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Episode 107: Coronavirus Update with John Sims

John Sims of TIS Insurance discusses resources, tools and precautions that senior living operators should take regarding the Coronavirus. 

Argentum’s Coronavirus Toolkit
CDC Healthcare Professionals: Frequently Asked Questions and Answers


Lucas: Welcome to Bridge the Gap. It’s a special edition of Bridge the Gap here at the NIC Conference. Lots of conversation going around about the coronavirus and it’s a very interesting conversation, a very needed conversation at the time as many of our communities and operators and investors in the industries are a little bit scrambling to get ahead of this so that they’re completely prepared. 


We reached out to no other than our friends and partners at TIS. We’ve got John Sims on the program. Thanks for joining us. 


John: Absolutely. Great to be here guys. 


Lucas: We’re here at the energy of this conference. There have been a number of groups that have put some travel bans out there. It’s not gone unnoticed and we’re continuing to watch this unfold day by day by day. And while we don’t know exactly how this is going to play out, we want to talk about preparedness. 


John: Absolutely. 


Lucas: So, Josh, do you want to help drive this conversation? 


Josh: Yeah, so, you know, I think as you alluded to, Lucas, a lot of groups are not here, particularly operators. They’re very concerned about their communities. You know, the conversation has centered around, you know, while they’re not as concerned about themselves, for many of them it’s that their workers are healthy. But also a lot of the unknowns about the transmission of this virus, how contagious it is and it eventually hitting our elders, our residents, the ones that we care for that have been entrusted to us to care for and this hits them potentially really hard. 


So, for those that aren’t here and are here are talking about it, so we thought we should be talking about it which is why we’re having this special edition. So, TIS is a trusted partner helping communities, no how to mitigate risk in a variety of areas and providing resources. Obviously, none of us, including John, are clinicians but he is a representative of TIS and a trusted resource. His team is an excellent resource out there out on the frontlines in the communities with training and education. 


So I think one of the things we wanted to talk about, John, is just education in general and there’s more than just education of our residents and the team members, but it is a great time to talk with our team members about education. So, what are some of the things and resources you are putting out about education? 


John: No, absolutely, and I want to start by thanking our clinical team because I’ve spent a lot of time with them. They’ve done a ton of research. They’ve been the ones to drive, whether it be email blasts of phone calls to specific clients, communities, etc. They’ve done a wonderful job and certainly have utilized the tremendous resources of the CDC and the state associations so I don’t want to lose track of what they’re doing which is incredibly impactful and great information. 


Certainly, we’re trying to hone in on specific points: Education, screening, reporting, communicating. Educating with the residents, education to the team members, education to the families which is hugely important once you adopt new policies and procedures or re-up some of your policies and procedures. In the capacity, I think the more proactive you are with families, certainly the much easier it is going to be able to do things like potentially having to close a building to third parties. 


You know, the screening: residents. Absolutely. You need to be screening every resident. That’s a huge piece of what we’ve been talking about. If for, whatever reason, the state were to come in for a reinspection or something like that, they’re going to be hyper-aware and hyper-focused on anything from washing hands to a resident that seems to have elevated an element of exponential coughing, or something along those lines. 


Reporting anything you see, any resident that you don’t think is right way, obviously, you want to report that immediately. So that’s the pillars. 


And communication, communication daily. This is not- you don’t keep waking up thinking this is it, they’re gonna have a vaccine, this is going to go away. We have a population that is more impacted by this and the more you communicate with your team from top to bottom, so from corporate office to the communities, to the families to the residents, that’s what we’ve been stressing, you know. Policies and procedures need to be in place, but that communication, that evaluation, especially with the boots on the ground team members, is hugely important. 


Josh: So, you touch on a variety of things. We could talk all day on this topic, but one particular thing. All of our operators that have ever closed down a building as far as quarantining a building and closing off to third parties coming in, non-critical care members coming in, know how difficult that is on everybody including the residents, the family members. I think to that point, communication and education of all those groups really goes hand-in-hand because I think we take for granted sometimes those of us that are in the industry, that are in communities, sometimes we don’t communicate great with each other, but often times, we don’t educate and communicate to those family members who have entrusted their loved ones to us who really don’t understand sometimes what we’re doing but in particular why we’re doing it. So educating them around that. 


I think you made another interesting point as regulators are coming in even if they’re coming in to investigate something non-related, you know, in most states you’re judged not only by the regulations, but also by your own policies and procedures. And sometimes it’s opportunities like this that we have to reevaluate those policies and procedures, to audit, to make sure that we are using the best connection controls, policies and procedures and those standards. 


But I have to imagine, John, I don’t know if you’re hearing anything, but we’ve heard just rumbles, and you never know what’s gossip or what is just truth to it, but that CDC and the federal government and state governments are going to start probably implementing some requirements for communities from a regulatory standpoint, putting some things in place even from an emergency standpoint if it gets to that point that may require an overhaul of new policies and procedures and we know how critical it is to take your time and understand how to craft those policies correctly. 


John: Oh yes, absolutely. Policies and procedures are the baseline for what we do. In your communities, that’s the core of kind of how you set the baseline, again, for resident care, which is really what everyone does. So, 100%. Reeducationing is super important, making sure that policies and procedures are up to where they should be because the federal government, to your point, if they’re going to come and do routine surveys for some length of time, I mean they’re doing it because they’re honing in on this. It’s a tremendous issue and it’s top of the line. 


