May 22, 2020
Re: Covid-19 Update and Phased of Easing of Restrictions
Dear Residents, Families and Staff,
The last few months have been a challenging time for us all. At Cogir, we have been responsive to the extraordinary recommendations by public health officials and diligent in our enhanced safety protocols in an effort to prevent the potential impact of the novel coronavirus in our communities. I am proud of how we have come together as a team of residents, families and staff rising to this moment. We have been diligent in our safety measures, and while they have been necessarily restrictive, we have received incredible support from you in recognition of our efforts. Our primary goal throughout this time has been and always will be the safety of all that live, visit, and work within our communities.
With that, we would like to share an update on the effectiveness of our response to the coronavirus thus far. Early on, in the second week of March, we learned that one of our staff members in a Washington based community had tested positive for Covid 19 after having been exposed to the virus outside of our community. This occurred at a time before the ability to obtain adequate levels of personal protective equipment (PPE), and private lab testing was extremely difficult to obtain. We were unsuccessful in convincing the health department to widely test our staff or residents as they proclaimed that only symptomatic staff or residents would be tested. This was disturbing to us because we felt that as a precaution, we wanted to know if any other of our staff or residents had contracted the virus in order to get them the proper care and importantly, to isolate them away from any others. Ultimately, this led to a total of 27 residents and staff that eventually tested positive in that community.
But this experience enforced our strong belief that active precautionary asymptomatic situational testing was key to tracking down potential carriers and preventing further spread. It also shows how effective the combination of disinfecting, PPE and testing can be to tackle even a small outbreak, stop it in its tracks, and keep a community safe. Through diligent means, we were able to contract with multiple testing firms enabling widespread testing in our communities. We have been testing when we believe that a resident or staff member has tested positive outside of the community or has come in close contact with a positive carrier of the virus. To date, this approach has resulted in us conducting over 600 tests, and we will continue to conduct testing when we have indications that warrant it.
As a result of this approach, beyond the 27 positive cases noted earlier, we have only experienced 11 other positive cases in our company which has over 2,300 residents and staff. This is less than one half of one percent of our other residents and staff members. In fact, 50% of our communities have yet to see a single case. This is a tremendous result and truly a testament to the remarkable heroes working in our communities, coupled with a highly effective combination of protocols, use of PPE, disinfecting and testing.
While Covid-19 has been disconcerting for us all, we have found that the traditional protocols that we implement for flu and norovirus work exceptionally well when combined with our new enhanced safety protocols. Some of these protocols have included:
- Residents staying in rooms as much as possible
- Dining room closing and food delivery
- Limiting visitors to essential personnel
- Screening of all staff, visitors and residents
- Increased the cleaning and disinfecting in our buildings
- Requiring all visitors and staff to practice handwashing or sanitizing as they enter and exit the community
- All staff in all positions wearing appropriate personal protective equipment (PPE)
- Widespread Covid-19 testing as needed
As we start to consider our new normal and look into the future until a vaccine is widely available, it is becoming clear that each of our buildings will experience varying levels of infection control protocol at times. As a result of these recent experiences with coronavirus, we know that if we see an active case in a community, we have demonstrated the ability to implement situational controls like we have experienced in the past during a flu or norovirus outbreak.
We take comfort in the fact that our measures have allowed us to avoid positive cases in half of our communities, only isolated cases in several others, and stop the spread of Covid-19 where we experienced it first with quick and decisive action. We are convinced that our residents and staff are safe in our communities and challenge the media’s perception of seniors housing. We are an active voice throughout the industry and stay in very close contact with the scientific community throughout the country. This enables us to remain highly informed about the most effective practices as more is learned about the virus, treatments and protocols. While Covid-19 is going to continue to have an impact not only on us, but on society at large, we remain confident in our ability to limit its negative impact on our residents and staff.
