48 Hours With A Senior Living Executive Director on the Frontlines of Covid-19

Like other senior living executive directors across the United States, Max Rheinhardt III had to scramble last month as the Covid-19 crisis escalated. With this staff suddenly down by about half, he moved quickly to secure The Firs, an independent living community operated by MBK Senior Living.

Now, the challenges remain intense, but they have changed. Staffing is still down, but a “new normal” has been established at the community. Today, maintaining vigilance and boosting morale are two of Rheinhardt’s toughest jobs as the pandemic grinds on.

Rheinhardt is used to big challenges. When he assumed his duties in October 2016, The Firs was struggling, but as of last year it boasted the lowest turnover and highest staff satisfaction in MBK’s portfolio.

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Irvine, California-based MBK owns and manages 33 senior living communities consisting of approximately 3,800 units in California, Oregon, Washington, Arizona, Utah, and Colorado.

The hardest thing about social distancing is one of the biggest tools residents have for reassurance is a hug, and we can’t do that right now.

The Firs Executive Director Max Rheinhardt III

As of April 15, The Firs had no positive Covid-19 cases. Rheinhardt is trying to steer with a steady calm and clear communication in order to dispel any misinformation about the outbreak and the response from public health authorities.

To learn more about how The Firs is handling its Covid-19 response, SHN spoke with Rheinhardt on Thursday, April 9. He painted a picture of two of his days on the job. One day occurred relatively early in the Covid-19 crisis, and the second day was more recent, showing how the day-to-day experience on the frontlines of the pandemic has changed.

Day 1: Monday, March 16

Rheinhardt began his workday around 7 a.m., reviewing emails from MBK’s corporate office with guidance and recommendations for securing communities in response to the virus’ spread.

That guidance was the focus of Rheinhardt’s 9 a.m. meeting with his leadership team, he told SHN.

Rheinhardt also had to contend with a reduced staff. The Firs employs seven directors and 33 front-line associates — the majority of them teenagers. As Washington state became the first epicenter of the pandemic in the U.S., The Firs lost 20 frontline workers whose parents asked them to stay at home.

“You have to respect that,” he said.

Rheinhardt’s 9:30 a.m. meeting with the full team focused on easing their fears about working in an environment full of people in higher risk demographics to have serious repercussions from Covid-19, sharing the guidance from MBK corporate and addressing questions from the remaining team members.

“Our big challenge for this one particular day was getting everybody to understand the severity of the situation, because there was a lot of misinformation out there. I was going to spend the day managing this information and trying to get everybody to the same level of understanding that we need to socially distance ourselves,” he said.

After the meetings, staff spent the morning securing doors and establishing a dedicated entrance and egress point for the building, setting up a hand washing station outside for visitors to wash their hands, and rolling out screenings for Covid-19 symptoms and temperature checks for residents, staff and essential visitors.

The Firs also secured its dining rooms and worked to establish meal deliveries to residents in their rooms. For this, Rheinhardt was able to draw upon past experience guiding The Firs through renovations, when elevators were out of commission for maintenance, making it impossible for some residents to reach communal dining areas.

“We just modified some existing plans and made them fit for the situation we were in. We had a good outline for what we were going to do,” he said.

With that out of the way, Rheinhardt turned his attention to The Firs’ supplies. Personal protective equipment was inventoried. Dining serviceware was scrapped in favor of disposables. And inventory was relayed to MBK corporate so that replenishments could be ordered or secured from other communities with ample stock.

In the midst of this hectic day, he also had to contend with the realization that The Firs’ operational departments no longer existed as they did before the pandemic. Sales and marketing staff would be asked to pitch in on housekeeping. Dining staff will take on maintenance duties. Everyone is juggling multiple tasks now, which Rheinhardt calls a “new normal.”

“There isn’t anyone on the staff who isn’t willing to do a job that is asked of them, from taking out the trash to vacuuming the floor to delivering a meal,” he said.

In the afternoon, Rheinhardt and his leadership team reached out to residents and their families, explaining why these new measures were being implemented, as well as to address any misinformation they were hearing about the situation. Emails about the measures were sent to residents, staff and families through VoiceFriend, a communications platform used by The Firs.

Finally, knowing that staff is in a high-risk demographic as essential personnel, Rheinhardt established an employee assistance pantry, stocked with essential foods and items such as toilet paper for staff to take home as needed, so they would not have to risk their health shopping for these items in supermarkets.

This is not anything that any of us wants to have to do, but it’s a have-to, because we love you. And we need you to be safe.

The Firs Executive Director Max Rheinhardt III

“I have an obligation to my residents, their families and to my team members. But I also have an obligation to my team members’ families as well, because they’re the ones providing for their families,” he said.

Rheinhardt spent late afternoon and early evening holding individual conversations with residents, families and concerned team members, assuring them all that he had things under control, and projecting an even keel as a new reality set in.

