Questions and Answers with John Moore, Chairman and CEO
“What are you doing to combat resident isolation?”
Socialization and connections are very important to us. Up until this crisis, quality of life for our residents meant high engagement and high personal interaction with others. In a quarantined world, we have had to innovate, whether it’s through virtual connections with families through FaceTime, Zoom or Skype or programs that residents participate in from their apartments.
But we have to do more, keeping in mind that we only get “all the way there” by continuing our processes of testing, screening, tracing, using personal protective equipment (PPE) and adhering to protocols.
We will continue to find more ways to get residents engaged and, as much as safely possible, out of their apartments. In parts of Canada where the virus penetration is much lower, we are starting to relax some of our quarantine protocols. That includes things like daily social distance dining for groups of eight residents at a time, resuming some Engage Life® activities for up to nine residents at a time, providing transportation services (or just for “touring”) at 25 percent vehicle capacity, and just generally allowing residents to leave their apartments while wearing masks and respecting social distancing protocols.
Having communities in Canadian provinces that have seen minimal disease impact gives us an opportunity to test out reducing quarantine protocols while keeping a watchful eye on infectious disease protection. We’re hopeful that we can use our Canadian experience in the next few weeks to guide quarantine reduction in the U.S. In fact, some of our independent living communities in Texas and Arizona may be early candidates for quarantine relaxation under safe conditions.
Already in the U.S., we are rolling out guided walks where an individual resident can take a half-hour walk with an individual staffer, both in proper PPE and socially distanced. We expect that communities across most of the country will start scheduling guided walks over the next week or two (in fact, Yolo County, California public health officials used our “drive-up” protocol, verbatim, as guidance for senior housing communities they oversee). We’ve arranged approximately 60 drive-up visit days, where families drive to our front entrances and chat in person with their family member from a safe distance. We’ve also arranged for more than 40 communities to set up small group social distance dining experiences for residents (two groups of four at a time), and we expect social distance dining to continue to grow.
Having said that, you should know we remain constrained by state and local regulatory authorities, which have everyone’s best interests at heart but are also very cautious when it comes to the health and well-being of senior living residents. Some have welcomed our programs, while others continue to turn down things like social distance dining and drive-up visits. We are making it a point to avoid seeming annoying while advocating at the top of our lungs, and they are starting to listen.
And we can’t do it without you – our residents, families and loved ones. Your patience and adaptability have been remarkable and inspiring. Many of you are taking to technology in ways you never would have imagined. We appreciate how much support family members have provided, through dropping off necessities, keeping track of loved ones’ needs and generally just being understanding. We’ve collaborated with you on designing and delivering 21,000+ custom Mother’s Day cards to residents, and we’re still counting the virtual hugs and pen pal letters. We look forward to continuing to work together.
Above all, we appreciate the support you’ve shown our frontline staff. They have been, and continue to be, heroes in this crisis. More than anyone, our frontline staff are doing everything they can to balance safety and engagement in the way they do their jobs every day. They’ve gone above and beyond to make sure our residents are not just cared for but treated like family. Our residents’ isolation is personal to our staff.
“Why are you testing employees? Are you testing residents?”
The best way to protect our residents is by testing our employees, continuing our quarantine protocols, checking for symptoms, using all required PPE and screening all outside visitors. Our staff has the most frequent outside contact in any given community, making them the highest priority for testing.
Working with Mayo Clinic Laboratories, more than 13,000 Atria community and regional employees, third-party agency staff and private duty aides hired by residents have been tested. Another 2,300 tests have been initiated by doctors and local agencies for residents and staff. That means more than 15,000 people – equal to almost half of our total Atria population – have been tested so far. That’s more than the number of tests administered by some states.
Overall, less than one percent of tested employees were shown to be positive, and our numbers are in line with data reported for each local market. We, of course, saw more cases in the hard hit Northeast, but in no situation did testing create additional operational challenges for our communities. Every Atria community is now operating with staff who have all recently tested negative for COVID-19. Most important, testing has allowed us to identify more than 100 COVID-19+ asymptomatic employees and put us in a position to better protect residents and staff as a result of having this information.
Additionally, we are going to conduct testing in our Life Guidance® (memory care) neighborhoods as a way to confirm that each neighborhood, as a whole, is COVID-19 free. Given practical limitations of quarantine protocols in memory care settings, we treat one positive test for a resident or employee as if the whole neighborhood has tested positive. Our process is aimed at managing the disease out of entire neighborhoods, which means those spaces with known exposure will be given time to heal, followed by full testing until we are able to confirm the neighborhood is COVID-19 free. We do plan to ultimately test all memory care neighborhoods.
Testing has been a finite resource to date. We are fortunate to have our relationship with Mayo Clinic Laboratories, who sources and processes all of our tests. Testing is not a vaccine, nor does it guarantee prevention of exposure to the disease, but it will certainly help us identify previously undetected pockets of exposure. Given testing availability, our strategy so far has been to start with employees, and then move to memory care neighborhoods in order to best accelerate our ability to manage the disease out of our communities. Our policy will continue to thoughtfully utilize any testing resources that become available to us, and to continue to partner with local regulatory authorities to champion for increased testing availability.
To give families an additional window into the day-to-day lives of residents, and our symptom monitoring, we are in the process of fast-tracking a prototype Atria mobile app. This week, we are submitting an iOS app to Apple for review and inclusion in the App Store, with hopes of getting a quick response. Once published, the Atria mobile app will put us in a position to share temperature checks and other information about symptoms in real time. We plan to have the app grow into a more fulsome tool for communication with residents and families, both now and in a post-COVID-19 world.
“How are you communicating the testing results?”
Our outbreak protocols require strong and active communication with residents and families. Executive Directors continue to communicate directly with you on all aspects of life in the community, and testing is no different. Our Executive Directors are making sure you know when or if any staff member tests positive, and if you or your loved one has had direct contact with a staff member who tests positive.
Testing results continue to be reported to appropriate authorities, and we also keep track of overall company testing results at our Support Center in Louisville, Kentucky. We use digital tools to track, trace and analyze all information about COVID-19. Our Senior Vice President of Care leads follow-up investigations into sources of exposure and interactions with respect to every new positive case.