Because of the seasoning and experience gained over the last several months, we are confident in our staff’s ability to handle and manage infectious disease as we consider recalibrating our safety protocols. Broad phased “reopening plans” are being discussed by local governments and public health agencies. As a result, we too are taking steps to begin lifting restrictions in our buildings. Socializing is critically important to our residents, and we consider this a high priority along with the critical safety measures that will continue. To be clear, we will not be going back to business as usual for quite some time, but rather we anticipate loosening our restrictions in phases that will initially improve physical movement for our residents within the community and promote safe socialization opportunities while maintaining adherence to strict social distancing. In later phases, we will reopen our dining rooms and enable regular nonessential visitors back into the community when public health departments deem appropriate. Throughout these phases, we will follow our new rallying cry of “Space, Face and Trace.” Maintain strict spacing to adhere to social distancing requirements, ensure all residents and staff wear face masks when appropriate, and trace interactions with residents and staff so as to track contact in the event we do have a positive case necessitating tracing back to those individuals that may have been exposed.
All of our restrictions will remain consistent with or, in some cases, more aggressive than public health departments and local government recommendations. We are following local public health department guidance and sharing our plans with them so we can proceed with gradually loosening restrictions appropriately. Each of you will receive an update from the Executive Director in your community in the next week or so which will provide a road map for that building when we begin to loosen some of our restrictions.
Our commitment in managing the dangers of Covid-19 as well as the very real need for all of us to be social will be accomplished with the stepped lifting of our restrictions. We also know that with new information or unforeseen reemergence of the virus may necessitate that our best laid plans change. As we move forward, we will continue to communicate as anything changes or as we modify to our phased plan.
At Cogir, we have the safety of all our residents and team members at heart. We simply cannot be successful as a community fighting Covid-19 without you and your partnership. You have been so cooperative and understanding throughout this time, and we truly thank you from the bottom of our collective hearts.
All the best and stay safe,
March 31, 2020
Re: Covid-19 Update – Social Distancing and Programming
Dear Residents and Families,
At Cogir, we have been responsive to the extraordinary recommendations by public health officials and diligent in our safety protocols by limiting contact of our residents and team members to the potential spread of the novel coronavirus. Consistent with shelter-in-place guidelines issued in both Washington and California, we recently extended isolation measures in all of our communities. All of our actions previously taken including cancelling group activities, cancelling dining services, providing tray service to resident rooms and limiting visitation to only essential services have been implemented an effort to increase social distancing for the safety of our residents.
While all residents remain in full quarantine, we continue to monitor them on a daily basis for any symptoms of the coronavirus as has been our protocol for the last several weeks. We also continue to monitor staff for symptoms of illness including temperature checks prior to each of their work shifts. We are fortunate to have devoted team members that are committed to being at our communities daily providing residents with consistent care and attention. Team members also remain self-aware monitoring themselves for potential symptoms, communicating with their ED’s and have been instructed not come to work if they are not feeling well. Once again, the safety and well-being of our residents continues to be our primary focus during these challenging times.
The need to quarantine will remain in place for the foreseeable future, and we are working to find creative alternatives to our typical programming to keep resident’s body and mind active. Our operations teams have been delivering hallway happy hours, courtyard music performances enabling singing and dancing from residents’ balconies, and exercise videos on internal television channels. Each community has varying entertainment options and capabilities that allow residents to remain in their apartments while enjoying music, games and other activities. Staff are primarily focused on community safety protocols including maintaining a clean sterile environment, delivering meals, and performing daily resident checks. Because of that, families are encouraged to continue to engage their loved ones with frequent telephone conversations. Videos calls with applications like Facetime, Zoom, and Skype are also great ways to catch up, connect, and play games.
At Cogir, we have the safety of all our residents and team members at heart. We know you understand and appreciate the importance of the measures we have taken and thank you for your continued cooperation as we all work together for the benefit of everyone’s health and well–being.
March 17, 2020
Re: Covid-19 Update
Dear Residents and Families,
New developments and updates on coronavirus are released daily by local, state, and national health agencies and governmental bodies. Over the weekend, the governors of the states of California and Washington both took aggressive action to limit the size of gatherings closing places of entertainment and recreation statewide. Yesterday, the White House advised all Americans to avoid groups of more than 10 and urged seniors to stay at home altogether in a set of new guidelines designed to mandate social distancing measures. These conditions are expected to persist for at least the next few weeks and our management teams have been meeting daily to make arrangements to keep everyone as safe and as comfortable as possible through this extraordinary event. This is tough on everyone, and we ask for your understanding and cooperation as we look to pull together as a country and a community.
