In February of 2020, it became apparent that Covia needed to find a new way to respond to the emerging threat of COVID-19.
“We had existing emergency preparedness and disaster plans, but really with only a token reference to ‘emerging infectious diseases’,” says Grant Edelstone, Senior Director of Risk Management. “We didn’t have any pandemic policy or playbook. Even the lessons learned from the swine flu preparation were mostly forgotten, with expired respirators and fit testing kits stored away in an unused closet. So we had to accept the fact that a pandemic was happening and we had to rapidly change our practices to prevent and mitigate outbreaks.”
With communities and programs located in multiple locations, and the prospect of the Support Services office employees working remotely, representatives from all areas of Covia’s operations began to meet as a COVID-19 Task Force to coordinate Covia’s response. With nine members, drawing from operational and clinical functions, Life Plan Communities, Affordable Communities, and Community Services, the Task Force allowed Covia to understand the impact of the pandemic from all directions.
“The work of the task force was crucial in keeping the residents and employees safe during this pandemic. It allowed us to all share in ‘drinking from the fire hose’ and to dissect and process the information so that we all understood how it affected the organization not just our individual areas,” says Prab Brinton, VP of Human Resources. “This allowed us to provide cohesive solutions to our communities at large.” At first, the Task Force met by Zoom four days a week as Covia learned to extent of the changes that needed to be put into place. Eventually, the Task Force was able to meet three days a week, and now is down to twice a week.
Cynthia Shelby, Regional Quality and Care Nurse remembers “the endless hours and constant changes in the beginning, but my most fond memory is that the leaders decided to stockpile PPE and create the task force. I believe these two things afforded us favorable outcomes.”
Acquiring Personal Protective Equipment, or PPE, at a time when resources were scarce – and the sources were sketchy – was one of the first hurdles the Task Force addressed. Chris Ichien, VP of Life Plan Operations, tracked down N95 masks being sold from a remote warehouse in Southern California when all other avenues seemed closed. To provide steady supplies, Covia purchased PPE on behalf of the whole organization, which was stockpiled at the now-closed Los Gatos Meadows campus and disbursed to all the communities as needed.
Many of Covia’s Community Services programs stepped up, adapting quickly to the restrictions of the pandemic and providing all-important social connections to people as the virus caused isolation. When Market Day had to shut down its produce markets in senior affordable housing and senior centers, it delivered produce as people learned to find new sources of food and fresh produce. Social Call, which had already created a phone visitation program, switched entirely to remote visitation, as well as inviting people to send personalized greeting cards to people throughout the United States. And Well Connected’s phone- and online-based program was well situated to provide support not only to Covia, but to many other organizations as well. Tracy Powell, VP of Community Services, says that the ability to be flexible and pivot is a skill that she will take with her, long after the pandemic is over.
Along with flexibility, the Task Force helped Covia to think about what risks might lie ahead. With an awareness that fire season was fast approaching, Ichien set up contracts with hotels outside the fire zone to allow people from Covia’s communities to evacuate to a safe locations, should the need arise. In September, that foresight made a difficult situation a little bit easier as Spring Lake Village and Friends House residents evacuated to a hotel near Sacramento.
Senior Director of Risk Management Grant Edelstone was a linchpin of the Task Force, providing updates on the vast array of new regulatory requirements that emerged during the pandemic. In a recent survey, one respondent said, “I think the company response was great in general; personally, the support of the Senior Director, Risk Manager and my building Administrator was outstanding to navigate the early challenges of the response.” With more than 100 Provider Information Notices (PINs) coming from the California Department of Social Services over the course of the year, having a source who could track the most recent requirements gave community administrators the assurance that they were doing the right thing. Likewise, “Knowing that our work advising others, saving them the time to have to look up and read and follow constantly changing information contributed to the work of our frontline heroes” is one of the things that Edelstone says has kept him going through the pandemic.
Keeping people informed was another key responsibility of the Task Force. Whether through meetings with clinical teams or housing administrators, or through the website or weekly written updates, the Task Force prioritized giving residents, employees, visitors, vendors, and families the information they needed to feel confident in Covia’s response. Laura Darling, VP of Communications and Spiritual Care, says, “I didn’t expect to write an update every week for over a year, but I am so glad that we have the record of how we responded to this crisis. It feels like an ongoing conversation that has helped us all get through this.” She especially remembers an email that came from the Russian speaking residents of Bethany Center, thanking the maintenance staff for their dedication. “If we hadn’t opened those lines of communication, I would never have known about that. As it is, there are so many unsung front-line heroes and many more stories to hear.”
