The Square
News and perspectives from Covia.

Cynthia Shelby worked for 15 years as a hospital nurse – including emergency rooms, ICUs, and medical/surgery – before she took a position as an Assistant Director of Nursing in a skilled nursing community in Ohio. As a hospital nurse, Shelby notes “You become a very good clinician and you have good diagnostic skills and you’re real quick on your feet.”

But skilled nursing is a different world. She adds, “Nobody just jumps into this field. It takes experience. You have to learn all the regulations and all the little pieces of the puzzle that have to get put together before someone can go home.”

For the past three years, Shelby has worked for Covia as a Regional Quality and Care Nurse, providing support to six Skilled Nursing Facilities, from Pacific Grove to Santa Rosa. 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.

Covia offers skilled nursing care within its four Life Plan Communities and at Canterbury Woods, a multi-level community.  Skilled nursing care “illustrates key parts of our mission,” says CEO Kevin Gerber. “It’s about the continuum of care and how the full team help residents transition through changes. Skilled nursing is also about the whole person – not just thinking about their physical needs, but all of their needs.”

Skilled nursing facilities “have always had a bad reputation and many joke it’s a death sentence,” says Connie Yuen, Healthcare Administrator at St. Paul’s Towers. “Yet, while skilled nursing care can be the final home for some who are frail and sick, it can also represent an environment to rest, strengthen and recuperate so one can continue living life and even return to a prior home. Working in skilled nursing care means that I have the privilege of providing great care to our residents during difficult times and uncertainty.”

May 10-16 is National Skilled Nursing Care Week. This year, it comes as skilled nursing facilities have become the face of the COVID-19 pandemic on top of the stereotype of the “nursing home.” Add in a few bad actors who skimp on care for profit, it is not surprising that the perception is negative. 

The negative perception exists in the nursing profession itself. “I too was a nurse for years in big medical centers,” says Mary Linde, Executive Director at St. Paul’s Towers. “People thought I was nuts when I moved to long term care. But the beauty of the skilled nursing home is the relationship with the residents. Because it’s a long term relationship, the care can really be tailored to that person’s personal preferences.”

Far from causing a reduction in the care and services residents receive, the COVID-19 crisis has only encouraged new ways of serving Covia’s skilled nursing residents. “I have been astonished and amazed in the most beautiful ways at watching the staff adapt to how they do care,” says Linde. “Staff who are normally behind the medication cart are now finding ways to do one-on-one activities with residents. Because if they weren’t doing them, they may have times of isolation. They are innovating and caring in new ways, and it’s amazing to witness.”

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 different 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. During weekly Infection Prevention Zoom calls, team members share best practices, discuss concerns, and answer questions to ensure that the Covia’s health care services are prepared for what might happen next.

“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.”

“I get to work with a team of intelligent, compassionate, kind individuals that provide and coordinate care to older adults with various healthcare needs,” says Yuen. “Together, we promote healthy aging, safety, well-being, quality of life, dignity and meaning if one becomes more frail towards the end of life.”

“What happens over time is love,” says Linde. “The care is driven by that relationship and there’s not another word for it. It is love that happens there.”

As the COVID-19 pandemic continues, Covia’s Market Day has stepped in to provide fresh produce and staples to almost 1,600 seniors.

Market Day, a Covia Community Services program designed to offer pop-up produce markets in accessible locations such as senior communities, senior centers, and churches, made the difficult decision to temporarily close its events starting in mid-March in light of the risk they might present to seniors and volunteers alike. But the team is working behind the scenes to provide new, creative ways to get fresh produce to seniors without exposing them to risk of infection. 

“Covia knows that our clients, residents, and neighbors are all dealing with a lot of challenges during this pandemic,” Market Day posted on its Facebook page. As a result, “During the month of April, Covia offered produce delivery for free to older adults and community members.”

In April, Covia employees and volunteers wearing masks delivered bags of produce to 1,593 seniors living in twelve locations that normally host Market Day, ranging in location from Santa Rosa in Sonoma County to Pomona in Southern California. Each delivery contained a variety of fresh produce, from blueberries to broccoli, pears to zucchini, along with a pound of rice.

“The gesture alone helped my spirits,” said a resident of Presidio Gate Apartments, a Covia Affordable Community in San Francisco. “The bananas and berries were most appreciated and the sweet potatoes were good mashed.”

“I can’t tell you how much the groceries will be appreciated by my residents,” said a staff person at Cottonwood Place in Fremont. “I’ve seen the need for food increasing. This is so generous of Covia and it is definitely needed…We will get through this all together.”

