Hi, I'm Juliana Bilowich, with LeadingAge, and I'm here today with Gus Keach-Longo. Welcome Gus. Thank you for having me on the show. I really appreciate this. Thank you. I'm the president and CEO of The Towers in New Haven. We have 320 apartments and we have about 170 people who get services, and we have about a 130 actual assisted living units within our community. This is great to share our experience with you. Fantastic and I know that Gus, you and your team are doing everything you can to help keep residents, to keep staff as safe as possible during the pandemic. Let's talk about how you manage exposure. What criteria at your communities have you used to assess staff and residents for exposure? Is there anything that you're doing that's actually an excess of current CDC guidance or extra steps that you take? Well, at this particular point, we are testing every person, every week. We test all of our residents except for the few who opt out, and we also test all of our staff. It's a mandatory thing for them in order to be on the schedule and we also do allow visitors to come in, but they have to be tested as well. Oftentimes, the way that the state of Connecticut is suggesting, is that the testing started to happen around the end of June, and the rest of the state we started testing about two, three weeks earlier, and once there's 14 days without any positive case, you can switch to a different testing schedule, which we didn't feel comfortable doing, so we actually test everyone every week. Regardless of whether or not a person has had a positive test or a negative tests, we still continue testing beyond that, which is beyond what the recommendations are and we have never shifted from that. But because we are testing everyone on a weekly basis right here on site, we have a setup downstairs in our large dining room for the staff and for anybody who comes in as a caregiver. Then we also have our testing partner go from apartment to apartment. We're able to have started to loosen up a little bit, and start to have some of our programs. We've also started to be able to have visitors come back in. We're being very careful but it's only because we're testing everyone every week, that we're able to do any of them. With all of that, actually, as of this past Friday, we've had some cases in our nursing homes around the state that have started to really creep up and have some outbreaks. So DPH just went to having everyone be tested. All staff members have to be tested in assisted living facilities. Now as of last week, they only needed to be done every other week, and on a different schedule, which we really didn't focus too much on because it really didn't mean what we wanted to do. Yeah absolutely. Yeah that's a big initiative to test everybody every week. Who else is involved with that? Are there other things you're doing also to assess residents? How do you make that all happen? Residents can come and go out of the building in anytime. It's obviously their home. When it comes to anyone else who's coming into building, whether it's an aid, any kind of caregiver, any kind of family member, any staff member, you have to show a negative test that has been administered within the prior ten days. If the person is tested here, then they go on and clear-to-enter list, and that is kept at the front desk. But if they're tested anywhere else, they can bring that in, and show the front desk before they're allowed to come in and be buzzed. We actually had to change our door system so that you can't just walk into the building anymore. You have to be buzzed in order to get into the building. We had to have those doors manned for 24 hours a day, and so thankfully, we have 24 hour security here. We're able to do that. When it comes to the testing partner, we were lucky that early on, the city of New Haven actually contacted us to come and start talking about what its in your housing buildings dealings around the city, and we were sharing some of our protocols. We had removed all of our furniture, we closed our dining spaces. We started broadcasting things on our internal television system to the apartments and all that stuff. Started delivering meals to all the apartments and everything. But we were doing that when other housing sites were just beginning to start thinking about some of that stuff. They were concerned in general about finding out if there were cases in housing site. They contacted a group called Murphy's Medical Associates, who is out of Stanford and out of Greenwich, and basically, made that connection for us. The beginning part of June, we started testing out how to do this. We knew that we didn't want our residents to come downstairs. There were 21 story building and a 13 story building. It would be creating traffic and people getting elevators together and all that stuff. But we knew that we needed the provider to go from apartment to apartment. Thankfully, the National Guard stepped in as well, on the early weeks and helped them go from place to place and do all the testing as more labor to do this. Then we also set up testing booths downstairs in our dining room that was cleared out. Between a combination of the two, the first week took us about two and a half days to get through everyone. But over time, they started to get a little faster and they started to get some better systems down. At this point, we have the tester, also does the labs. As soon as the lab results comes back, I end up getting a text message from our provider, stating that we have a positive case. We go with our Director of Support Services who supports all of our partnerships and all of our different care providers in the building. We wait until the doctor has contacted the resident or the family member who's positive, and then we follow up and we start doing the contact tracing. A local health department just is not able to do that. The volume is just too great. We do all the contact tracing here in the building, especially since we know the people, we know their daily pattern and so on and so forth. We were able to take that over. The local health department does get the results from the lab, but we don't have to go back and forth with the local health department anymore because we know what you guys are doing and we're good. That has enabled us to really change in the way that we're doing our operation. Wow, incredible system, especially the next message part, that is cool. You mentioned the