Karim Sultan, VP of Affordable Housing, says that his work on the Task Force “has been some of the most gratifying work I have done since I have been with organization. I felt a strong duty to protect residents and staff and the task force allowed me to participate in a process that facilitated that.”
Ron Schaefer, Chief Operating Officer, reflects, “I knew this before, but what has been valuable to me is that we have incredibly capable, smart, and wise people on this Task Force and in our communities, and I have been humbled and delighted seeing everyone shine in bringing their hearts, hands, and minds to this work.”
“I am very impressed with Senior Management’s commitment to keeping the residents and employees safe,” says Brinton. “I am proud to be working for an organization that actively balances the needs of its employees and residents all while keeping the organization poised for financial viability well into the future.”
The members of Covia’s COVID-19 Task Force are:
- Ron Schaefer, Chief Operating Officer
- Prab Brinton, VP of HR
- Chris Dana, VP of IT
- Laura Darling, VP of Communications and Spiritual Care
- Grant Edelstone, Senior Director of Risk Management
- Christopher Ichien, VP of Life Plan Operations
- Tracy Powell, VP of Community Services
- Cynthia Shelby, Regional Quality and Care Nurse
- Karim Sultan, VP of Affordable Housing
The week of January 11th kicked off the start of vaccine clinics at Covia communities, starting on January 12th at San Francisco Towers and following later in the week at Canterbury Woods and St. Paul’s Towers.
“When the long awaited day finally arrived, it really seemed to fly by in a flurry of activity,” says Christina Spence, San Francisco Towers Executive Director. “We were getting people their vaccines, having them monitored, and then sending them on their way.” Over 636 members of the Towers community have signed up to get vaccinated over the course of the three vaccine clinics.
“Staff and residents alike were so grateful and the atmosphere was full of hope,” notes Spence. This excitement was covered by local news stations, including CBSN Bay Area and KPIX-CBS, who were onsite to document the experience.
Friday January 15th saw clinics at both St. Paul’s Towers in Oakland and Canterbury Woods in Pacific Grove. Connie Yuen, Assistant Executive Director at St. Paul’s Towers, highlights that at the Towers clinic “there was a nice steady flow and we were able to avoid long lines and wait times.” 100% of St. Paul’s Towers residents participated in the first clinic with 60% of staff participating as well. “More staff signed up for the 2nd round and about a dozen staff members have already received their vaccine,” notes Yuen.
Residents, staff, and contractors were excited and hopeful about getting the vaccine and Yuen says that even though “a few people were nervous, they understood this is the step we need to take if we want to go back to a ‘normal’ way of life.” Yuen feels “very fortunate to be given the opportunity to take the vaccine early on” as it brings hope for the future.
Spirits were high at Canterbury Woods as well. Geoven Snaer, Director of Administrative Services, says that “residents and staff were both very excited and relieved to finally get their vaccine.” 39 residents and 129 staff participated in the first clinic with more signing up for the second clinic, which will take place on February 4th.
The clinics “really are a team effort,” says Snaer, who highlighted the importance of staff who helped not only organize but also run the clinic, including intake, processing, providing assistance to residents, and notifying everyone about the correct time to arrive.
The clinic’s success was also due to the support from the local pharmacy, which Snaer notes “was fantastic. The pharmacists and support staff from Walgreens treated our residents and staff with much respect and courtesy. One pharmacist even stayed with our very last resident vaccine recipient to make sure she didn’t have a reaction afterwards.”
Common side effects like “soreness, body aches and headaches seem to be the things we are hearing about,” notes Snaer, who says that his “arm was sore for about 3 days, but that was about it.”
Vaccine clinics are continuing to be set up for all Covia communities with some starting their first clinics this week. Each community will have three clinics, which ensures that residents and staff both have the opportunity to get vaccinated. The second clinic will provide not only second doses for those who have already received the first dose but it will also provide first doses to those who weren’t able to attend the first clinic. As Spence notes, “looking forward to our second clinic, we know that being vaccinated won’t immediately change our new normal – but it’s moving us forward in the right direction to be together again.”
Dr. Timothy Gieseke, who served as the Medical Director at Spring Lake Village from its opening in 1986 until 2019, sat down on Monday, December 14 for an interview with Laura Darling, Covia’s VP of Communications and Spiritual Care, to give his perspective on the safety and effectiveness of the COVID-19 vaccines. Gieseke is a member and past President and Board Member of the California Association of Long Term Care Medicine (CALTCM). The full interview is available online here.
