Assured Assisted Living Coronavirus Response March 19, 2020

Francis: Good afternoon Assured family. I am excited that Allyson and I get a moment here to sit and chat about how Assured is handling the COVID response and some of the new things that are coming out very quickly. So Allyson, thank you for sitting down and joining us.

Allyson: Hi everybody. I hope I can clear some confusion and answer some questions. Francis: That's awesome. That's what we're here for. So let's kind of start, let's just dive right into it. A big question we've been getting a lot lately is what would we do if a caregiver or a resident is diagnosed? So Alison, why don't you kind of, let's dive right into that and see how we're going to handle it?

Allyson: Okay. So we are taking everybody's temperature at least once a day in the morning, and that's including the caregivers and any of the caregivers who have had a fever or having any signs and symptoms of being sick, they're not working right now and we are putting them on at least a 14 day quarantine. We also did this for caregivers who traveled right before all of this started, they're not working either. So we're kind of nipping that in the bud before anything can start, we're not even wanting people to work if they're sick or travel or anything like that.

And then as far as the residents go, same thing, we are checking very frequently being on top of any of the other symptoms, cough, and shortness of breath. We are especially monitoring the residents who just have these kinds of things chronically already, the respiratory issues. So we're really working with the provider to give them the information. And if we were so we so far haven't suspected that, but if we were to then the health departments notified, I mean the physician, the hospitals. So they are sent there and with our population, they would probably more than likely be sent there for testing. Someone would stay there until we got the results of the test back. And then at that point I don't really know that they would send them back and they would probably keep them for a while, depending on what their needs were.

Francis: And I want families to know and anybody listening is that now is the time for us to be as proactive as possible. We've been in, I'd say a restricted visitation now for what, a little over two weeks now, Allyson? Allyson: Yes.

Francis: And so what we're really trying to do now is being as proactive as possible from wiping down surfaces, doing all those things that we can, multiple times a day to really help try to limit, the likelihood of letting the virus get into the house. And so it's really important for us that we stay on top of that. So Allyson, I know you, you're trying to stay on top of the ever-changing news. What's some of the—and I'm going to put a link up right now. Can you tell our families a little bit about this covid19.colorado.gov, this link that I have up on the screen? What is the benefit of that?

Allyson: Yes. So yesterday Governor Polis announced he was releasing that website just to kind of be something almost like a blog, if you want to call it. Just with the newest information, being somewhere easily accessible for people living in Colorado, I think it’s a little confusing or there's so many places that you could check information, the CDC, federal, state. And so I think that's a really great resource for everybody, especially our families, just so they can kind of see some information that we're getting also. It's not really a secret where we're getting our information. And I think they did a good job. It's an easy accessible website. Yesterday, it was a little glitchy because I think so many people were reaching it, but they've kind of upped their IT, whatever goes behind that. So, it's working today. It's a good resource for families.

Francis: Yes. And definitely we're always a resource here too. So Allyson, feel free to reach out to any of our staff members. Allyson is really leading our response teams since she is our nurse administrator. So she is overseeing a lot of the practices that we've been implementing now for well over two weeks. And our goal is to continue to refine those practices as we learn more about COVID and how the response is being handled by the hospitals and the skilled nursing facilities. So with that being said, we've heard a lot about testing, Allyson, and I think you mentioned to me before this, that we've seen testing increasing in the state. Is that correct?

Allyson: Yes. That is state and nationwide. Yesterday, during the federal briefing thing earlier in the morning, one of the doctors did say, and she warned everybody, "Don't panic, our curve is going to look worse than Italy's, but that's just because we're going to have about at least four to five days’ worth of tests coming in. And because we now have more testing than we had even earlier this week, a week ago. And so we are going to see a huge increase in the number of positives. And just want to reiterate, don't panic, it's just because we're testing more people." Francis: I think what's really important here right now is that we will see a spike in the number of positive cases. Correct?

Allyson: Yes.

Francis: And how can someone handle that? Knowing that it can be overwhelming to hear that maybe we have, I can't remember. I think we're below two hundred right now, that all of a sudden that could double right? I mean, or who knows, it could do, right? Allyson: Yes. I think, people can guess as much as they want, the scientists and the doctors behind all this, but we really just aren't sure exactly what those numbers are going to spike to, but yes, just that they are going to greatly increase. And I think just something to say to people is just don't panic. And just to know the reasoning behind it, that it's actually a good thing that we're getting more tests and the majority of these people, they're going to go home safe and they'll be okay. It's just that we have to take these measures to protect the people who are at higher risk.