National Guard, you mentioned public health officials. You're interfacing with a lot of different external partners. What about, what happens within the community when there is a confirmed case? In a state of living, how are you managing isolation, any other strategies that you're utilizing? Because everyone has their own apartment here that we're able to keep people isolated when we have a confirmed case or a confirmed exposure. In the very beginning, when we started really using what was happening when COVID was getting bad in New York City and marking its way through Fairfield County towards us, we started taking these measures, but I also started writing memos to the community. I wrote a memo just about every week and a half now, where in the beginning, it was every three or four days explaining everything that was going on. I'm very grateful to groups like LeadingAge, because I was listening in on those calls and our state president Mag Morelli is amazing. When I had questions, I was able to contact her. We've also got on the calls with our state Department of Public Health, the [inaudible] calls as well. Through the very beginning we were mostly on calls, just trying to absorb information of what was going on and how to deal with this. Then I would put that information on those memos and pretty openly sharing what was going on. In the very beginning, when we had our first couple of cases, I did share that with a community. Of course, I didn't say who it was and never did any identifier. I was able to say, "Okay folks, this is what's going on. We did have one case that happened because somebody snuck someone in." When we share that, people actually got upset about it and they started taking things really seriously. I've had several people say to me that the memos that we put together and send out all the time, often times had information that residents haven't heard before. Then eventually they end up hearing about it in the news. They started to really trust us. In the beginning, people were upset and people were saying, "How dare you do this? How could you close this? Who says you have the right to do this?" In the beginning we just knew we had to do this and people were going to be upset. I've never mandated anything necessarily, I've always said we have strong expectations. We are all one community together. I was walking around talking to some people, how would you feel if you were the one who ended up bringing the virus to this other person? We did have one caregiver who ended up bringing the virus in and gave it to one of his clients here. He took care of a couple, and the husband passed away and the wife thankfully never caught it, somehow, and we don't know how. But he's living with the guilt of having done that. I don't want to second guess things, but he has to live with that now I've shared that with some of our folks and people go, "Yeah, you're right." I think it's the combination of a lot of communication. I've sent out over 50 memos, and some of these memos are two pages, that's usually the shortest and some are six or eight pages long depending on what was going on at the moment. Who wants to read that? I certainly don't. But I think we've earned their trust and we were trying our best to stay ahead of that. Now, when we have a positive case, we have one just about every other week or so. I do share just in general terms to say we've had two cases over the past couple of weeks, and our thoughts are with the person and we have had, not amongst our residents, but amongst our staff, we've had four people on our staff contract the virus, all from somewhere else. Two of them got them from their own churches. When they went out to the churches. And then the other two got them from family members who were exposed at their work. Two of them have been in ICU for a month. When that happened we were sending out prayers and messages and saying we're here for them and never saying who they were. Of course, people try their best to figure out who they are. Sometimes they guess sometimes they don't. There's one person who considers herself a detective so she decides on her own that there's something going on, and she has to find out whatever it is and she very clearly makes it her mission to figure out who it is. She comes to me and she says, "I know who it is, it's Stewart." And she's completely wrong. [LAUGHTER]. That's okay. But for the most part, people really are following what we're asking them to do. Yeah. Wow. I'm so sorry to hear about the person who passed away and the guilt that comes along with that for the caregiver. But I'm also just in owe of the communication, the testing that you all are doing, still the levity that you're bringing to the whole situation that you can still retain a sense of community. I can tell you one story really quick. We had to close off our beauty salon, which was what we needed to do. Of course, there are plenty ladies who really need a beauty salon. In one of my memos, after having people calling me and leaving me messages and also threatening me, I had to write them a memo to say, "Look, I understand this and I know you're going to say I don't have that problem because I can just buzz my head in the shower. But if anybody wants a Corona cut, I'm happy to bring my clippers to work and we can take care of that for you." Then the women didn't really appreciate that as much, although some people thought it was funny. There was this one resident person who was quite angry with me because how dare I make fun of leading together in to get a hair cut. She went to a local paper, and she reported me to the local paper who literally published that. Which I thought was bizarre, that the local paper would publish the fact that we closed that and I made a joke. When I was being interviewed as a follow up, I said please understand that was meant to be a joke, I wasn't going to buzz anyone's head, but we have to prioritize our residents safety first. [LAUGHTER]. That's one of the funny moments. So nobody got a Corona cut from you then? Nobody did. Now I'm a hero because we opened up the salon last week. We did very carefully and everybody thinks it's just the best thing in the world. So now I'm a hero again today. Oh, good, we'll get you your cape back. [LAUGHTER] Well, thank you Gus. Thanks for sharing the stories and for everything you do. Thank you very much. I appreciate the time and I appreciate you inviting me on this. Thank you.
