing results; gave bonuses totaling $600K to providers and may do it later in the year again; and managing communication across a multi-state organization. Length: 21:44.
July 22, 2020: Don Blose, CEO, Spanish Cove Retirement Village
Topics: Blose is former OK state immunization director; surprised by the lack of PPE stockpiles that public health departments had; our incident command team met every day for 4 months—group had an incident commander, different managers for various areas of operations, a scribe, etc.; my background helps me keep my eyes on the big picture; make sure to give everyone something to do, and sometimes doing something is the only cure for anxiety in a crisis; you can manage a pandemic, but can’t manage a panic; our residents also need something to do too, so have to figure out better ways to keep them involved; our residents need a lot from us at a time like this, so we have to “love ‘em more than we ever did before, to make them feel special”—go over the top to help them; breakdown of what happens in daily incident command meetings. Length: 18:40.
July 23, 2020: Dr. Noah Marco, chief medical officer, Los Angeles Jewish Home
Topics: 50 residents tested positive, and there have been 10 deaths; 86 staff positives, and 64 have returned to work; a new patient-centered visitors policy is in the works, to adjust what we do with residents based on their own risk tolerance; belongs to a nationwide Delphi group to come up with ways to do it; need for a national movement to share best practices on this, maybe involving “idle industries”; comments on CMS announcement of testing in nursing homes; concerns about specificity of machines; what we need most is asymptomatic testing; got LA City and County to bring testing to nursing homes; 50% or more of cases are coming from asymptomatic people, so really the only way it can spread in a facility is through asymptomatic people; the other 2 aspects are PPE and infection control; reducing spread of COVID—washing hands, PPE protecting eyes, noses, and mouths, and infection control and testing; staff really devoted to preventing spread and committed to following protocols; and staff buy-in for more visitation requires strong staff relationships and empowerment. Length: 24:08.
July 24, 2020: Hank Lovvorn, COO, Presbyterian Homes
Topics: Moved 58 new residents into a new community in April and May; under the pandemic, you learn a lot about your culture, and our culture is doing well; have had resident cases in 2 communities, 5 cases total, but a lot of employees have tested employees; stories of visit with HHS Deputy Secretary, in an outdoor setting; we shared details about our experience with him; talked about testing costs, quarantine sweeps, PPE, he had specific questions, and we talked about person-centered care, value of nonprofit providers, regulatory matters; I asked him about his priorities, and said he oversees vaccines, priority of therapeutics for treatment, and where the money goes; he said the whole industry is now working on a vaccine and they are working on all of the rollout/distribution logistics in advance; and he found that advocacy is easy if you’re willing to take your opportunities. Length: 18:04.
July 27, 2020: Sondra Norder, president and CEO, St. Paul Elder Services
Topics: For the most part, our COVID experience has been fairly light, only a few positive cases among residents and staff; how St. Paul took in 28 residents from another community that had a fire; how 75 off-duty staff members showed up to help; needed to test everyone weekly and state was helpful in getting that done; those residents will be allowed to stay here through the end of the year; St. Paul’s documentary; we have a nun on staff with video production background, who did the filming; decided to do a deliberate media strategy to get our narrative out there; it was a chance to show our expertise and change the media picture. Length: 14:21.
July 28, 2020: Andrew Banoff, president and CEO, Jewish Senior Services
Topics: Had 92 residents and 62 staff who were COVID-19-positive; 2 intense months early on; staff rose to the occasion; CT dept. of public health has worked really well with providers; I had opportunity to have a Zoom meeting with legislative committees; participated in a 4.5 hour meeting; in my segment I used the LeadingAge 5 Essential Actions as structure; LeadingAge CT was a great help; I told them PPE comes first, the price impact of PPE; talked about testing (which has gotten much better lately); discussions related to safe reopening; our campus is home to other organizations; talked about funding, and what happens going forward; talked about staff recognition, incentive pay, resources, support, staff as heart and soul of the organization; lost $500K per month because of COVID-19—it’s not just a cost problem but also a revenue problem; fundraising—we had truly remarkable response from family members, we haven’t been shy about asking and families, board members, donors, and foundations have been generous. Have had 7 focused infection control surveys by state during the pandemic. Length: 19:09.
