During my six years as the Executive Director of The Clare, my focus has always been on taking one step at a time, remaining focused on challenging the status quo and moving The Clare forward. This has meant solving the day-to-day issues that arise, creating opportunities for our workforce and delivering a level of service to our residents that is unmatched. Back in February, The Clare had a fantastic month of operations. We recorded several sales and move-ins, occupancy was at an all-time high and all of our staff positions were filled. I anticipated that 2020 would be another extremely successful year for The Clare.
Then COVID-19 happened.
When I step back and think about what I look for when I hire directors, managers or employees, I assess their character and potential based on one question in particular: If they fell into the deep end of the pool, could they survive? To me, that means if everything they know falls apart, are they able to quickly adjust? Can they be creative? Can they think outside of their current job and do somebody else’s? How resilient are they? Now, in this scenario that I play out during an interview, I am mostly thinking about day-to-day operational challenges, not a pandemic. But the reason The Clare has managed COVID-19 successfully is that our team was unknowingly built for it.
As of this letter, The Clare has dealt with 16 positive employee cases of COVID-19 and four positive resident cases. We have not had any deaths associated with the virus, and 90% of the positive cases were asymptomatic and identified during mass testing. I am not willing to “celebrate” our overall good record and how we are managing COVID-19. We have learned COVID-19 seemingly lurks around every corner. Constant vigilance is required. For transparency, I think it is important to share what I think were critical decisions we have made, some that in hindsight were right and others we might have carried out differently.
On March 9, Illinois issued a state of emergency related to the spread of COVID-19. By March 13, the state issued another warning that deemed congregate settings as very risky for the spread of the virus. Within a few hours of that release, Francesco Tardio, Director of Dining Services and Hagop Hagopian, Executive Chef already had a plan in place to shift dining operations to delivery and pick-up only.
Around the same time, our Director/Management team met every morning in The Grafton. This functioned as our COVID-19 task force to quickly adjust to feedback and new information from the Centers for Disease Control and Prevention (CDC) and the Illinois Department of Public Health (IDPH). Within a few days, we halted all community programs and restricted visitor access.
We always felt that if the virus was going to get into The Clare, it would come from our employees. The biggest threat we faced was that many of our employees work in other retirement communities and nursing homes. We therefore made a decision early on that if an employee worked at another community, we would not allow them to also work here.
Additionally, we documented employee spouses who worked at other communities, tracking cases in these facilities. If an outbreak was reported at a community in which one of our employee spouses work, we required our employee to quarantine for 14 days. Likewise, if an employee, spouse or someone else in the household experienced any symptom, however minor, we had them quarantine for 14 days, as well.
Throughout March and April, we had close to 100 employees stay home for a variety of different reasons. Safety was our greatest priority, and we made the crucial decision to take absolutely zero risks with our staff. If we were even the slightest bit concerned about an employee’s health, they stayed home.
At this point, we played out worst case scenarios to determine how we could deliver essential services with the lowest number of employees. We even purchased 100 sleeping bags, just in case we needed team members to spend the night at The Clare.
PPE and Masks
Looking back, I realize we were never prepared for this type of situation. I have been in communities dealing with minor infectious outbreaks, but with those, we were able to isolate the resident and immediately stop the spread. While we were always ready for those type of occurrences, COVID-19 presented challenges we didn’t expect. We quickly scaled our supply of personal protective equipment (PPE) and found new outlets to source various items. This started by identifying our current inventory and establishing what our “burn rate” is for specific items. Masks and gowns became the hardest to source. The Federal Emergency Management Agency (FEMA) sent us trash bags for gowns, and we purchased rain coats, scarfs and other makeshift gear to protect us in case we ran out of PPE.
In the beginning, it wasn’t perfect. We had to be very strategic on how PPE distribution while still protecting our residents and employees. Fortunately, Life Care Services (LCS) was able to do much of the heavy lifting and found reliable sources for PPE. Currently, we track PPE every day, and we now have a year’s worth of supplies.
In early April, we made it a requirement for residents to wear a mask when in the building outside of their apartments. We provided washable masks to the community. As we have learned more, that recommendation and our residents’ willingness to follow that guidance has likely saved lives.
Early in the pandemic, COVID-19 tests became gold. Everyone was looking for them, trying to establish connections with labs to produce timely results. We heard on the news how readily available tests were, but the reality was much different. We had employees with a symptom that could never get tested. A few of our employees were out for nearly six weeks awaiting a test.
While testing has certainly improved and we now we test every employee each week, we still face a 48-hour delay in getting results. The incubation period of the virus means the test becomes outdated the minute you get the results. The Centers for Medicare and Medicaid Services (CMS) is working on sending retirement communities instant testing, which will go a long way in our ability to reopen.
I could write for days about this virus and its overall impact on the community. Oftentimes we have felt like we are flying blind, unaware of what’s to come. Our motto has been to make the best decision today, for today. We are lucky to have the unwavering support of our residents and their families. For that, I am eternally grateful.
When you move to The Clare, you expect the very best. This is the brand The Clare has built over the last 10 years. Our world has changed, and The Clare has changed with it. But you should have great confidence in knowing The Clare will consistently rise to the top. I look forward to seeing you all very soon around The Clare.