48 Hours in a Senior Living Covid-19 War Room

As the Covid-19 crisis swiftly escalated across the United States over the last two weeks, senior living providers sprang into action, reconfiguring every aspect of operations. The effort has demanded unparalleled coordination between corporate offices and community frontlines, and necessitated constant communication with associates, residents and residents’ loved ones.

Omaha, Nebraska-based Heritage Communities created a crisis communications “war room” to manage the unfolding coronavirus situation on Feb. 28 — at the time, leaders with the provider planned to meet there on a weekly basis. Needless to say, that plan quickly changed.

“Now, we should have cots in that room, as often as we’re there,” Heritage Vice President of Sales and Marketing Lacy Jungman told Senior Housing News.

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Heritage has implemented a work-from-home policy, so only 10 people are still working out of the corporate office. Three of them — Jungman, COO Amy Birkel, and Director of Community Healthcare Chris Johnson — meet regularly in the war room, where they maintain social distancing of six feet.

Jungman’s four kids are now at home rather than at school each day, so she does sometimes work remotely, but she sees value in continuing to meet in the war room as long as the pandemic conditions in Omaha allow for that.

“The best communication for us is when we’re face-to-face, so for now, we are still physically meeting,” she said.

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Jungman’s description of two recent days in the war room illustrates how dynamic the Covid-19 situation is, and how nimble senior living operators must be to stay on top of new developments, craft policies in response, and communicate those decisions across multiple platforms to a variety of stakeholders.

Day 1: Monday, March 23, 2020

The war room day began at 8:00am, when Jungman, Birkel and Johnson convened to get ready for the day ahead. On this particular day, Jungman was working remotely via Zoom. But she was patched in with her fellow war room leaders in order to prepare for the 13 back-to-back phone calls that kick off each week —- one with every community in the company’s portfolio.

At 8:30am, the calls began. The calls are intended as a chance for each community’s executive director and director of health care to talk through challenges, ask questions, and share questions from associates, residents and residents’ families. Hearing these questions each week helps Jungman identify sources of concern or confusion and craft appropriate messaging. For example, family member pushback on new visitor restrictions indicated that more communication was needed regarding the reasons behind these policies.

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Last Monday, the calls stretched throughout the morning and into the afternoon. Around 3:00pm, the war room team was on the phone with a building in Arizona, when Jungman received a news alert on her phone that Arizona’s governor was about to do a press conference related to Covid-19.

Jungman tuned into the press conference while still on the Zoom call with the community leaders in Arizona. As the governor recommended new guidelines for limiting the virus spread, the Heritage team made decisions about how to implement those practices in the senior living setting.

It was a coincidence that the war room was talking with an Arizona community at the same time that the governor’s press conference took place, but Jungman is constantly receiving news alerts from all the media markets where Heritage has communities. Local news stations are particularly rich and timely sources of actionable information, she has found.

“I downloaded all the apps for every local news station in our markets,” she said. “Basically, my phone lights up every 30 seconds with some new information, and I want to stay on top of it.”

By late afternoon, the calls with each community were complete. At this point, the war room leaders generated action items based on those conversations. One the biggest takeaways was that anxiety had started to permeate communities, with many questions revolving around building access and visitation. To resolve this anxiety, Jungman began to create a frequently asked questions document based on the inquiries that executive directors were hearing most frequently.

“I knew that we needed to create FAQs for staff, but also for residents and family members,” she said. “Because even though we’re limiting visitors to our communities, sometimes the family members say, ‘Okay, great, I’m not going to come in, but I’m going to have my mom come out, and I’m going to pick her up and then we’re going to go through the drive-thru at McDonald’s or go here or there — Hobby Lobby is still open, so I’m going to take her out. And it really negates the purpose of limiting visitors.”

Communication around this issue was important because Heritage residents do have the right to come and go from the buildings that they call home, Jungman emphasized. So, she worked with her colleagues to craft a message to more clearly educate family members and residents about the risks involved in going out.

Carefully crafting the message is critical because the FAQ doc would just be the starting point — the same information would be adapted for letters, social media post, website updates and other forms of communication.

“There [are] a lot of next steps that come from those 30-minute calls,” Jungman said.

After leaving the war room, her work day continued, as she had to work through crafting the communications in various forms and formats and determining the best ways to cascade the information across the enterprise. Jungman also has to provide ongoing support to sales teams.

