Do not expect a “return to normal” for senior living move-ins as the nation gradually reopens during the coronavirus pandemic.
New residents will need to be prepared for testing prior to moving in, quarantine periods before joining the larger census and the continuation of virtual tours and sales processes in searching for the right community. And communities will not fully reopen to non-essential personnel, especially in states that have seen spikes in positive Covid-19 cases in recent weeks.
Testing will be a linchpin in many providers’ move-in procedures. Charter Senior Living demands a “double negative” test before new residents can move-in, COO Jayne Sallerson told Senior Housing News.
Other providers, such as Thrive Senior Living, are advising new residents to move in as soon as they receive a negative test result.
Coupled with heightened infection control protocols, this is another sign of how deeply Covid-19 has disrupted the industry in just a short span of time, and the lengths that the industry is taking to ensure the health and safety of residents, build trust with them and their families, and work to improve occupancy rates that took significant hits in the early weeks of the pandemic.
As with infection control protocols, move-in guidance is not one size fits all. Providers will need to be on top of federal, state and local public health department guidance to amend their procedures accordingly.
Testing and quarantine periods
Charter — which operates a portfolio of 18 communities in nine states — has not stopped accepting new move-ins since the pandemic spread, except in cases where there was a positive case and a community was in quarantine.
After the hectic early weeks of the pandemic, the provider’s regional teams now studies all new move-ins on a case-by-case basis, identifying factors that could introduce the virus to a building, such as a transfer from a rehab or acute care setting, a new resident moving in from out of state, or if a move-in is leaving home for a need-based move.
Once that has been vetted, Charter tries to get a double negative test result from the prospect. If a person is making the move to senior living from home, the provider will test the person at home. Then, a follow-up test is conducted just outside a community’s entrance, Sallerson told SHN.
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If a new resident is entering from a congregate setting, Charter demands that providers conduct a test and share the results before moving forward. If that first test is negative, the second test will be conducted outside a community.
This can be challenging for a provider with Charter’s footprint.
“Every local health department is different about what you can do. We try to make [procedures] as strict as possible,” she said.
After testing, Charter’s new move-ins are quarantined in what Sallerson calls “transitional wings” for 14 days. These are named as such in part to reassure families that their loved ones’ wellbeing is the priority, as well as to contain any potential positive cases that emerge during the quarantine period.
“It’s been pretty successful. If someone tests positive, we just continue to isolate in the transitional wing,” Sallerson said.
Atlanta-based Thrive, which operates 17 communities in eight states, tests all new prospects for Covid-19 and, upon receipt of a negative result, requests referrals to move into a community within 24 hours of the test result, Chief Sales Officer Nicole Moberg told SHN.
“We want to control their environment. If they do a test and they test negative, but then they’re home for another couple weeks, it defeats the purpose of testing,” she said.
Upon arrival, new move-ins are isolated for seven days and re-tested. If the results are negative, they can then join the rest of the community.
During the pandemic’s early days, Thrive did not accept new move-ins from congregate settings but has relaxed that policy as it became clear that it would be hard to find a congregate setting that did not have a positive Covid-19 case.
Omaha, Nebraska-based Heritage Communities has welcomed new move-ins throughout the pandemic, but only tests for Covid-19 on a case-by-case basis. Part of this is due to increased margins for error in results, depending on the type of test used, Corporate Director of Sales and Marketing Lacy Jungman told SHN.
She noted that Heritage has seen resident tests return false negatives and false positives, which can complicate the move-in and isolation process.
“[Testing is] a snapshot of time, they could test tomorrow again, and have a different result,” she said.
Heritage, which operates 13 communities in Arizona, Iowa and Nebraska, places all new residents in a 14-day quarantine, working under the assumption that a move-in is positive until proven negative. During that time, staff tending to them are decked out in full personal protective equipment.
“It’s certainly not the ideal situation that we want to onboard a new resident with. But we also are tasked to provide those residents that live with us currently a safe environment,” Jungman said.
Stronger sanitation procedures
Providers are taking extra precautions to ensure new residents’ living quarters and possessions are cleaned and disinfected upon arrival. And with communities restricted to essential personnel, the responsibility to move a new resident’s possessions into a building now falls to the staff.
Thrive conducts curbside sanitation for belongings. A second round of disinfecting is conducted before a new resident exits quarantine, Moberg told SHN.
Although families are restricted from buildings for the time being, they still have input as to where a loved one’s belongings are situated in an apartment through the use of real-time virtual interior design sessions, led by a staff member in the suite.
Charter is also cleaning and disinfecting the possessions of new residents upon arrival, followed by a second round of sanitation when moving belongings to a suite.
Heritage contracted with a single moving company to handle transporting the possessions of new move-ins to a facility in Arizona, and a couple in the Midwest. These movers are taught proper donning and doffing of PPE, and enter and exit from designated areas within a building, using push button access, Jungman told SHN.
This move could prove beneficial for Heritage’s Arizona communities. The Land of Enchantment is experiencing a surge in positive Covid-19 cases since the state lifted its stay-at-home orders on May 15.
Heritage’s three Arizona communities are located in Maricopa County, which is the epicenter of the state’s Covid-19 surge. Nearly 36,000 Arizonans have tested positive for Covid-19 and 1,188 have died from the disease as of June 15. Maricopa County accounts for nearly 21,000 positive cases and 540 deaths.
“We are, in a sense, auditing during those moves and then cleaning right behind them when they leave to ensure that there is some form of infection control happening at those buildings,” she said.
The added complexity to the move-in process is not deterring providers from accepting new residents, now that the massive disruption of the pandemic’s early weeks subsides. The severe occupancy declines that swept the industry in late March and early April have stabilized, and some communities are even reporting occupancy gains, according to the latest executive survey insights report from the National Investment Center for Seniors Housing & Care (NIC).
With more states relaxing shelter-in-place restrictions, operators are now turning their attention to rebuilding occupancy rates and many are looking to resume move-ins within the next 30 days.