Dr. Gieseke gave an overview on how these novel vaccines were developed and how they work. Using a well-established technique that has been in use for the past 10 years for cancer therapies, scientists created a messenger RNA, or mRNA vaccine for SARS CoV2. Not using the COVID virus itself, the mRNA vaccine “creates a sideshow, if you will…so the body sees it as a foreign protein and makes antibodies against it. So that when the virus actually does infect us, or attempt to affect us, very quickly it’s identified as something foreign to be destroyed and the virus is destroyed.”
Like every other therapy approved by the FDA, Dr. Gieseke explained that the COVID vaccines went through three trial phases. “Physicians get interested in the phase three study, which is where they had 43,000 volunteers” – 30% of whom were from ethnically diverse backgrounds, and 45% between the ages of 45 to 85.
After a phase 3 trial lasting two weeks longer than the usual period and review by committees, including the Vaccine Related Biologicals Products Advisory Committee (or VRB PAC), “at a federal level, they felt that this vaccine was effective at a 95% level, which is really amazing.”
It’s effective. But is it safe? Dr. Gieseke explained that although “this was a rapid review, rapid approval process, but the actual scientific process was the same.”
“There’s things that we don’t know about this, but that’s true of everything in medicine, that’s new,” he says, “But the potential value of this vaccine is so large that I can tell you I’m signing up, all my associates at Spring Lake, Drs. Greene and Rao are signing up. I had another colleague say, ‘Where can I get it?’ And I can tell you, physicians are just really excited that this vaccine is available.”
A review of the side effects did not raise any alarms for him. “I mean, there are always problems with these medications and there’s problems even after you get your emergency use, but the common ones were the ones you’d expect,” he said. Side effects were similar to those of the flu vaccine: soreness at the injection site, or a systemic immune response, “feeling like you’re getting the flu, because that’s part of your immune system, how it gets rid of the flu and actually SARS CoV2 as well.” Dr. Gieseke said these side effects were found in less than 3% of trial participants after receiving the first injection, and less than 7% of people after receiving the second.
The vaccines are given in two doses because “you get more effectiveness and better safety if you split the doses,” Dr. Gieseke explained. “So rather than giving a big dose all at once, you give a tolerable dose and then you repeat it three weeks later.”
“I think it’s effective and safe and it’s something that when your turn comes I would be, ‘I’m gonna be the first in line,’ quite frankly,” Dr. Gieseke says.
The Pfizer vaccine has already been approved, and the Moderna vaccine is not far behind. Dr. Gieseke thinks the Moderna vaccine may be the one more likely to be given to Covia residents and staff. “The Moderna vaccine which is an mRNA vaccine has very similar 94.7% effectiveness, differs in that it does not require the cold storage that the Pfizer vaccine does. So it’s more like a normal vaccine, has a better shelf life.”
So when will we all be vaccinated? “Hard to know,” Dr. Gieseke says. “Experts are predicting anything from May, June, to more likely the Fall, September, something like that, because these companies are selling to the world. It’s not just the United States.”
In the meantime, Dr. Gieseke says we need to continue to follow public health guidelines – including wearing masks, avoiding gatherings and enclosed spaces, and cleaning. “What we know about SARS CoV2 is public health actually works. But you really have to practice it effectively and I’ll just give you a couple principles that you may not want to hear:
“Now that medical masks are available, that’s what you should be wearing. And the reason medical masks are more effective than the cloth masks is, they actually have electrostatic forces that trap the virus embedded within them,” he says. Dr. Gieseke reuses his masks, storing them in a paper bag to allow them to dry out and be used again.
“Number two: Always use a mask when you’re outside your apartment because you just don’t know… all it takes is one person to not mask to blow the whole thing open, and I see that happen all the time.”
Number three: “follow public health guidance. So right now we’re on lockdown. Because in December, every week we’re doubling and tripling the prevalence of COVID. And what we know is the more common the COVID is in the community, the more likely we are to get COVID.”
Dr. Gieseke says that, even with the vaccine, “continue to do all the public health measures until public health says this no longer makes sense.”
Dr. Gieseke does have words of encouragement for everyone who has been dealing with the limitations imposed by COVID over the past year: “Number one, this is not forever.”
“I think the vaccines is going to allow us to have a more normal life, even if the virus has the ability to change like influenza and becomes a persistent problem,” he says. “I don’t think we’re going to see it out of control, like it is right now…Going forward, I think this will be a part of our lives. But I think it’s going to be a manageable part of our lives.”