“It makes for late days, long hours, but it’s critically important stuff,” she said.

Day 2: Tuesday, March 24, 2020

Jungman, Birkel and Johnson again convened in the war room to start the day. They reviewed their markets for newly confirmed cases of Covid-19, to update a war room white board that has running tallies. They then determined where they stood on action items from Monday and set goals for what to accomplish on Tuesday.

The next 90 minutes were devoted to an executive team meeting, which saw the company’s owners, CEO, human resources and finance leaders join the war room. This team discussed the lessons learned through the community calls that took place on Monday. They concluded that communications needed to create more unity among residents, families and staff, and Jungman was tasked with creating a multi-channel marketing approach to reach all those audiences and get everyone on the same page.

“It’s all about unity,” Jungman said. “We are standing united to make sure that our loved ones are safe. That means I’m going to limit my visitations to see my mom. That means me, as an associate, I’m going to scrub up, and I’m going to use soap and water every single time I go into a resident’s apartment. I am going to do what I can to limit the potential spread of Covid-19 in our buildings.”

In particular, Heritage leaders wanted to proactively combat any “us versus them” conflicts between the company and residents, or residents’ families. For example, a resident should not feel that Heritage is handing down orders that stop them from seeing their loved ones — instead, residents should feel that they are on the same team as Heritage associates, all pulling toward a common goal.

After the executive meeting, Jungman finished the third draft of the FAQ document she began on Monday. These sorts of documents require multiple drafts to be sure that the messaging reflects the priorities and values of stakeholders from across the company, including clinical and human resources teams.

Next on the war room agenda for the day: a meeting of the pandemic planning committee. For this meeting, Jungman, Birkel and Johnson were joined by a handful of other company leaders, to go over logistical considerations and develop strategies and contingency plans. For example, the corporate dining director brought up the possibility of styrofoam running low, which would complicate the newly implemented practice of passing meals in residents’ apartments rather than in communal dining rooms.

The planning meeting lasted about an hour-and-a-half, and was followed by an hour-long call with all of Heritage’s executive directors. For roughly the first 30 minutes, the war room team shared information based on what the pandemic planning committee had discussed, and then EDs asked questions for the next half hour. These questions help clarify policies around certain scenarios, such as how long an associate should stay away from a building after developing a fever. The war room team does not always have ready answers to questions, but the discussion is still critical in developing answers or providing guidance.

For instance, in response to the question about an associate who develops a fever, the current approach is to evaluate each situation on a case-by-case basis any time a worker presents with questionable symptoms. If an associate presents with a fever, that person would be sent home or told not to come in, and the executive director at that community would call Johnson to discuss the details. Johnson is fielding a lot of calls each day, but the company wants to proceed cautiously so as to ensure resident health and safety.

“There’s just a lot of unknowns that we’re trying to navigate through as best as possible,” Jungman said. “What we’ve found is communication — proactive communication — has been our best resource.”

In the interest of being proactive, Jungman spent the last part of Tuesday drafting a press release, communication to family members, and general messaging to go out in the event that someone in a Heritage building does receive a positive Covid-19 diagnosis.

“While I hope I never have to use these documents, I feel they our best way to help family members join us and stay united is communication,” she said. “I finally got out of here at probably eight o’clock, but it was well worth it to go home knowing we had some form of communication, at least in draft form, in the event we [have] a confirmed case.”

Although these two days demonstrate the general structure of Heritage’s response, a “typical” day does not exist in the midst of an unfolding crisis like Covid-19, Jungman stressed. She and other company leaders are continuously on alert for developing situations in any of their markets that would demand a quick response, and for that reason, Jungman, Birkel and Johnson meet seven days a week.

While the three of them are working hard in the war room at the corporate office to spearhead and coordinate the company’s efforts, Jungman also emphasized that the spotlight should shine most brightly on those working on the frontlines of the pandemic in Heritage communities.

“I really want people to know that it is the folks at the building level that are really on the battle lines of communication, of calming anxiety and executing on all these new changed strategies and protocols,” she said. “So, they’re really the ones that deserve the credit and the accolades.”

It was the input from leaders at the community level that first gave rise to the idea of a communication effort to unite team members, residents, and families. Now, one week after those war room calls occurred, the “Heritage United” campaign is up and running, having launched with the video below:

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