Tyson Belanger has slept in his office since mid-March.
Belanger, owner of Shady Oaks Assisted Living in Bristol, Connecticut, gave up his home next door to the 36-unit facility for staff members to live in during the coronavirus pandemic. Other staff are living in five recreational vehicles Belanger purchased, and still others are living in empty units within Shady Oaks as part of a two-month initiative where staff moved on site to care for residents.
In total, 17 employees have moved into or next door to Shady Oaks, at a cost of $40,000 per month. Belanger is footing the bill from his personal savings, he told Senior Housing News.
Shady Oaks is not unique. Larger providers such as Juniper Communities, Generations and Isakson Living have created staffing “bubbles” at communities to better care for residents, limit interaction from the outside, and address staffing shortages that arose from workers choosing to stay at home rather than risk exposure to the virus. In the process, teams are learning more about their buildings and leaning on each other more for general wellness.
For every large provider with the ability to absorb the additional expenses for an extended period of time with staffing bubbles, there are smaller operators such as Shady Oaks that risk financial ruin in order to protect their residents.
Staff step up
When the first coronavirus clusters emerged in Washington state in late February, Isakson Living ran scenarios to determine how to respond to the virus if it spread across the country, COO Donna Moore told SHN. The Roswell, Georgia-based operator owns and manages two life plan campuses — Park Springs in Stone Mountain and Peachtree Hills Place in Atlanta.
When it became clear by mid-March that the best way to protect residents was to limit interaction and secure facilities, Isakson asked employees at Park Springs to live on the 61-acre campus for up to four weeks. Of Park Springs’ 300 employees, 60 immediately volunteered, before any of them knew what it meant for them logistically or how they would be compensated for their efforts. After an initial commitment of two to four weeks, 90% of the initial staffing cohort signed on for extensions, and more workers joined them. Park Springs now has 75 workers living on campus, committed to stay through May 30, Moore told SHN.
Isakson purchased air mattresses for staff moving onto Park Springs’ campus. Some staff are living in empty apartments, cottages and free-standing homes. Others, including Moore, are living in tents within the facility. All are putting in 12- to 16-hour workdays.
“It is exhausting. It is laborious. It is exhilarating. It’s all of those things, but we have built such an amazing camaraderie and we take care of each other,” she said.
Four Park Springs staff members tested positive for Covid-19 in mid-March, were told to quarantine and have recovered. Two residents were exposed to the virus while visiting hospitals for separate, non-Covid issues.
“One fully recovered before we even got the results back. One is an active case that we have right now that we’re taking care of, and that individual is back on the mend,” Moore said.
A third resident died in hospice care of a separate issue, but was also exposed to the virus.
Juniper Village at Brookline, a Juniper Communities senior living and memory care facility in State College, Pennsylvania, decided to create a staff bubble because no residents were showing symptoms for Covid-19, even as confirmed positive cases for the virus continued to climb in Centre County, Pennsylvania. Leadership wanted to keep it that way, Juniper Communities Regional Director of Operations Anne Campbell told SHN. The Bloomfield, New Jersey-based operator as a portfolio of 22 communities.
Juniper worked out a deal with an RV dealership near Brookline to rent vehicles, establishing a camp in the parking lots. The volunteer cohorts were set up into smaller teams, assigned to different buildings within the campus. To date, Juniper Village at Brookline has not had any positive cases.
Generations LLC set up bubbles at two communities, Wheatland Village in Walla Walla, Washington, and Cherrywood Village in Portland, Oregon, President Chip Gabriel told SHN. The Clackamas, Oregon-based provider operates seven communities in five states, at middle-market price points.
Generations is paying associates an additional $50 per night to live in empty apartments, working 12-hour shifts and providing meals.
Having staff live in a facility is not a new concept, Seasons Living President and COO Dan Williams told SHN. Based in Lake Oswego, Oregon, Seasons 15 communities across seven states, and has a robust development pipeline.
Williams started his senior living career in 2002 as an executive director for Holiday Retirement, living in a community. Back then, Holiday hired couples as managers and co-managers for their communities, with the idea that living in a building would be the fastest way to learn about operations, work-life balance and the residents under their care.
“We rotated shifts. You’d have the manager couple work for four days and then the co-manager couple would work four days, then they overlap on one day,” he said.
In 2016, Holiday began to phase out this management model. It was a “fabulous” approach, but finding and retaining couples to fill the live-in roles became too difficult, Holiday CEO Lilly Donohue told SHN in 2018.
However, the Covid-19 experience could help resuscitate the idea of staff living on-site in senior living. Williams, for one, sees opportunity for providers to change their staffing models for a more prolonged period of time. He envisions a sustainable model of moving staff into and off site for two or three week blocks, followed by an equal isolation period, particularly in areas where it is likely that a flare-up arises.
“Let’s lock down and get our employees to come stay with us. Let’s look at that scenario,” he said.
These bubbles may be the gold standard in limiting the risk of Covid-19 but they add significantly to costs at a time when senior living operators are already trying to cope with soaring expenses.
Generations is paying volunteers living on site an extra $2 per hour, as well as increased personal time off benefits by 50%, with the caveat that staff are required to take that time off once the outbreak subsides, Gabriel told SHN.
Non-bubble workers at Juniper Village at Brookline are being put to work doing spring cleaning on campus, fetching supplies and shopping for people in lockdown, and delivering meals to the families of staff working on site, Campbell said.
This is resulting in higher expenses, although she could not place a figure.
“In our mind, the benefits of keeping people safe and healthy outweighs the cost,” she said.
Isakson is offering front-line associates time and a half for all work beyond 40 hours, as well as earning a weekly bonus stipend, depending on the role.
The provider also placed workers who did not volunteer to move to Park Springs on PTO and, once those benefits expired, immediately furloughed them so that they could collect unemployment, Moore said.
“That was a conscious decision: they’re still members of our employee body and I needed to make sure that they had some means of income,” she said.
Larger providers can weather these hits to their margins. Smaller providers such as Shady Oaks run the risk of financial ruin as the pandemic continues.
Even though Shady Oaks is receiving $343,243 from the Payroll Protection Program, as well as a smaller amount of donations from a PayPal link on the facility’s website, Belanger is still running this cohort at a loss, and called for federal and state governments to find ways to fund long-term care facilities during the crisis in a recent New York Times op-ed.
“[It’s a] pretty significant loss, but it’s not as dire as when I first got into this,” he said.