July 29, 2020: Colleen Frankenfield, president and CEO, Lutheran Social Ministries of New Jersey
Topics: Have been COVID-free for about 68 days, after having lost over 40% of our residents in SNF and AL due to COVID or complications after COVID cases; 1 nurse passed away, another nurse recovered after being on a ventilator and now has neurological issues. Big challenge was that none of our residents and staff started with the symptoms that we were told to expect; hospitals were sending us people who were probably actively infected but the hospitals had not accurately diagnosed them; motivating staff meant meeting the needs of the individuals; we housed staff in empty units when we could because they were afraid of taking the virus home; others were put up in hotels, others on nearby college campus; provided all meals to all staff; hazard pay and bonuses for staff; biggest need was emotional and psychological support; our chaplains are licensed counselors; doctors and nurses are used to dealing with illness and death, but not so much of it; staff camaraderie was a big factor in keeping everyone on board; my faith and focus on the goal of caring for seniors is what kept me going; organizations without on-board counseling resources should consider employee assistance programs, local churches, etc.; had many staff who refused to work, many were out for a month or 2; some returned and there was some tension between coworkers; bought tablets for residents to help their communication; daily wellness calls for all residents in IL and housing; set up food pantries in all affordable housing buildings; connected with local college radio stations; connected with pen pals; used hospice and bereavement staff to help residents, and extended the service to family members not a part of hospice. Length: 17:19.
July 30, 2020: Shelly Griffith, CEO, Eben Ezer Lutheran Care Center
Topics: Our county was one of hardest-hit in Colorado, a rural area with meat harvesting and milk plants, and a prison system that were hard-hit; many team members shared households with people working there, so we had some cases; we are the largest LTC organization in northeast Colorado; had PPE problems early on; after we had an outbreak we were the first to have access to supplies from local health department, though it was not enough; lots of scrambling to get more supplies; also partner with local hospitals, and we all have plans in place to cooperate, but hospitals were hesitant at first; later hospitals allowed some of their ancillary staff to come work here after being furloughed; we have less access to resources others might have, but the local community did everything they could to help us; the amount of supplies and food and drink showing up was very fulfilling to our team; most amazing thing is that our turnover was lower during the worst time than it normally is; people have that “rural grit and tenacity” to stick with it; one retired nurse came back to work to help with infection control; PRNs stepping up to full time and volunteering for the COVID units; many other great examples; many home care clients opted out of service at that time; “reconnection visits,” for families, contacts go through one individual on our team and she’s doing all scheduling; all visits outdoors; trying to do it M-F because weekends are more challenging because of staffing; we thought we would need additional marketing to re-brand ourselves but we learned that was not the case—community has a lot of faith in us. Question is now how we can handle the number of people who want to come here! Trying to understand how the virus came into the building; might have been from a person admitted in February without symptoms; later tested positive for antibody, so it could have been her who brought it? Length: 21:15.
July 31, 2020: Terri Cunliffe, president and CEO, Covenant Living Communities & Services
Topics: 10 of 17 communities had positive cases; learned a lot about infection control, esp. in housekeeping and facilities; a “staffing up” plan to help cope with the pandemic, with a “quick hire” process that hired 452 people in 10 weeks; 3 recruiting teams, each with 3-4 screeners of prospects; brought people into orientation while doing background checks; created SWAT teams for each site; we do lots of digital recruiting; some home health staff re-deployed in the earlier days, until home health business picked up again; learned that we had not been as diligent in recruiting practices that we should have been before; brought in an infection control physician to point out areas to be improved; had to do a lot of retraining for housekeeping; a new housekeeping training program was created; new “hospitality aide” position—entry-level, non-trained position for a variety of needs like answering call lights, help with cleaning, screenings, delivered meals, packed meals, activities, one-on-one with residents, allowed us to better deploy our certified assistants; did not include them in our PBJ report; almost all of our positives now are staff; created a re-opening guide to give us a structure consistent for every community; phase-to-phase decisions rely on data for SNF and AL, but a little more subjective for independent living; trying to bring services back to IL so they don’t need to go out too much; appreciation bonuses are earned bonuses tied to coming to work for all scheduled shifts; trying to figure out a way to carry that in the future; re-opening guide was useful for residents and families. Length: 22:01.