Although the vaccine is good news, for right now his guidance is, “mask as much as you can. That’s kind of where you live at this point in time.” But, Dr. Gieseke assures us, “this too will pass.”
All five Covia Communities are among the 21% of U.S. skilled nursing facilities that have been recognized as a Best Nursing Home for 2020-21 by U.S. News & World Report.
The communities received Best Nursing Homes status by achieving a rating of “High Performing,” the highest possible rating, for Short-Term Rehabilitation, Long-Term Care, or both. Canterbury Woods in Pacific Grove, St. Paul’s Towers in Oakland, and San Francisco Towers all received the recognition for Short Term Rehabilitation. Webster House Health Center in Palo Alto was recognized for its Long Term Care. And Spring Lake Village in Santa Rosa received the honor for both Short Term and Long Term care.
U.S. News gives the designation of Best Nursing Home only to those homes that satisfy U.S. News’s assessment of the appropriate use of key services and consistent performance in quality measures. This year, to accompany the new ratings, nursing home profile pages were updated to include a patient safety summary that reflects COVID-19 data alongside other measurements of safety and related advice on choosing a home or facility amidst the pandemic.
“I am so proud of all our Covia teams and their leadership, especially their implementation of the infection prevention processes that resulted in exceptional resident outcomes during this challenging pandemic,” says Cynthia Shelby, Covia’s Regional Director of Quality and Care, RN, RAC-CT.
All of the communities noted the extraordinary care and efforts given by their team members. Max Brodsky, Health Care Administrator at San Francisco Towers, says, “As I make my rounds checking in with the residents staying at the Health Center, one thing I hear over and over is ‘You have the most wonderful staff working here. They are kind, hard-working, and always do their best.’ It’s our culture of respect and integrity, and staff who embrace our philosophy that makes us the best and a five star facility.”
At St. Paul’s Towers, Health Care Administrator Connie Yuen says, “Our staff works from the kindness and love in their hearts. We’ve been told time and time again we do not work with patients, we work with residents that become a part of our family that we love and care for. The staff go above and beyond to connect with residents and take it a step further by providing updates, photos and spontaneous phone calls to give loved ones peace of mind.” Executive Director Mary Linde adds, “We at SPT are delighted to be among the best nursing homes in the country. But it comes as no surprise because we see the care, and the relationships that drive that care, on a daily basis. I believe the staff in our SPT SNF are, indeed, among the best in the industry.”
Kris Hermanson, Health Care Administrator at Spring Lake Village which was rated as High Performing for both Short Term and Long Term care, says, “It’s satisfying knowing you are giving quality care to our residents who deserve and have earned it!”
Now in its 11th year, the U.S. News Best Nursing Homes ratings and profiles offer comprehensive information about care, safety, health inspections, staffing and more for nearly all of the nation’s 15,000-plus nursing homes. The Best Nursing Homes ratings reflect U.S. News’ exclusive analysis of publicly available data using a methodology defined by U.S. News that evaluates factors that it has determined most greatly impact patient and resident care, safety, and outcomes.
“U.S. News strives to provide access to information that allows consumers to make educated decisions on all types of care,” said Ben Harder, managing editor and chief of health analysis at U.S. News. “Updating the profiles to include a patient safety summary that highlights COVID-19 data paired with other measures of care arms families, caregivers and patients with the information needed to make a decision that keeps safety at the highest priority.”
The Best Nursing Home finder features ratings on both long-term and short-term care. The Long-Term Care Rating aims to provide prospective residents who need help with daily activities, and their families, with analysis and information regarding the quality of care provided by nursing homes. The rating includes data on staffing, success in preventing ER visits and pneumonia vaccination rates, among other metrics. The short-term rating incorporates measures of quality including consistency of registered nurse staffing, use of antipsychotic drugs and success in preventing falls.
U.S. News & World Report is the global leader in quality rankings that empower people to make better, more informed decisions about important issues affecting their lives. A digital news and information company focused on Education, Health, Money, Travel, Cars and News USNews.com provides consumer advice, rankings and analysis to serve people making complex decisions throughout all stages of life. More than 40 million people visit USNews.com each month for research and guidance. Founded in 1933, U.S. News is headquartered in Washington, D.C. For more information behind both U.S. News ratings please refer to the FAQ.
Watch our video interview with Grant Edelstone here.
