How to Evaluate the COVID-19 Response at Life Plan Communities

Some things to consider beyond confirmed case counts

The coronavirus pandemic has changed the way people view senior communities. As some of the most vulnerable to serious illness due to COVID-19, older Americans have been especially hard-hit as the pandemic swept through the nation in the spring. With significant clusters occurring in nursing and rehab centers, some people are evaluating whether a particular retirement community—or even any retirement community—provides an acceptable amount of safety and security during an outbreak.

We’ve asked these questions of ourselves and other life plan communities we stay in contact with. Because while most of the outbreaks making the news are occurring in facilities dedicated exclusively to skilled nursing, those like BRC that offer the entire continuum of care aren’t off the hook.

We have always felt a tremendous responsibility to our residents to safeguard their health and safety. We take this calling seriously, and the coronavirus pandemic has put our preparations and dedication to the test.

Of course, there are no ideal solutions—every prevention measure addresses a less-than-ideal situation. It should also be emphasized that luck and factors beyond anyone’s control affect how the novel coronavirus impacts a community. So it’s not always wise to judge a community solely by the number of cases alone. Rather, it’s how we respond to our situation that makes the difference.

If you are considering a move to a retirement community, here are some questions to ask:

Prevention measures

If prevention is the best medicine, what’s in the community’s medicine cabinet? When this pandemic started spreading:

• Did they close the campus? As states begin reopening their economies, are their campuses staying closed? How are they handling dining rooms, fitness centers, and beauty shops?
• How early did they begin screening team members and what is their mask policy? If you’re curious, you can request a copy of a community’s screening guidelines from their Infection Preventionist or Director of Nursing.
• Do their responses meet or exceed the guidelines set by the Centers for Disease Control (CDC), the Centers for Medicare and Medicaid Services (CMS), the World Health Organization (WHO), and other groups?

BRC made the difficult but necessary decision to close our campus to visitors on March 13, two weeks before the governor’s stay-at-home order came down. We were equipped to make this decision as our Infection Preventionist began tracking the virus’s spread as early as January. Screening of team members with temperature checks became standard procedure on arrival for every shift, and we implemented new sanitary and contact procedures. All our protocols meet or exceed CDC, CMS, and WHO guidelines.

As a result, we are happy to report zero resident infections at the time of publication.*

Staffing levels

During the crisis, how did the community’s team respond? Did the community:

• Experience challenges with staffing and scheduling?
• Lose team members?
• Have trouble replacing lost staff?

All health care workers experienced strain as the coronavirus swept across the country. Fortunately, BRC has so far been able to maintain our above-average staffing levels throughout the organization. In fact, our call-outs fell to all-time lows during the spring. We attribute this to the culture of care and compassion we’ve worked hard to build. We know many of our colleagues at other communities exhibit the same dedication, but it’s worth examining, especially if you’re interested in independent living in a Life Plan Community. The team in assisted living and nursing care may one day be your lifeline.

Other response to COVID-19

• Has the community set up isolation rooms?
• Can they test residents or team members who exhibit symptoms?
• Do they regularly monitor temperature and vital signs for all nursing and assisted living residents?
• How are their supply lines for PPE, food, and other essentials?

While we are fortunate at BRC to have, so far, avoided any confirmed cases of COVID-19 among our residents, we have an isolation suite ready. When a part-time nursing assistant tested positive in early April, we immediately quarantined the household she worked in, asked team members who worked closely with her to self-isolate, and closely monitored the household’s residents. These efforts served us well, and we were fortunate to avoid any community spread. Plus, because of our innovative household nursing model, we could avoid quarantining the entire nursing community.

There’s been a lot in the news about the lack of supplies and PPE for healthcare workers in regions hard hit by COVID-19. There’s no question that supply lines have strained to keep up with demand, but BRC is well stocked and working daily with our suppliers to ensure that we remain so. We have a supply of COVID-19 test kits, plenty of N95 and surgical masks (we were even able to donate some to the local fire and police departments), and UV cabinets to sterilize our goggles. And yes, we have plenty of toilet paper!

Services to residents

After closing our on-campus dining venues and asking Independent Living residents to refrain from leaving campus, we knew we needed to provide new services to support them during the pandemic. BRC is pleased to now provide:

• Grocery delivery
• Prescription medicine delivery
• Take-out and delivery of hot and cold-prepped meals prepared by the dining team
• Increased campus security to enforce no-visitor policies

These new services are expensive to develop and implement, and each community must decide how much or if to charge residents for these additional services. BRC is offering them at no additional charge.

Dealing with social, psychological, and spiritual needs

Even without a quarantine, social isolation is a critical issue facing many older adults. While communities must restrict visitor access as required by CMS (at least in nursing and assisted living), ask what they are doing to ensure their residents’ mental and spiritual health.

• Have they developed new, creative programs?
• Do they offer religious services, access to streamed worship, and/or support groups?
• How have they made up for the absence of volunteers?
• Have they made efforts to connect residents with their families?

In 2018, every independent living resident received an iPad as part of our Wellzesta program. This program has turned out to be a major lifeline, as many residents have a way to connect with family, friends, and each other via FaceTime. We’ve also made efforts to bring volunteer contributions “in-house” using technology. You can read about some of these efforts here.

Lockdowns, quarantines, and COVID-19: a perspective

We’re proud of the work that life plan communities across the country are doing to reduce the risk of resident infections on their campuses. At BRC, we’ve worked overtime to not only protect the health of our residents, but to uplift, encourage, and support them. Residents tell us all the time that there’s no place they’d rather ride out this storm.

 

*While no resident has tested positive for COVID-19, a team member and BRC President Rodney Alderfer tested positive at different times. Both reported the results of their tests immediately and went into isolation.