August 3, 2020: Dr. Ashish Jha, director, Harvard Global Health Institute
Topics: Hoping this is an 18-month pandemic, starting in January 2020—we are still not even halfway through it; aging services providers have faced enormous challenges; always some risk of visitors in a community until there’s a vaccine, but things we can do to dramatically reduce risk; wearing and mask and being outdoors could be quite safe; but nothing is 100% foolproof; there is such a cost to not having visitors, so I’m generally in favor of moving forward in some ways; I’m optimistic we’ll have the testing we’ll need by next June; there are now cheap reliable tests available; antigen tests are coming to NHs; the technology exists if the policy makers will allow it to come to fruition; antigen testing—what we should not care so much about missing people who are infected, but we should really care about missing people who are infectious; these tests work much better on the latter, so false positives are less of a problem; if these tests can be offered on a regular basis, you’ll end up picking up people who are infectious; the majority of people who spread COVID-19 will develop symptoms, but start spreading a day or two before that, those are the people we want to catch; we have to have some kind of testing regime for those people, and the antigen test is pretty good. Advice to senior housing providers: Single biggest thing for everybody is press your government to do a better job in managing the virus; a national mask mandate would be a good idea; no bars, no indoor dining, no gyms, no gatherings above 10; if done in a vast majority of states everything would become easier; paper antigen tests—they are coming but the problem is making enough; federal govt. needs to do more to speed that up; cost profile for antigen tests; false positives—with PCR testing and with antigen tests we don’t see many false positives; false positives are a huge problem in antibody tests; anyone who tests positive on the antigen test should then get a PCR test as a confirmation; with enough $$, how long it would take to get a better testing regime in place. Length: 23:12.
August 5, 2020: Dave Sanford, Brig. Gen., Deputy Director of the White House Supply Chain Task Force
Topics: Status of 2nd PPE shipment to NHs; contents of shipments; recourse if shipments have problems; what can providers do who can’t get the PPE they need; FEMA now buying PPE to support state requests; this fall, leveraging the Defense Production act we should see more of what’s needed this fall; private-pay NHs that are not supported by Medicare/Medicaid not eligible for these shipments, but are eligible to work with their state emergency mgmt. functions. Length: 13:21.
August 5, 2020: Derrick DeWitt, CFO and director, Maryland Baptist Aged Home
Topics: Small 29-bed nursing home in Baltimore, has has no COVID-19 cases; we locked down very early, March 1; eliminated visits from some service visitors; asked staff to take extraordinary care in their free time and limit contact with other people; staff deserves most of the credit; screen tests every day, almost accounting for hour-for-hour activities; asked “are you willing to commit to these measures to keep yourself and the NH safe”; began providing private transportation to limit exposure; brought in extra cleaning personnel, brought in additional activities people; battling staff fatigue, starting to see frustration, but want to be careful that our staff is not relaxing too much; we make sure we have reserve, working with on-call staff, created a plan to give relief to current staff; cross-training to give staff time off; reaching out to displaced workers; 1-800 counseling number for staff; we weren’t sure if help would come when we need it; bought PPE early on, felt that in these depressed areas, POC can get the short end of the stick; for us being a small independent, we are 95% Medicaid, our building is not as nice as others but we pride ourselves on quality of care; we can’t afford the cost of testing; haven’t been able to bring in new residents; some activities ideas we’ve tried; and greatest concern is maintaining our success in having no COVID-19 cases. Length: 24:34.
August 10, 2020: Dawn Barker, VP of HR, RiverWoods Group
Topics: Manchester, NH status had an outbreak and lost 22 residents; 2 other communities had just a few cases, mostly staff; greatest concerns right now are 1) parents dealing with children’s schooling and 2) the number of jobs we have open between our communities; concerned that fear and other factors is keeping people from applying; children staying home increases household expenses for employees; EAP program for employees; “town hall meetings” that staff can attend to talk with other people to overcome isolation; keeping staff engaged; self-care is often a very simple moment of relief; and supporting families of residents with “park & chats,” drive-up programs to allow families to meet residents face to face from their vehicles. Length: 15:33.