Francis: And I do want to say something to our current families, is we understand the difficulty of the virtual visits. And I think you and I both empathize as much as we can with our family members. And we are trying to be as creative as possible. We are going to be getting more tablets in each of the homes to make that a lot easier for families to do the virtual visits through whatever type of application, whether it's FaceTime, Skype, Google chats, whatever that may be, but please know that we truly are here for you guys. We want to get as creative as possible for you to feel connected to your person, your loved one, your best friend that we are providing care for. But ultimately we are trying to make sure we protect our residents. That's really where our focus is right now. And that's also why we're very excited that the majority of our external providers have gone to virtual visits. So can you tell us a little bit more about that Allyson?

Allyson: Yes. So I did that earlier this week, we thought something was going on with some of these medical providers but we wanted to kind of check in with Rocky Mountain who is the provider that I talked to. And so they had me download an app on my phone. It was really easy. I know now Tina and some of the other girls have done it as well. And so really all I did was I set up a time with the on call nurse practitioner and then her and I got on the app, we spoke for a little bit, and then I took my phone into the room with the resident and she was able to kind of look her over and talk to her about a few things and it worked out.

And so I think going forward, they're wanting to do that to limit visits and just from it to spread because, they're not just in all of our homes, but they're going to other facilities and seeing other residents and just the nature of what they do. They're around people who are sick. So I think that's a really great thing to try to limit any exposure. Francis: Yes. And that's why we're trying to be as careful with external providers as possible. We are making everybody that enters our door do temperature checks, questionnaires. So we are really being proactive and who is entering any of our residences to try to lower the likelihood of transmission. So I think that's important. We are making everybody do a temperature check and fill out our questionnaire prior to entering. So why don't you tell us a little bit more about what that questionnaire is Allyson?

Allyson: Yes. So in both for all service providers, we mean the physicians, hospitals, PT, OT, those. The thing is that I've had somebody reach out to me and say, "Hey, this is a little scary. My husband is not going to receive physical therapy for who knows how long." And we are still allowing, you know, those necessary people in, because we don't want our residents to decline. And we recognize that some of these things are a necessity. But we want to be very cautious with that. And so on the front door, I've already placed a sign saying that, if they're sick or they've traveled, please don't come in at all. Call us, please don't come in.

Then, once they come in the door though, they need to, I mean, originally they all need to sign in anyways, but now we've just kind of upped the sign in sheet. So, I want to know that they've had no fever for the past 72 hours that they haven't traveled domestically or internationally for 14 or 21 days. And just that they're wearing a mask and that whoever they work for, that they're providing them with a mask. Just because since they are coming in and even if they're not showing any of these signs or symptoms, that they haven't had a cough or a fever, shortness of breath, anything like that, that they've been around other residents I don't know anything about. And so, just taking every precaution that we can.

Francis: Yes. And that's what, again, as I mentioned when we first started is our goal here is to be as proactive in an unknown time. Because we want to limit the likelihood. Again, we want to do our best to put our residents first. And that's really, what's our focus is why we are in these very tight restrictions and why Allyson is being very proactive in getting us to as many virtual visits as possible, unless it's absolutely necessary. So we are still going to be keeping though—again, our resident's quality of life is what matters. And why don't you talk a little bit about what Blair's doing for our residents and how he's looking at external resources, such as some of the virtual visits and shows and stuff like that?

Allyson: Yes. So everybody's favorite Blair, he's really on top of everything trying to make sure that he can do as much as he can for the residents’ social and mental wellbeing. So he has reached out to some people who can maybe do the music therapy virtually. So some of those things that we're not really wanting so many people coming into the houses right now, he's really trying to do a lot online or virtually. So he found some things where it's music or like an exercise app and all of these other different just types of things that we could set something up on like on a monitor and so that everybody can see it. So just one more thing just to kind of keep everybody as active as possible.

Francis: And I think that's important is that we are, again, constantly looking at what else is out there, how we can improve what we're doing, how we can better engage our residents and also engage the family. So currently we are using the Serenity app at one of our houses off of that circle. We have very successfully tested that there, and now we are going to slowly roll that out to a lot of our other houses. And what this is, allows us to share videos, comments, pictures about how your loved one is doing on top of what the virtual visits are. We've also had some requests to share some pictures on social media. So we will also be limiting, be showing some engagement activities that we are doing on social media as well too.