For the general election on November 3rd, the State of California has provided guidance to make it easier – and safer – for registered voters to participate in the election process. In particular, the California Department of Public Health sent a letter to remind Skilled Nursing Facilities “of their obligation to assist and encourage residents to exercise their rights…This includes their right as a citizen to vote safely during the COVID-19 pandemic.”
Grant Edelstone, Senior Director of Risk Management, explains some of the safer options available for all voters. “One thing you can do to stay safe is to vote by mail. Avoid voting in person.” California voters who are already registered to vote have been sent their ballot by mail. They can complete and mail in their ballot or drop them at an official ballot drop box.
Edelstone says that, for those who like to vote in person, there are safety practices that everyone can do. “If you go to a polling station, only go if you feel physically well and you have no respiratory symptoms. Try to avoid the lines by having your documentation and forms prepared in advance. Get familiar with who and what is on your ballot before you arrive at the polling station. Try to go at an off peak time, like mid-morning. Bring your own black pen or an e-stylus, if you have one.”
Edelstone also emphasizes the importance of standard safety practices at polling stations: wearing a cloth face covering or mask; wearing gloves; maintaining a physical distance of at least six feet from others if you’re standing in line; using hand sanitizer frequently before and after touching objects or surfaces; and washing your hands when you get home. “You could consider wearing eye protection like goggles,” he adds, “And if you’re going to stand in a long line maybe bring a portable chair and wear comfortable shoes.”
Residents who may not be able to get to a polling station can ask staff members for assistance in ways that respect their privacy, Edelstone says. “That could be helping them register if they’ve changed their address to update their voter registration if needed.” (The last day to register to vote is Monday, October 19th. Californians who meet the registration requirements can register online at https://registertovote.ca.gov/.) Staff can also help people to go online to get materials in the language that they prefer, or help read the election materials to someone and help someone with alternative voting methods.
Edelstone also shares what staff are not allowed to do. “You can’t influence a resident’s vote. You can’t mark a ballot in any way other than the resident directs you to. You can’t tell anyone how a resident voted. You can’t decide if someone is mentally incompetent to vote. You can’t determine if a resident is eligible to vote. And you can’t vote on their behalf, if you’re unable to reliably determine how the resident wants to vote.”
“So basically you have to listen to the resident, respect their wishes, and do what they are directing you to do, is the easiest way to put that,” Edelstone says.
Fundamentally, Edelstone says, “There’s ways to participate in and support civic activity without having to interact with too many other people and to have your voice heard and make your vote count.”
To learn more about how to vote in the upcoming election in California, go to https://www.sos.ca.gov/elections/voting-resources/voting-california.
During a recent webinar, Covia leadership gathered with prospective residents to give insight into management and operations at Covia. The webinar panel included Mary McMullin, Chief Strategy and Advancement Officer; Diana Jamison, Chief Financial Officer; Ron Schaefer, Chief Operating Officer; and Mary Linde, St. Paul’s Towers Executive Director. Katharine Miller of the Covia Foundation moderated the discussion.
The webinar offered prospective residents the opportunity to ask questions about what is currently going on at Covia from a leadership perspective, including COVID-19 preparation, the upcoming affiliation, and adapting to socially distanced activities. Part 1 about Covia’s response to COVID-19 is below. Part 2 about the affiliation can be found here.
Covia has approached the COVID-19 pandemic both from a community standpoint as well as system-wide. At the community level, Mary Linde, Executive Director at St. Paul’s Towers in Oakland, detailed how St. Paul’s prepared after hearing about COVID-19.
“When I first learned on January 20th that COVID-19 had hit Kirkland [Washington], we immediately brought our leadership team together to say ‘That’s two states up. How do we get ready for this migrating down here?’” Linde notes. “By January 27th, we had restricted outside visitation for travelers who had travelled out of the country to those tier 3 countries. And then progressively, through the month of February and by mid-March, we started sheltering in place.”
When California Governor Gavin Newsom shut down all but essential businesses, Linde says, “we looked at St. Paul’s Towers as though it were itself a village: What are the businesses that operate within this village, which of those are essential, and how do we carry those out safely?” She explains that initially care giving and meals were the essential businesses for St. Paul’s. With in-person dining not permitted, “we said, how do we do takeout at St. Paul’s Towers?” The team wrote guidelines for how to do safe takeout. “We set up two separate takeout staging areas in our community and we designated times for people to come at meals so we wouldn’t have crowding.”