As for the Market Day team, “We can’t wait to celebrate all our volunteers when our Markets open again soon!”

Market Day is a program of Covia Community Services. Find more information about Market Day or make a donation to support this vital program here.

UPDATE: As of May 31, 2020, all cases of COVID-19 at San Francisco Towers have cleared.


On Wednesday, April 15, Covia was informed that there are two confirmed cases of Coronavirus (or COVID-19) at our San Francisco Towers community. SFT immediately contacted the San Francisco Department of Public Health and is following all of their guidance. In addition to the Infection Control Plan that was already in place, San Francisco Towers immediately implemented a prescribed protocol to respond to these positive cases of COVID-19.

Those affected are a resident in the Skilled Nursing Facility and a nurse who was caring for that resident.

“We have been fortunate so far to not have any cases of COVID-19 in any of our Life Plan communities, but we prepared, expecting this day would come,” says Mary McMullin, Covia’s Chief Strategy and Advancement Officer. “We know that the San Francisco Towers staff is well equipped to respond to this situation.”

The resident, who began experiencing shortness of breath on Tuesday, was tested for COVID-19. The  symptoms increased overnight and the resident was admitted to a San Francisco hospital on Wednesday where the test result came back positive. The nurse was tested due to working at another site with COVID-19 positive cases and the result came back positive. The staff member was not tested in conjunction with working at the Towers. Appropriate protocols are being taken.

The resident’s roommate in the Skilled Nursing Facility was tested and found negative for COVID-19.  

As required by California Department of Public Health protocol, all staff that interacted with the patients in this skilled nursing room will be surveilled and a log will be maintained with frequent checks of their vital signs. Any staff that are symptomatic will be tested for COVID-19.

The community is asking residents to take extra precautions, including remaining in their apartments except for medically necessary purposes. Residents returning back from trips will be quarantined in their rooms for 14 days and monitored for signs and symptoms of COVID-19.

San Francisco Towers has also contracted with an outside vendor who will thoroughly sanitize the entire Skilled Nursing Facility.

“The safety of our community members is of the greatest importance to us,” says San Francisco Towers Executive Director Christina Spence in a letter to residents. “We continue to take all available steps to control the spread of infection, based on the recommendations of the Department of Public Health and our own best practices for infection control and prevention.”

San Francisco Towers is not a Skilled Nursing Facility, but a multi-level Life Plan Community, primarily consisting of independent living apartments. Only 18 of its approximately 300 residents are receiving skilled nursing care. 

We will provide further updates as they become available.

Questions can be emailed to C19info@covia.org.  

Update: April 17, 2020

San Francisco Towers has begun testing all residents in its Skilled Nursing Facility for COVID-19 in the wake of a resident and a nurse testing positive earlier this week (April 15). This testing far exceeds the current guidelines of the San Francisco Department of Public Health for what they consider a “low risk exposure” at the community. The community will also do periodic testing of skilled nursing staff.

“This is a unique process to address SFT’s specific situation and aims to ensure the well-being of our Towers community,” says Executive Director Christina Spence.

SFT purchased the limited available tests from a private provider. The tests will be performed under an umbrella order from SFT’s medical director and results are expected within five days of submissions. Health care for individuals who test positive will follow public health quarantine protocols. SFT is working closely with the San Francisco County Department of Public Health, which, if needed, will direct any future testing.

SFT also continues to implement all current steps to control the spread of infection based on the recommendations of the Centers for Disease Control and Prevention and the SFDPH and utilization of best practices for infection control and prevention.

Update: April 20, 2020

Results so far from testing Skilled Nursing residents and San Francisco Towers staff have found one additional resident with a positive case of COVID-19. Although largely asymptomatic, the resident is now in the hospital for further testing. The resident’s roommate tested negative for COVID-19.

A few resident and staff results are still pending but complete results will be shared as soon as they become available.

The SFT resident who was diagnosed last Wednesday, April 15th was reported by the hospital to be in critical but stable condition. Covia continues to monitor the resident’s status and to communicate with the person holding Durable Power of Attorney.

In addition, San Francisco Towers has heard from two Independent Living residents who have been traveling since mid-March who contracted – and recovered from – COVID-19. SFT Executive Director Christina Spence writes, “We are under the impression that they were not exposed to the Coronavirus at the Towers, but while they were out of state. We do not believe their illness will have any effect on the Towers community. We are also very happy to hear that they have fully recovered.” 