So, in my opinion, there will be some trickle down of some additional requirements in the future, but it’s a great opportunity for you to reevaluate, I mean, at the bottom line, all of your residents, all of your policies and procedures, all of your team members. And there’s certain things during this period of time, simple things. Washing hands. Again, if a resident is progressing in a way that you think this needs to be reported to your health department, you’re much better off to be proactive and report that. 


And to the initial point, we always talk about setting expectations, totally outside of what we’re talking about today. When a resident comes in your building, absolutely you want to set the expectations of what you’re trying to provide, your care model, your care plan, etc. and with this, you absolutely want to communicate with the families and be proactive with what you’re doing to mitigate any potential situation where let’s say one resident was, you know, impacted with coronavirus and all the sudden 27 have it. As a family member, that’s the last thing you want, so I think to be proactive on that front, set those, in this case it’s not expectations, but just communicate and explain to them what you’re doing to be proactive. 

Josh: Yeah, I think that’s huge. Lucas, kind of switching gears, in your day job and renovating communities and working in this population, we’ve even talked even at the renovating level how critical at communication, educating not only the residents and the team, but those family members on what you’re doing in the community and so forth, this is another example of that. 


You know, it is a little bit scary because this does have the ability to very negatively affect our communities. So a lot of people are sharing, collaborating information which is something great about our industry, that the sharing of our industry of information. There’s great resources out there like your broker or your carriers like John with TIS, the education and the tools that they provide, even policy making help for communities that may not have great internal resources for that. But I think as we look at this, this is going to have a lot bigger impact potentially than on just the residents and just the communities themselves. 


You know, we were talking even offline, Lucas, about a lot of communities that we’ve already heard are even completely even if they’re not impacted yet just trying to go into protective mode and they’ve closed off really unnecessary visitors as they call it, or non-critical healthcare workers from entering the community. And even projets, like potentially renovations and things like that may be potentially negative impacts on the communities right now. 


Lucas: It could be. On a positive level, I think that the senior living community is probably more poised to be able to tackle this thing because every single year, senior living communities have battled the flu season which is pretty prolific and tends to get a little bit of news but nothing nearly like the coronavirus. Clearly because there’s a lot of unknowns here and we’re not quite sure how the impact of this is, what it’s going to be. But I am optimistic that our communities and their policies and procedures and the staff and the training that’s gone on or are going to be able to implement, I would love to see a way that this type of collaboration between operators and clinicians is something that our general population may be able to glean from. 


Josh: Absolutely. I 100% agree. And this is when our, we have an opportunity to shine as an industry. To your point, I know, and I’ve shared these stories with you as an operator and administrator, I remember early on in the first community I ever opened, it was an outbreak of norovirus, you know, sometimes it’s called the cruise ship virus, that was not fun, but I remember multiple hospitalizations not only at our community but in the county I was in. Multiple deaths just within a week’s worth of time. Not just one story about it. Nothing talked about and those were even reportable incidents.


So, there was actually much more death around that in a short amount of time than what we’ve experienced even nationally with this virus so far. I think, to your point, the industry will rise to the challenge. We will have some love stories that are produced out of this as we call them just because of the commitment of our team to rally together to do this. And, you know, John as we looking through some of the resources and information that your team is putting out, a lot of it seems like as far as infection control, you know, it kind of mimics that of what we see for infection control for the flu. 


John: No, absolutely, and I think going back to one of the points we talked about: education and educating your team members and residents and families. Screening is so hugely important. You know, you’re bringing third parties into these communities regardless of what capacity they’re working in. You need to be proactive in screening each and every outsider that’s coming into the community whether it be family member or third party home care provider, hospice, whatever it may be. In this scenario, your worst case is that someone from the outside comes in and infects one of your residents and that’s something we’re also preaching as one of those core pillars is that screening is, I mean, if you have tell somebody, hey, you can’t come in this community, you absolutely need to do that to mitigate what could be a worst case scenario. 


To the second point, there’s great resources out there like the CDC, MDS and all of our associations both state and national that are putting out great info. In each and every email or document blast that we’ve produced, we’ve included as many links to those specific websites where there’s posters, there’s just a laundry list of things you could be doing to get out in front of this. 


And then, here again, you take that and communicate proactively with the families, tell them what you’re doing to mitigate this exposure and it is great to see an industry that’s not always working 100% in collaboration to really be working in collaboration. And all these different associations working together to put out, you know, I’ve seen certain associations reference something from another or another association that hones in on a different piece of the continuum. 


And you do see universally, everyone’s aware this is a problem and it has kind of brought the industry together to work together and do the best we can to mitigate this. 


Josh: Love it. Well, great information from our partners at TIS. Appreciate John, you taking time away from a busy conference schedule to pop in and say hello and resources has sent to us. We can provide those links as well that you guys have sent us on this special edition of Bridge the Gap.


Lucas: You got it, you got it. We’ll make sure we put those in the show notes and we even, our other partner, Argentum, they’ve got stuff on their website, we’ll make sure that we link to that, and we’re rooting for this industry to be prepared and happy to be somewhat of a resource. If anybody has any questions, just shoot us an email, check out our links and thanks for listening to another great episode of Bridge the Gap. 

Thank you to our supporting partners NRC Health, OneDay, TIS, Morrison Living, Argentum, Solinity, and The Bridge Group Construction. 

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Episode 107: Coronavirus Update with John Sims