From a system-wide perspective, Covia established a COVID-19 task force that met daily initially and now three times a week. Ron Schaefer, Covia’s Chief Operating Officer, who heads up the task force, explains that its role is to “keep in touch with the health directives that are coming from different locations and provides advisories to our communities to help the Executive Directors make sure that nothing gets by them that they need to know.” The taskforce also provides guidance around the evolving best practices for infection control and testing and ensures that each location has the Personal Protective Equipment (PPE) needed.
Even with visiting restrictions in place, prospective residents can connect with a community during this time.
“If you are interested in a particular community, we encourage you to reach out and talk to people at that community,” says Mary McMullin, Chief Strategy and Advancement Officer. Community marketing teams are all ready to do a virtual tour that meets your needs, including walking you through the community, creating a special video with your specific interests in mind, and video conferencing.
The marketing team can also connect you “with residents who are living at the community and you can talk to them,” McMullin highlights. Another great option is the community Facebook pages, which post updates and photos about what is going on. They can provide great insight into what events are taking place as well as what precautions the community is taking.
All communities have embraced new ways to stay connected, adapting programming so that residents have a full schedule of activities. Linde shares that St. Paul’s Towers is “doing a lot of activities through the in-house television, like exercises and cooking classes where they deliver ingredients to apartments and residents can follow along on the in-house channel or on Zoom.” The St. Paul’s Towers chaplain has also transitioned her programming to Zoom for book discussions and more. “We do a happy hour on Zoom every Tuesday night,” Linde notes. “It’s such a gift of connection.” St. Paul’s Towers has also created an ice cream truck complete with a signature jingle that delivers ice cream and treats to residents in their apartments. Linde says “If the residents ask for it, we are really trying to find a way to do it.”
Covia also offers connection programs that are accessible to everyone, utilized by residents in Covia communities as well as the wider public. Well Connected provides a full catalog of sessions that are available over the phone or online and are completely free. Sessions cover everything from arts and yoga to armchair travel and wellness. The current catalog of sessions is available here. For connecting one-on-one, Social Call matches older adult participants with volunteers for weekly meetings over the phone. Participants enjoy talking with others from the comfort of their home and these weekly meetings go a long way toward fostering the connections that social distancing has proven are a crucial part of wellness.
Although the challenges of responding to COVID-19 are real, Covia is still finding new and positive ways to make healthy communities, build connections, and stay engaged.
Watch our video interview with Jerry here.
Jerry Brown, Covia’s Senior Director of Affordable Housing, has no idea how he got exposed to COVID-19. “Between March 12 and June 28, I probably saw less than 20 people total the whole time,” he says. Nevertheless, on June 28th, “I got a really bad upset stomach. I thought I probably had food poisoning. And that lasted a straight 48 hours, two days. And then that Sunday, I felt like an elephant was sitting on my chest. I could not get my breath.”
A trip to the emergency room confirmed his suspicions: he had COVID-19.
At first, the doctors thought he could be treated at home. “I thought I was doing fine for seven days. But the next Sunday, the elephant was sitting back on my chest again and just could hardly breathe at all.” After the hospital confirmed he had COVID-19, Jerry was admitted to the hospital to a floor designated for COVID-19 patients. “There were 70 rooms. All of these rooms are individual rooms that have special air filtering so that it doesn’t get into the rooms of the rest of the hospital,” Jerry explained. “I was lucky enough to get the last room that was available that night. I didn’t get in to my room until three o’clock the next morning, but I did get in there, and I felt so much better once the nurses and the CNAs all came around and started taking care of me.”
He thought he would be in the hospital just a couple of days, but ended up staying 10 days as his medical team determined what treatment regimen would work best for him. “They said, ‘We don’t really have a set treatment for this. Everybody is different. So what we’re going to do is just sort of throw things at you over the next few days to see what works for you.’”
Remdesivir proved unsuccessful, and his medical team was unable to get approval from the Federal Government for a plasma treatment. What ultimately worked was a steroid treatment. “The problem with the steroids and the reason that was [treatment] number three is because steroids don’t really work well with people who have diabetes.” Although Jerry’s diabetes is not severe and well controlled with Metformin, “when I started taking the steroids, which made me feel a lot better breathing-wise, my sugar levels went to 700. That’s the reason I had to stay in the hospital, so long. With that sugar level, I could have had a stroke or kidney problems.”
From the outset, his medical team told Jerry he had one goal: Stay out of the ICU! “They actually wrote it on the white board in my hospital room. There were 18 ICU rooms and they were full the whole time I was there. Over that 10 days, seven people died. You would hear that through the nurses and the medical staff and the doctors were very honest.”