Update: April 24, 2020

San Francisco Towers reports that one additional staff person has tested positive for COVID-19 and will not be working at the community for at least two weeks. The staff person, who is asymptomatic, had been in self-isolation since Monday, April 20 and was tested as part of surveillance testing provided by the Towers.

The community has received all results for its Skilled Nursing residents with no further positive tests. Executive Director Christina Spence says, “Several residents are in isolation due to positive roommate exposure but have tested negative and have no symptoms.” 

The initial resident found positive remains hospitalized in critical condition. The second resident found positive was in hospital under observation, but has since returned to SFT where isolation precautions are being taken, including team members dedicated to this resident’s care. The first staff person who tested positive is asymptomatic and recovering in self-isolation at home.

Update: April 28, 2020

The resident from San Francisco Towers’ Skilled Nursing Facility who tested positive for COVID-19 on April 15th has passed away. Executive Director Christina Spence informed residents and staff of the news today, saying, “Our thoughts and prayers of peace and comfort go to the friends and family members.”

Currently, there are four active cases of COVID-19 connected to San Francisco Towers: two residents and two staff. 

The former roommate of the resident, who had originally tested negative, returned a positive result late on April 24. This resident, as well as the second resident in the Skilled Nursing Facility who tested positive, are in individual rooms being supported by dedicated staff in the isolation wing and “are doing well.”

The first staff member who tested COVID-19 positive has recovered and is cleared to return for work. The second staff member remains asymptomatic at home. 

A third staff member has tested positive for COVID-19. San Francisco Towers received the results today for a test administered on April 21 as part of the community’s blanket voluntary employee testing. “We are determining whether any residents or other employees might have been exposed. We are also taking steps to ensure that the employee’s colleagues receive the proper testing and take appropriate precautions,” Spence reports. 

San Francisco Towers has enhanced its employee screening process to include the additional symptoms listed by the CDC as potential indicators of COVID-19. Employee temperatures are now tested twice per shift. Employees who are not required to use medical personal protective equipment have been provided with face coverings from their supervisors to wear whenever they are in the Towers. In addition, SFT is providing cloth face coverings for employees to wear when they are off site.

Update: May 8, 2020

Currently, there are two residents and two staff who have active cases of COVID-19.  

Late on Wednesday, May 6, an Independent Living resident in the hospital tested positive for COVID-19. Executive Director Christina Spence says, “We are currently doing trace testing and have told those we know have been in contact with this resident to remain in isolation.” 

One resident previously in isolation after being found positive for COVID-19 has recovered and returned to the Resident Health Center on Thursday, May 7. The second resident who tested positive is reported to be “doing very well.” The community anticipates that this resident will also be cleared and able to leave the isolation unit soon.

Although not all test results have returned, tests for SFT team members have been found negative for COVID-19. Of the three team members who tested positive, one was cleared and has returned to work and the other two are doing well in self-isolation at home.

Update: May 29, 2020

San Francisco Towers has had no new cases of COVID-19 since our last update on May 8. The resident who tested positive on May 6 has recovered and returned to Independent Living. Currently, only one staff person remains in isolation and is expected to be cleared to return to work soon.

Update: June 3, 2020

San Francisco Towers Executive Director Christina Spence writes, “I’m so happy to report that San Francisco Towers has had no new cases of COVID-19 since May 6. All cases have been cleared since May 31.” 

During one of his daily briefings, Governor Andrew Cuomo of New York told listeners to be “socially distanced but spiritually connected.” Covia’s Spiritual Care team is responding to the challenge of the COVID-19 stay at home orders with creative solutions to keep residents spiritually connected during holy days and every day.

Holy Days

Since gathering in person is not a possibility, the chaplains have found new ways to offer Holy Week and Passover services for their communities.

At Spring Lake Village, Chaplains Jacquie Robb and Jeanne Forte have worked with a member of the Wellness staff to record services for Palm Sunday and Easter that are broadcast on the community’s internal TV channel. Bulletins are distributed to interested residents so that all can participate, including singing along with favorite hymns.

For Passover, Chaplain Meredith Cahn worked with Well Connected to develop a virtual Seder that will be offered live on Zoom on Thursday, April 9. Residents from all Covia communities as well as seniors living elsewhere can register to join by calling Well Connected at 877-797-7299 or emailing coviaconnections@covia.org. Cahn also created a coronavirus-related haggadah, available for all participants. The St. Paul’s Towers community in Oakland, where Cahn serves as chaplain, is creating individual Seder plates that will be delivered to the apartments of residents who wish to participate.