With that, we have implemented or are in the process of pursuing the following measures:
- Most importantly, we ask families to refrain from visiting communities as we need to restrict visitation to only that which we determine to be essential:
- Necessary medical personnel will be allowed (home health, hospice, etc.)
- Families will be allowed to visit for certain compassionate care situations but are being asked to eliminate social visits
- Families are encouraged to use technology such as telephone, video conferences, or mobile devices (e.g., Facetime, Skype) to remain in contact with residents. Consider purchasing an IPad and learning some of the many available applications to help keep connected to family, friends and information.
- Note that some areas of the building have limited WIFI coverage and the extra traffic on our network may necessitate activating a service provider (T-Mobile, Verizon, etc.) to connect your device vs using our WIFI if you are having connection trouble.
- Deliveries from our pharmacy and other essential suppliers will be managed by the concierge, and we are limiting delivery persons from having access into the community past the front desk. We will augment our staff as necessary to accommodate deliveries from families or providers in order to ensure everyone gets their deliveries. If you do not have a prescription service and need some help there, we can work with you on making that connection.
- Actively managing our supply chain of essential items for our operations and to meet the needs of our residents in an effort to weather a prolonged period of quarantine at our communities. We will be trying to source items of daily need in case our residents run out of such thing like toilet paper, toothpaste, tooth brushes and other items of daily need. Please notify us if you are in need and we will do our best to source those items for you.
- We are working with a private lab to gain access to limited Covid-19 testing kits that will enable us to test high risk residents and screen our staff at each of our communities in WA and CA. These tests will better enable us to identify carriers of Covid-19 and in the event we have someone in our communities that tests positive, we can make a more informed quarantining decision earlier.
- With testing in mind, everyone in the community including residents, visitors and staff MUST be on the lookout for any signs of the COVID 19 virus which include regular flu like symptoms, coughing, congestion, and shortness of breath and/or a fever. ANYONE with those signs MUST contact their doctor immediately and PLEASE LET US KNOW at once so we can help as quickly as possible. A doctor can order a test and self-quarantine procedures should begin right away until tests results are known with further treatment can be administered accordingly.
- Prepared staffing contingency plans in an effort to secure adequate staff in anticipation of labor challenges or disruptions due to schools putting pressure on our staff to be home, or symptoms that require our staff to stay home until tested or well enough to return to work. We want to take every precaution, so we expect some staffing interruptions as well as additional staffing needs as a result of having to deliver meals, packages etc. at this time.
At Cogir, we treat the safety of our residents, families, and team members as our top priority. We ask for your patience and support as our approach to the virus evolves over time. We know you understand and appreciate the importance of these measures and thank you for your continued cooperation as we all work together for everyone’s safety. Lastly, I am proud of the amazing teams, families, residents and friends that are all pulling together during this difficult time. We have staff working tirelessly for all of our residents, and we have received some wonderful letters from families calling attention to this good work. Thank you for that feedback as it rejuvenates us all and we appreciate your continued support.
March 10, 2020
Re: Covid-19 and new Protocol
Dear Residents, Families and Staff,
The Covid-19 virus and the response to it has been rapidly evolving. At Cogir, we have been responsive to the extraordinary recommendations by public health officials and diligent in our safety protocols by limiting contact of our residents and team members to the potential spread of this virus in our communities. Our goal is to continue to provide a safe and healthy environment. Currently, we do not have any presumptive or confirmed cases of the coronavirus, and we will continue to make safety and cleanliness our top priority. We will distribute updates as we have new information.
Prior to today, we have employed a multi-pronged approach to limiting contact with Covid-19 taking the following actions:
1. Actively monitoring residents and staff for symptoms of the virus
2. Screening all visitors for current or recent flu-like symptoms, and empowering our teams to prevent entry of any visitor who is exhibiting symptoms, reported recent symptoms or those having been in contact with anyone who had experienced symptoms
3. Required all visitors and staff to practice handwashing or sanitizing as they enter and exit the community
4. Limited outside activities and group gatherings
5. Closed our salons
6. Closed our salad bars and buffets
7. Increased the cleaning and disinfecting in our buildings
We understand the inconvenience this may have caused you and your families. Your cooperation and willingness to comply with these extraordinary steps has been inspiring and appreciated.