Although he’s doing better, Jerry is not fully recovered. “I exercise my lungs. I speak through Zoom with a therapist. But we’ll see how it goes. Right now I’m breathing fine. I can walk about 40 feet before I get tired and need to sit down.”
He also knows that this is still a scary situation – and understands it, having lived through the AIDS crisis of the early 1980’s. “I came to San Francisco in 1979. I got transferred with my job to San Francisco, and it was right at the top of the AIDS crisis. So that was really scary for me. And we all know that that lasted a little while before we figured out that it didn’t need to be as scary as we thought because there were things you could do to make sure that you didn’t get it. I’m sure that’s going to happen with COVID-19 too. But this disease is a little different because it’s in the air. How do we manage that, other than with these masks and watching our hands and social distancing?”
He’s concerned at the number of young people who aren’t taking COVID-19 seriously. “I see so many people that aren’t wearing masks or social distancing, and that’s very scary for me. I saw a lot of that in San Francisco. I live on Nob Hill and the younger people were still playing basketball and not wearing a mask and running without a mask. Hopefully they will get over it, being young and having strong bodies and a good immune system. But there are so many people around them that could get COVID.”
Aside from practicing good infection prevention habits of handwashing, wearing a face covering, and maintaining your distance, Jerry wants to remind people that, whether it’s COVID-19 or any other illness, “you are your own best advocate for your medical care.”
While he was in the hospital, “Every night I would put my questions together about nine o’clock. I would think of everything I wanted to ask them, ‘Can I do this? Can I do that?’ And then I would have my questions ready. It made me feel better too, you know, just getting an answer to things I had questions about.”
He also advises everyone to update your health care and financial directives (such as wills or trusts) “now – not when you are in the hospital bed.” He also recommends purchasing an oximeter – a battery-operated finger device that gives instant reading of your pulse and blood oxygen levels. “One of the first signs of COVID is not enough oxygen in the blood. To be up walking at a natural movement pace the reading should be 90 or above. You can purchase at most drug stores or on line for around $30. I now check mine twice a day.”
The experience has made him reflect on the importance of connections. “I thought about the people from the 1918 flu. How awful. They didn’t have Zoom. They didn’t have the Internet. They didn’t have a way to connect to people. And even though I was in that room alone, I spoke with my family every day. We FaceTimed. I Zoomed friends. People dropped things off. I got cards and I was surprised they let flowers come to the room, and all of that made the experience. I had the feeling that people were caring about me. We figured out ways to connect with each other.”
All of us at Covia wish Jerry and all who are affected by COVID-19 connection and comfort during these difficult times.
Watch our video interview with Jerry here.
As the realities of the COVID-19 pandemic set in, the healthcare staff at each Life Plan Community and at Support Services rose to the occasion and continued to do what they do best: provide excellent care to our residents. Covia has always had strong health care delivery and infection control procedures, but the pandemic has made the planning and training required to maintain safety more evident.
At Spring Lake Village, Jodi Arnheiter, RN and Director of Staff Development, and Sherry Taylor, RN and Director of Nursing, have led the local infection control response. Jodi, who has worked at Spring Lake Village for over 10 years, was trained by the Association for Professional Infection Control and Epidemiology (APIC) — the leading professional association for infection control specialists. The training includes epidemiology, microbiology, science-based infection prevention practices, and implementation of practices in a long-term care setting.
“We are so lucky to have Jodi on our staff. From the first day, she was providing daily guidance on what we had to do to be prepared,” reports SLV Wellness Director Diane Waltz. Jodi communicates frequently with the Sonoma County Public Health Department on any new data regarding the current situation, as well as reviewing the updates from CDC and the California Association of Long Term Care Medicine (CALTCM). Jodi’s colleagues praise her calm, reassuring presentation of the facts and actions that need to be taken.
In Oakland, Lisa Hiltbrand, the daughter of Helen Hiltbrand, a resident in the healthcare center at St. Paul’s Towers, expressed her gratitude for the staff, whose compassion and care for their residents was especially important during a time when family members had to stay at a distance. “Since the beginning of the restrictions due to the virus, their extreme dedication and professionalism have been exemplary. The nurses and staff have gone to extraordinary lengths to support my mother. Ranka and the other nurses have organized regular Zoom meetings for my siblings and me,” Lisa says. “It is such a relief to see our mother when we cannot be physically with her. These extra steps are even more spectacular as they’re taken in a time when the staff’s workload has been increased. I know they are taking extra time for interacting with residents due to the lack of visitors,” she says.