At San Francisco Towers, Chaplain Hans Hoch is assisting the community’s Passover celebration with Congregation Emanu-El via Zoom and offering opening remarks and welcome. He is also broadcasting Sunday services through the community’s CCTV.

Every day

Chaplains have been turning to phone calls and other ways of reaching out and staying connected. Chaplain Cahn from St. Paul’s Towers says, “I provide one-on-one support over every remote medium I can.” Chaplain Kevin Philips from Canterbury Woods says, “I make several calls each day and so far have reached over 80% of the community in meaningful conversations.” “People need connection; they are so appreciative of calls,” says Chaplain Robb at Spring Lake Village.

The chaplains have also adapted to using Zoom as a way to offer services and keep connected – including helping residents learn the new system. Chaplain Cahn, who had surgery in early March, says, “Since I was expecting to be on medical leave convalescing from surgery, this has happened at a perfect time to work remotely. As soon as the shelter in place orders came, I was able to start working with our amazing IT staff member, Eric Powell, to introduce residents to Zoom.”

Using Zoom provides opportunities for residents to meet for services and spiritual practices. Chaplain Forte, drawing from her Episcopal tradition, is offering an evening Compline service daily by Zoom for residents at Spring Lake Village while Chaplain Robb is offering a weekly meditation class through the Zoom application. “Fourteen people came to our first meeting!” Robb reports.

Along with providing spiritual care for residents, the chaplains are a resource for Covia’s employees as well. Many of the chaplains are providing daily emails with reflections, spiritual practices, and other resources for their colleagues. Chaplain Philips from Canterbury Woods shared his own poem, Strange Days, to emphasize that “There is nothing that can keep our hearts apart.” Another day, Lily Godsoe, chaplain at Webster House, shared a simple breathing meditation practice to help reduce stress.

Laura Darling, VP of Spiritual Care for Covia, sends a daily email to staff at Support Services (Covia’s administrative offices in Walnut Creek – now all working remotely), Community Services, and Covia’s Affordable Communities. “One of the things I hope to do with these spiritual care emails is provide a real range of ways to connect with your spirit,” she said in one of her emails, which included a link to a 10-minute meditation video, a downloadable sheet for coloring, and the link to a blog post providing support and encouragement. “These emails are meant to provide support for people who come from a wide range of religious backgrounds, including those with no religious background at all,” Darling says. “This pandemic is affecting all of us, and we need to support one another in all kinds of ways.”

Advice from the Chaplains

When asked what they would say to help those who are socially distancing take care of their spirit, the chaplains had this advice:

Chaplain Jacquie Robb, Spring Lake Village: Give yourself plenty of rest and good food; don’t worry so much about getting things accomplished but give yourself time to BE with yourself and connect with others.

Try to Zoom with each other and do things together online. For instance, I’m watching a play that is offered online with a friend from Maine. Find a routine. Keep moving your body. Pray/meditate. Ask God the hard questions (Where are you in all this?) and listen for a response.

Chaplain Jeanne Forte, Spring Lake Village: Be gentle with yourself. There will be time, when this pandemic is over, for ‘amendment of life’ things. Now is not the time to launch into demanding life changes. Keep things simple. Keep things kind. Be generous with yourself.​

Chaplain Meredith Cahn, St. Paul’s Towers: Be in regular contact with loved ones – daily, or even more often, using every medium possible. Help your parent/grandparent/whoever get on Zoom or Skype or Facetime. Exercise, eat healthy, limit news intake. Laugh when you can find it. Dance. Recognize and name your fears, and see if you can let them go.

Chaplain Kevin Philips, Canterbury Woods: Food for the spirit comes in so many forms and by so many conduits. For those I know who have faith in something, I will encourage tapping in to that. For those who are able, I encourage walks or just sitting on a bench somewhere on our beautiful campus. For those with only a phone, I suggest calling up old friends. For those with Zoom, I pass on information about how to connect with others. For those without Zoom who have a computer, I encourage them to download it and give them the information they need to do that. 

I hear myself say to people who are angry or having some other ego dystonic feeling:  “Don’t judge your feelings. That will only make it worse. Feelings are feelings and don’t have to be rational. Just accept that you are feeling that way and let it pass through you.” 

Image: Chaplains at a weekly Zoom meeting. 

