HCSHQ_102021

October 2021 — Health Care & Senior Housing Quarterly — Page 19 www.crej.com SENIOR HOUSING — INSIGHTS A fter 24 years in the senior living industry, I can say without a doubt that this last year and a half has been the most challenging I have ever experienced.What COVID-19 did to our seniors and health care workers pushed many to unfathomable brinks of fear, frustration and burnout. And just when we saw a light at the end of the tunnel and mask mandates were beginning to be lifted, the delta vari- ant made its unwelcome debut. The staffing crisis is very real and very scary, and companies are hav- ing to be extremely creative in ways in which they can be better, different, faster and smarter. Recruitment is challenging and cutthroat between providers, and retention is as impor- tant as ever as we come up with new ways to celebrate, honor and appre- ciate our health care workers. They have spent a year and a half putting themselves and their family members at risk, and this has pushed many tenured, dedicated workers to reach the point of burnout where they have decided to leave the senior living industry altogether. Many employ- ers have looked to sign-on bonuses, retention bonuses, competitive wage increases and unique benefits that may set them apart from the competi- tion. As a company we are proud that we are not utilizing agency staffing to care for our residents. From a conti- nuity of care perspective this is very important, not to mention what agen- cy staffing can do to your culture and bottom line. Unfortunately, this leads to increased burnout among associ- ates as they are working overtime, picking up extra shifts and working harder than they ever have before. In the midst of living through this staffing crisis, we as a company made the decision to make COVID-19 vaccines a manda- tory requirement for employment with our company, effective Sept. 1. We believe that this was the right decision to make to keep our residents and fellow associ- ates safe, but it certainly wasn’t the most opportune time to make this decision. A few short weeks after we rolled out this mandate, the state of Colorado followed suit with its own mandatory vaccine mandate for all health care workers by the end of October. As we anticipated, we were able to have many successful one-on- one meetings with associates where a little extra education helped get those individuals over the hurdle of making the decision to get vaccinated. In the end, we lost four associates out of our approximately 250 we have employed today.We are proud of our decision and know that this was the right thing to do for us as a company. The breakthrough COVID-19 cases that we are all experiencing have been extremely disruptive to the operation. The state and county authorities have come down harder and have been more stringent in their advisement and direction as a result of these cases. The mass testing alone is very time-consuming and certainly takes time away from the delivery of care and services to our residents. As a company we have been very aggres- sive from the beginning of this pan- demic and made decisions to close dining rooms and visitation in early March 2020, before it was ever man- dated to do so.We are grateful to say that, although we have experienced our fair share of COVID-19 positive residents and associates, we have not had any deaths resulting from COVID- 19. As we approach our 2022 budget season, we will have to look long and hard at all of the increased operation- al expenses we have encountered and find a balance between how to absorb those expenses and the appropriate annual rental rate increases for our residents. Everything from increased staffing, retention and recruitment expenses to the thousands and thousands of dollars spent on paper products for meal delivery that went on much longer than any of us ever believed it would, as did increased costs for raw food and supplies – just to name a few. Many companies have opted to begin collecting a COVID-19 monthly surcharge, but we have opted against this approach.We are proud that as a company we continued with annual staff performance increases through 2020 and 2021 as well as con- tinued with our 401(k) match, along with continuing other key employee benefit offerings. The pandemic impacts all aspects of senior living Susie Finley Founder and principal, Ascent Living Communities Hilltop Reserve in Denver will open at the end of the year. The timing of the pandemic and construction allowed for several design and technology changes with a focus on safety and infection control that will benefit residents and associates. Please see Finley, Page 20 I n addition to facing the chal- lenge of caring for and sup- porting vulnerable senior populations over the two-year span of the pandemic, another major consideration for senior living operators has been keeping workers safe since COVID-19 spread nation- wide. While focusing on worker safety always is important in senior living, it has become acutely critical today. The Occupational Safety and Health Administration launched a program in March – a “national