“You can’t get too swept away emotionally. Everyone is taking cues from me on how to react. I needed to assure everyone that this needs to be taken seriously and convey that not just with your words, but your demeanor. This is not anything that any of us wants to have to do, but it’s a have-to, because we love you. And we need you to be safe,” he said.

Rheinhardt was able to leave The Firs around 6 p.m. and arrived home at 7 p.m., where his wife had dinner waiting for him and encouraged him to not think about work for a few moments.

“I’m thinking about the next 15 things I’ve got to do in the morning. My wife is pretty notorious for telling me not to try to take on the whole situation, just take it one piece at a time,” he said.

Day 2: Thursday, April 2

Nearly three weeks after The Firs was secured, the challenge for Rheinhardt and his staff shifted to maintaining vigilance for signs of coronavirus entering the community, finding ways to engage residents chafing at being isolated, and not becoming complacent.

On this day, it became apparent to the team that its response to the pandemic would not be short lived. Inslee extended Washington’s stay at home order through May 4. This created another hurdle for Rheinhardt to clear during the 9 a.m. executive team meeting and 9:30 full staff meeting.

By this point in the pandemic, The Firs’ residents and staff had become acclimated to this new normal, so Rheinhardt’s advice to his team was to not let its guard down.

“One of the things that we focused on in that director meeting was ensuring that we weren’t getting too comfortable with [the situation], that we were still sanitizing as ferociously as we were when it first started. And it was [owning] accountability — are we taking the steps that need to be done?” he said.

In a nod to the social distancing guidelines at the foundation of the response to the pandemic, meetings were now being conducted over the video conference platform Zoom. Leadership, in turn, relayed the main points of the executive meeting to their teams via phone, texts or video chats.

There isn’t anyone on the staff who isn’t willing to do a job that is asked of them, from taking out the trash to vacuuming the floor to delivering a meal.

The Firs Executive Director Max Rheinhardt III

The Firs is still operating with its staff at half its usual capacity. So far, Rheinhardt has not seen a need to fill in gaps through temporary labor. He is reluctant to engage temp labor given the effort to keep people out of the community who may have been exposed to coronavirus. Mainly, everyone is still pitching in where needed, and without asking.

“We’re still fully operational with the staffing that we have for what services that are provided at this point. There’s not been a drop off [in service] and there’s no massive overtime [increases]. Nobody’s having to give too much themselves,” he said.

That goes for executive directors as well. To provide some respite from being on the front lines, MBK’s corporate office instituted a new policy where executive directors had the option of working from home one day a week.

“It’s actually proven pretty pivotal, because you’re able to work from home and make some of those [necessary] phone calls uninterrupted. Get all that stuff out of the way so that you can be one hundred percent [on site] the rest of the week,” Rheinhardt said.

Throughout this day, as he does every day, Rheinhardt communicated directly with residents and their families when the need arose. He also makes time to check in with other MBK executive directors to share best practices and inquire on sharing supplies when available.

To ease the sense of isolation residents are struggling with, The Firs was able to acquire laptop and tablet computers, so they can communicate with each other and loved ones. The Firs has even moved activities such as bingo nights to Zoom.

The Firs has tweaked meal service so that everyone is receiving their choice of meals in a timely fashion, and so that meals are still hot for residents who live at the furthest reaches of a passageway. Staff is conducting and recording daily resident check-ins for symptoms of Covid-19.

And Rheinhardt is reassuring residents that, while it is uncertain how long they will be limited to their apartments, it will eventually end and that this is being done to keep them safe.

“We don’t want them to be stuck in their apartments any more than they. It’s challenging for residents. I’m constantly asked, ‘can I do this or that’ and explaining what the guidance is and why they need to follow it,” he said.

I have an obligation to my residents, their families and to my team members. But I also have an obligation to my team members’ families as well, because they’re the ones providing for their families.

The Firs Executive Director Max Rheinhardt III

The Firs has started assisting residents to go on walks, on a staggered schedule with social distancing in mind. This has lifted their spirits as they have struggled with a new sense that this will be a long period, Rheinhardt said.

The Firs staff added hallway exercises as a way to get its residents mobile, and to encourage interaction at a distance, as well as a door-to-door ice cream sundae bar for residents to interact with staff.

“The hardest thing about social distancing is one of the biggest tools residents have for reassurance is a hug, and we can’t do that right now,” he said.

While these two days highlight how busy an executive director is during regular work hours, Rheinhardt’s job is not over when he leaves the community.

“This is 24 hour, seven day a week business. If there’s an opportunity to acquire facemasks, I’m not going to wait until tomorrow morning to take care of that. If it’s 10 o’clock at night when an email comes in or two o’clock in the morning, you have to act. You know a lot of this stuff is time sensitive. Making sure to jump on it right away is critical,” he said.

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