To all of our Covia family,

As you are well aware, the presence of COVID-19 in our country has impacted all of us in ways large and small. Every day, the story seems to shift as another news article or chart or special report appears. Coronavirus at the same time seems at once close and also very far away. It has affected all of our lives, even if we know no one who has become infected.

Through all of the sudden changes, the social distancing, the shelter-in-place orders, I have seen how everyone at Covia has worked together to care for each other. It is a sign of the strength of the communities we have built that things have gone as smoothly as they have in the midst of such uncertainty. It is a sign of the value we place on community that we have been able to provide multiple sources of connection even as we have been required to distance ourselves from one another.

We chose the name Covia as a way to announce that we “come together on the path of life.” I can think of no better place to be on this unexpected path than with all of you.

Thank you for everything you do. Stay safe, stay well, and stay connected.

Kevin

Kevin Gerber
President and CEO

News and updates about Covia’s response to COVID-19 can be found on our website at https://covia.org/covid-19-response-and-resources/

April 13

Covia is pleased to report that there are no additional cases of COVID-19 at Lytton Gardens after the case first reported one month ago. The resident who was initially diagnosed has fully recovered. Thank you to the staff and residents whose efforts and cooperation supported the health of all. 

March 18

There has been a confirmed case of COVID-19 (also called Coronavirus) at Lytton Gardens, Covia’s Affordable Housing Community in Palo Alto, in the Arbors neighborhood. Covia, the owner of Lytton Gardens, was informed of this today, March 18th. 

Since the pandemic started, Covia has been following guidance provided by state, local, and national officials along with long-standing established protocols for infection control.  We continue to take steps to ensure the wellbeing of our residents, staff, and the public.  We have informed the Santa Clara County Department of Public Health and are following all of their recommendations.

Here is what we know:

Last Wednesday, March 11, the resident reported difficulty breathing and went to the hospital which administered a Coronavirus test and instructed the resident to return home and remain in isolation.

On Wednesday, March 18, the resident’s son reported the positive test result to Lytton Gardens’ Housing Administrator who immediately reported the case to the County and began implementing their recommendations. The resident reports that he has not had any other contact with any residents nor has staff been in his apartment for any work orders for the past 7 days.

We continue to take all available steps to control the spread of infection, based on the recommendations of the Department of Public Health and our own best practices for infection control and prevention.  This includes:

As an affordable community, Lytton Gardens provides housing and social support and is not a health care provider.

March 26

Since the initial report of March 18, Lytton Gardens has taken the following actions:

To our knowledge, there have been no other cases of COVID-19 in Lytton Gardens. One other resident tested negative for the virus. Residents have been told to call their health care provider and to keep Lytton Gardens staff informed if they exhibit any symptoms of COVID-19.

Covia will provide further updates as they are available, as well as on our COVID-19 Response webpage

Covia has been carefully monitoring the situation around Covia-19, also called Coronavirus,  since COVID-19 has the potential to be far more dangerous for older adults. We will be providing regular updates on https://covia.org/covid-19-response-and-resources/

As the news about COVID-19 spreads as fast or faster than the virus itself, we wanted to share the steps that Covia is taking to prevent viral infections – not just COVID-19, but the flu, pneumonia, and other diseases.

What Covia is doing:

Covia is experienced in providing infection control. Each Life Plan/Multi-Level Community has a dedicated Infection Preventionist on staff, responsible for developing a community response plan built on best practices and current recommendations. In the current situation, each community is following the local, state and federal health authority guidance on prevention, case definition, surveillance, treatment and facility response related to COVID-19.

All Covia staff are trained regularly on injury and illness prevention. Each year, Covia provides flu shots to staff free of charge or reimburses staff who receive the flu vaccine. Although no vaccine currently exists for COVID-19, Covia is providing staff with additional resources related to preventing the spread of the virus, and taking extra care to ensure that staff stay home when they are sick.

Finally, Covia’s Risk and Clinical team members are in contact with public health officials and provide regular updates and information to leaders throughout the organization. Sources include the California Department of Public Health (CDPH), the Centers for Disease Control and Prevention (CDC), and others.

What you can do:

Here are steps each of us can take now to prevent the spread of Coronavirus or other viral infections, and to respond appropriately in case of an outbreak.

Please take ordinary precautions:

If you are the person who is coughing or sneezing, please note: Many people have reported a mild case of Coronavirus, believing it is only the cold or flu. It is important for the health and safety of others to take even mild upper respiratory infections seriously.

With everyone’s efforts, we can significantly reduce the chance of spreading COVID-19 or other viruses. Thank you for your help and cooperation – and we wish you good health!