August 12, 2020: Stacey Johnson, VP of quality, Trinity Health
Topics: Quality control—what is impact of all these changes in lifestyle on residents, for instance, falls; COVID magnifies all of the traditional wellness and health issues of residents; PPE certainly aligns with quality; had to develop more sophisticated logistics systems to deal with PPE; communication should be a quality metric; PPE training is a quality metric; and as daughter of a parent in a NH with dementia, I understand importance of communication much more than before. Length: 17:07.
August 17, 2020: David Grabowski, PhD, professor of health care policy, Dept. of Health Care Policy, Harvard Medical School
Topics: “A crisis on top of a crisis”; crisis in how we pay for and regulate nursing home services; steps that could be taken to stem the tide—PPE and testing, plus more dollars into hero or hazard pay and benefits; NH caregiving is the most dangerous job in America right now; some critics of NHs don’t pay enough attention to public policy; antigen testing machines are a great development; hope we can get them to every NH in country in near future, plus training; and hope to avoid nickel-and-diming anyone with this. What will the fall look like? Don’t think we can test our way out of this, we need PPE, cohorting, and workforce support; a lot of concern about what happens in the fall; what this crisis will mean for longstanding problems in our field; comments on paper-based saliva tests, lacks accuracy of PCR-based tests but they have real promise; and will nursing homes be “first in line” for vaccines if they appear? How to overturn bad public image of NH; and frustrated about PPE supply, need more federal govt. involvement. Length: 21:45.
August 19, 2020: Mitzi Epperson, associate campus director, Baptist Village at Owasso
Topics: Had 9 staff COVID-positive and 4 residents so far, all recovered; Dr. Deborah Birx visited our campus; had an area of the building where visitors would have not connection with residents; had a great small group of people to meet with her; she was taking careful notes; talked at great length; she promoted mask wearing, even outdoors; antigen testing machines—guidance to come from CMS, with distribution of devices by end of September; Birx is not recommending reopening, because of continued spread; doing whatever we can to keep residents engaged. Length: 15:53.
August 24, 2020: Monica Gandhi, MD, professor of medicine and associate chief in the division of HIV, Infectious Diseases, and Global Medicine at UCSF.
Topics: Masks protect the wearer and others; knowing that it protects yourself is a positive message that gives you control; N95 masks are great but are not feasible for most people to wear around; we suggest one of those surgical masks or a simple cotton cloth mask; after infection, people are most contagious for 7.7 days; working with staff to keep them healthy—the only place not to mask is at home; by wearing mask whenever you’re away from home is effective; you can eat while masked, so social distance at that time; asymptomatic people either have great immune systems, T-cells that help fight infection, or a low dose received; if we can drive up rates of asymptomatic infection, that’s positive; don’t look at antibodies, look at T-cells; over the last 2 weeks, major results have shown even with asymptomatic infection, you get immunity; her thoughts about antigen testing machines—even if it’s not the best test, if it’s fast it’s useful, places like NHs should use frequent testing; wouldn’t use it every day but reasonable once a week; re plasma treatment, we should wait for randomized controlled trials even though she is optimistic about it. Isolation and quarantine are different, the former used to be 14 days and is not 10 days from the beginning of symptoms. Quarantine remains at 14 days. No tests are perfect, in settings with lots of transmission positive tests are likely to be accurate; comments re aerosols vs. droplets; comments about rapid antigen testing along with verification tests; comments about international travel. Length: 21:56.
August 26, 2020: Brian King, director of health and wellness, Deerfield
Topics: 6 resident cases with one fatality; 13 staff cases with one death; grieving his loss remains the greatest challenge for the team; offer pastoral care and a counseling program, but the best thing to do was to talk to each other; servant leadership culture enabled us to cope with this; we are required to do weekly testing; test all staff on Tuesdays, all residents on Wednesdays, we also include contractors that come in; relationship with labs allowed us to improve turnaround time, by using a smaller lab as opposed to a big national lab, and have worked together to improve processes; think the antigen machine will have a role in our testing program when we receive it; we are self-insured so we can make the call to test everyone, but flipside is that it’s a direct cost to us, which is about $100/test, and get a discount with the lab we use; not testing IL staff, focused on health care area; and Deerfield’s system for testing large numbers of staff efficiently. Length: 16:05.