emphasis program” – to focus on workplace inspections, outreach and compliance assistance for compa- nies where workers had a high risk of contracting COVID-19. Beyond the expected hot spots for COVID- 19, such as manufacturing facilities and meatpacking plants, OSHA also would put a spotlight on assisted liv- ing facilities, continuing care retire- ment communities, home health agencies, skilled nursing facilities and others in health care. OSHA also reminded employers, as part of the Whistleblower Protection Pro- gram, that they should not retaliate against workers who lodged com- plaints about COVID-19 workplace safety. This announcement was a preview of what was to come. On June 21, OSHA announced a new Emergency Temporary Stan- dard to strengthen efforts to protect workers in health care settings. “Too many of our frontline health care workers continue to be at high risk of contracting the coronavirus,” said U.S. Secretary of Labor Marty Walsh in a press release announcing the ETS. The emergency rule requires many health care employers to implement a written COVID-19 infection preven- tion program, report COVID-19 cases to OSHA and pay workers who are unable to work due to COVID-19 symptoms. In the prevention plan, operators must cover areas of con- cern for certain medical procedures, physical distancing, physical barri- ers, personal protective equipment, cleaning, disinfection, ventilation, health screening, training, record- keeping and reporting. The ETS also stated providers should encour- age employees to get the COVID-19 vaccine; that encouragement later became a mandate. While OSHA provided templates and guidance for compliance, the rapid deployment for the new stan- dard caught many in senior living off guard. Organizations were expected to comply two weeks after the June 21 launch for some measures, 30 days for others. An estimated 10 mil- lion senior living workers fell under the new ETS, and despite pushback from senior living organizations such as LeadingAge and the Ameri- can Health Care Association for operators to have more implementa- tion time, the ETS was implemented without delay. n Size and experience mattered. Larger assisted living, memory care, home care and other senior living providers – especially those affiliated with operators of long-term care facilities – were able to cope with the ETS implementation because they have a framework for worker safety education and oversight in place. “Over the last decade, nursing homes have seen increased scrutiny from OSHA for workplace safety,” said Gloria Martinez, director of employee safety for both WellAge Senior Living and Vivage Senior Liv- ing. “Adjusting to these new mea- sures was not as much a burden for our locations since we have systems in place.” Under the ETS brought on by COVID-19 concerns, OSHA inspec- tors are conducting on-site visits or remote inspections as needed. Typical triggers for an inspection are a staff complaint or outbreak at a facility. In addition, OSHA is scrutinizing the quality of the on- site safety coordinator in senior liv- ing communities. This extends to reviewing the coordinator’s training, experience and ability to dedicate the time necessary to the job. Mar- tinez, who had more than 25 years as a safety and health professional (the last five in health care) before joining Vivage and WellAge, today oversees workplace safety at more than 40 facilities. In this role, she interprets OSHA standards for facil- ity safety coordinators, provides training for supervisors at the com- munities and develops everyday safety programs that benefit front- line workers. “Workplace safety is not a piece of paper, a policy or a procedure,” she said. “It’s about developing a culture of health and safety by creating pro- active safety programs.” While many organizations offer employees computer-based safety training, Martinez said in-person training is essential. She also said when the COVID-19 ETS guidance was released, it was much easier for her to roll out to facilities as systems and procedures were in place. n Safety saves. OSHA’s ETS for COVID-19 workplace safety comes with a bite from the Department of Labor. “OSHA citations come with maximum penalties of $13,653 per violation,” said Jon M. VonderHaar, a safety services consultant. “Willful or repeated violations can amount to penalties 10 times that.” Martinez and VonderHaar empha- size that while complying with the COVID-19 ETS is critical, having an overall culture focused on workplace safety is good for workers – and good for business. They also stress creating a culture of safety must start with organizational leadership to be effective. Businesses lacking safety prac- tices have more injuries, and these injuries have both direct and indi- rect costs. Direct costs include workers’ compensation payments, medical expenses and costs for legal services. Examples of indirect costs include training replacement employees, accident investigation COVID-19 highlights necessity for culture of safety Margie Guerrieri Regional marketing and sales director, WellAge Senior Living Please see Guerrieri, Page 20