And Allyson, can we talk a little bit about kind of our size versus like some of the larger residents that are out there, the bigger facilities, what unique thing we have and why we're really working hard to be as restricted as possible on the visits? Allyson: Yes. So, our homes being the size that they are, I mean, there are a ton of benefits, but specifically in this scenario, it's just, anything grows the bigger you are. So in our scenario now with there only being, maybe say nine residents in one of the houses. Okay. It's just those nine residents. But say we go to a bigger facility where there are 150 residents, okay, so let's say 75 of those residents go to the dining hall and they're all eating together or sitting at tables closely with each other or interacting with the staff. So, you have maintenance, the dining staff, the management staff, the nursing staff, the therapy staff, just everything, just the more numbers there are, the greater you are to catch something.

And so I think we really are lucky and this time with this going on, that we are smaller. I think we have a less of a chance of getting anything in one of the homes. Francis: And also too, since we have built staff quarters, a lot of our staff live in the house that they work either next door or above below. And that enables them to really be contained to that one facility. So we're not having them cross in the different facilities as often. Correct? And that has to have an impact. Right?

Allyson: Yes. And at the other facilities, say your mom's nurse and CNA, you don't know if they went to the grocery the day before, or before all the restaurants closed. You don't know if they were at a bar sitting in a community table with 10 other people. I mean, our staff, they live there and they really haven't been leaving. I mean, we have been delivering groceries for them as well. And so it's definitely less of a chance of contracting something.

Francis: And as admins too, we've limited our contact with each other as well, because we want to keep that social distance, but also be able to respond to if necessary, if one of us happens to get it, we don't want to spread it to ourselves and the house, and so we're being very mindful on what we're doing. Myself and my family, we've only gone out for groceries or gone to do some work. We're not doing anything socially that can expose us, which could then in turn, expose our residents. And I know that's very important for a lot of our team is we are being super conscious as to what we're doing outside of the houses.

Allyson: Yes, definitely. I mean, we've all made lifestyle changes as well. We've all canceled trips that we were supposed to go on. We've all taken steps to make sure that we're not bringing anything into the houses. We very much recognize that we work with a high risk population and we don't take that lightly. Francis: And we are taking our own temperatures every day. I'm checking mine and my family's as well too. And I know all of our admin staff is checking it. Blair's checking it as well. So, I know this is unsettling times. I mean, I don't think we've had anything like this challenge face us before, Allyson, that I can remember?

Allyson: No. We really haven't. This is definitely just uncharted territory. Everybody is kind of just trying to figure it out day by day. Francis: And what we're asking is we want to be here to support you guys. We know there are a lot of unknowns out there. We know this is nerve wracking, scary, things like that. So, we want to be here as a resource for you. So please feel free to reach out to Allyson. I had her email, Allyson@assuredal.com, and she can answer more questions for you in regards to what other actions we're taking.

But Allyson’s staying on top of this and we're making changes as we get new information. And so for the time being, we feel optimistic that we've been as proactive as we can, but we're always looking to get better. And whether that's through changing activities, through doing different things, our goal is to just continue to meet the needs of your loved one. And that's really what matters the most.

Allyson: Yes. I agree. And I just also want to throw out there, we're really trying to take care of our residents, but also you guys as well. We want you to be safe and healthy and that way, when it's all over, you can come back and visit. So please make sure that you're also protecting yourself. I know this is stressful and you're probably worried about your loved ones, but they're worried about you also. And you need to take care of yourself.

Francis: And I have a little person that want to say hi. Can you say hi to everybody?

Baby: Hi!

Francis: Come over here. Sorry. This is what happens when you're trying to isolate your entire family.

Allyson: [laughs]

Francis: So again, we're all both here. We're here to really help out as much as we can. We're going to try to be doing this more consistently where we're doing some of these videos. We're going to be keeping our email communication up. We're expanding the use of Serenity app. Our goal is to share as much information as possible about the things that we are doing with our family members and the loved ones.

Allyson: Yes.

Francis: So Allyson, thank you so much for taking some time and I really appreciate everything that you're doing. Thank you for all the hard work and the stress that you feel about the concern. And so I really truly appreciate that.

Allyson: Yes, of course. And thank you and thank all of our families for your support. We couldn't do it without you guys as well. So...

Francis: Yes. Thank you all and have a great day. Try to stay warm now that we're getting a bunch of snow as well too.

Allyson: Yes.

Francis: So thank you all. Have a good one. We'll talk to you guys soon.

Allyson: Bye.

Francis: Bye!

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