At Webster House Health Center, Executive Director Linda Hibbs shared her gratitude for her staff’s hard work: “I’m impressed with the dedication and compassion you have demonstrated to our residents, families, and staff. This has been a challenging time with many of you anxious about the COVID-19 virus implication and the economic future of family members. Thank you for your professionalism and willingness to be a team of heroes! The care you show for our residents makes Webster House such a great community.”
Organization-wide, the COVID-19 response is led by a task force of nine executive leaders representing Operations, Life Plan Communities, Affordable Communities, Clinical Care, Human Resources, IT, Community Services, and Communications. Grant Edelstone, Covia’s Senior Director of Risk Management, and Cynthia Shelby, RN and Regional Director of Quality and Care, are critical team members, providing guidance for local staff on best practices for infection control and compliance with local and state regulations.
As conditions changed rapidly, Grant’s support to track and implement changing mandates and rules was invaluable. St. Paul’s Towers Executive Director Mary Linde, who is also a nurse by background, says, “I am so grateful that Grant is on our team, especially right now with the onslaught of information coming from multiple regulatory agencies. Grant ensures that we all get the information and sends it to us with a concise recap. He also finds the information for us when we are scrambling to meet the demands of our situation. And he does all of this with patience and kindness.”
For the past three years, Cynthia Shelby has worked across Covia, providing support to the six health care centers at Covia Communities. She, along with other members of the Clinical Team, offers guidance on the complexities of skilled nursing, including regulatory requirements, preparing for surveys from state regulators, billing questions, staffing concerns, training, and even filling in for key roles as needed.
“A key part of our mission is the continuum of care and how the full team helps residents transition through changes,” says Covia President and CEO Kevin Gerber. “The continuum of care is also about the whole person — not just thinking about their physical needs, but all of their needs.”
Covia has been able to get staff the supplies they need, ordering personal protective equipment (PPE) like masks in larger quantities and distributing to the communities as needed. Shelby, as part of Covia’s COVID-19 Task Force, reports daily on the needs and concerns of the skilled nursing teams, as well as the creative solutions they are implementing — such as turning sections of the health care center into isolation areas should a COVID-19 positive resident need to be kept separate from others.
“We’re making history,” says Shelby. “We’re doing things we’ve never done before. We’re introducing lots of new technologies, new ways of doing things, new ways of communicating to our families. Everyone as a team comes together for that.”
*This article was originally posted in the Summer 2020 edition of Community Matters
“Ice cream has always been a big deal at Canterbury Woods,” says Robert Kershner, Director of Dining Services at Canterbury Woods in Pacific Grove. In 2019, Kershner reports that Canterbury Woods bought over 1200 gallons of ice cream – serving about 5 gallons daily.
“When we were restricted to our homes during the first stages of Shelter-in-Place, it was a natural choice to turn to ice cream to try to ease the stress and concerns on campus,” Kershner says. Since residents were no longer able to get their favorite flavors in the dining room, Kershner and his team turned to favorites like Dove Bars, Good Humor Cones, and It’s Its (ice cream sandwiches from San Francisco) to bring back comforting memories of years ago.
Each Thursday, two teams wearing masks and gloves “walk throughout the campus, knocking on every door to offer some edible comfort,” Kershner explains. Pushing a cart with a cooler attached and ringing a bell as they go through the 6 acre community, the ice cream delivery teams have become an important part of the week for many folks who now refer to Thursdays as “Ice Cream Day”.
Now, the “Good Humor Crew” has become highly popular as they make their rounds. Kershner says that people want to hear the full list of choices, and then sometimes ask for two. “One of our happy customers said it makes everyone feel like a kid again!” shared Mary Lou Kelpe, Life Enrichment Coordinator.
Ice cream has also become an important part of keeping the Webster House community connected. “I thought this would be a nice diversion for the residents to be outside eating a cold ice cream on a summer day,” explains Executive Director Linda Hibbs. “This is the first community social activity for our residents that have been sheltered in place.”
Each Wednesday at 2:00, about one-third of the residents meet outside for ice cream sandwiches, ice pops, or sorbet and an opportunity to meet and catch up while staying a safe distance apart. “The residents have the ability to socialize with their friends which I feel is best for their overall well-being,” says Hibbs. The ice cream is really just the cherry on top.
At Canterbury Woods, Kershner says it’s difficult to find words to describe what made these visits special. “When people open their doors and see who we are, the looks on their faces are very rewarding,” he says. “These folks were missing interaction, and that’s exactly what we’re doing.”