Today, Governor Inslee has distributed a proclamation focused on the safety of the citizens of Washington and prioritizing additional security measures for the senior housing industry. A copy of the decree can be found here:
https://www.governor.wa.gov/sites/default/files/proclamations/20-06 Coronavirus (tmp).pdf
Each of our communities has also posted this announcement at the front desk area of the community. For the most part, these steps are those things we have already been practicing as outlined above. However, in some cases, there are some further restrictions outlined below for additional steps for the safety of our residents and staff. We have already implemented these added precautions which include:
1. Visitors MUST be adults, thus no one under the age 18 will be allowed. (ID Is now required)
2. All visitors will continue to be screened, but now temperatures will be taken for all staff and visitors seeking entrance to the community. We will be doing this with touchless thermometers. These thermometers can sometimes produce a high reading after coming in from the outside, thus if someone has a temperature of over 100.4 initially, we will use a secondary method and confirm the temperature. If the temperature is confirmed above 100.4, a visit will be declined.
3. Approved visits must take place in resident’s room.
4. We will also be following the SAME screening procedure for our staff and our volunteers at the beginning of each shift.
5. All visitors and volunteers must sign into a log and the log will be kept on record for a minimum of 30 days. Required information will include name, address, phone number and email addresses so we may be able to contact visitors later if necessary.
6. All employees, volunteers and visitors who have passed the screening will have a sticker. Having the sticker indicates screening was successfully passed. Anyone who does not pass the screening will not be allowed to enter the community.
At Cogir, our professionals have the safety of our residents, families, and team members at heart. We ask for your patience as we work with the experts to understand the full reach of this illness and to minimize its impact on our residents, staff and our families. We know you understand and appreciate the importance of these measures and thank you for your continued cooperation as we all work together for everyone’s safety.
March 3, 2020
Dear Residents and Families,
At Cogir, the safety and health of our residents and staff members is our top priority. The recent events pertaining to the coronavirus in our area have prompted us to take extra precautions to protect our residents and staff members from the possibility of an outbreak in any of our communities. We will continue to adjust our actions based on recommendations from public health officials and our own internal health care professionals. We will distribute updates via resident, family, and staff memos as we have new information.
Here is a summary of actions taken to date:
- We are actively communicating with staff and residents regarding precautions they should take to protect themselves and the community.
- We continue to be diligent in maintaining a clean environment to help reduce the spread of germs.
- We continue to follow our existing policies and procedures related to preventing the spread of communicable disease among residents and staff.
- We have implemented visitation restrictions, including vendors and 3rd party caregivers, at all of our communities to prevent higher risk individuals from entering our community environment. Reception and other relevant employees are screening all visitors and vendors. Those who meet any of the following criteria will be asked to postpone their visit:
1. You have symptoms of illness or have been in close contact with someone with symptoms of illness, including fever, cough, and shortness of breath.
2. You have recently visited or come into close contact with someone who has contracted Covid-19 commonly referred to as the coronavirus.
3. You have recently returned from travel to any country with a CDC-issued Level II or Level III travel advisory, such as China, South Korea, Italy, Iran, and Japan. Visits should be delayed for at least 14 days after return to the US, and you can confirm no symptoms of illness such as fever, cough, and shortness of breath.
- We are investigating whether or not any residents or employees currently have upper respiratory symptoms (including fever, cough, and shortness of breath). We will ask any resident or employee with these symptoms to speak with their doctor, if they haven’t already, and based on that information, they may be asked to stay in their apartment or stay home from work.
- We are rolling out refresher training and supplemental training materials regarding cleaning protocols and infection control guidelines. We will expect each department director to review this with their employees as they begin their shift.
As a reminder, the best defense is frequent hand washing using proper hand-hygiene by scrubbing with warm water for at least 20 seconds. Hand sanitizer is useful but does not replace washing with soap and hot water. You should also avoid touching your face and keep your hands away from your nose and mouth. Health officials do not recommend wearing masks as they say it will not stop the spread of the virus and it reduces important resources from health care professionals.
Once again, we are working closely with our team members, remain committed to the safety of our residents, and we have regional clinical teams in place that can support our communities. We will continue to keep you updated as needed and please feel free to reach out to me or your community’s Executive Director if you have any questions.