FANWOOD, NJ – The coronavirus pandemic undoubtedly took a harsh toll on the elderly. Nearly 80% of the deaths in New Jersey have occurred among residents 65 and over. Almost half of the deaths (47%) were of residents 80 or older, Gov. Phil Murphy reported during his daily COVID press conference on June 4.
The senior population is the most vulnerable to sickness and possible death for several reasons: pre-existing medical conditions, diminished immune systems, the natural processes of aging, and the rapid spread of COVID-19 itself, a new disease for which people had not yet built immunity.
New Jersey’s Departments of Health, along with local health departments, has lumped nursing homes and assisted living facilities together during the pandemic, although the typical regulations for each industry are different, according to Roger Bernier, president of Chelsea Senior Living.
Bernier, who operates 15 facilities in New Jersey, believes his industry has been unfairly treated by Gov. Phil Murphy and Health Department officials. He sat with TAPinto to explain the differences between nursing homes and assisted living facilities and why they should be regulated differently.
For someone who might not be familiar with the industry, what is the difference between a nursing home and an assisted living facility?
Assisted living is a social model. It’s more of a choice for independence and privacy. We have different regulations. Our residents are typically private pay although about 25% is paid under Medicaid. We have less RNs on staff than a nursing home, and our residents are generally less medical needy.
We take care of the aged; our average age of our residents is 89 years old. Residents have own apartments and make their own choices based on individuality. We don’t have round the clock nursing. Unfortunately, in the public’s mind and at the highest levels of state government, we are viewed as the same as nursing homes.
One similarity is we are both underfunded by Medicaid.
How difficult has it been on the company to operate during the COVID-19 pandemic?
It’s clearly been difficult. But PPE isn’t the most difficult part. Our initial issue was staffing; 30% of our staff was concerned about health and left in the mid-March. We then were scrambling to get help.
Once people started to get sick, and some passed way, it became emotional for the residents, their families, and the staff. We turned from a social model to staying in your own room. Medical professionals, such as physical therapists and psychologists, didn’t come in. Residents couldn’t see their families. For people who are 90 years old, the virtual world doesn’t exist, for the most part. It doesn’t mean anything to them.
The two main issues have been the disease and isolation. We are still not doing social dining and the activities people are used to. It’s not ‘business as usual.’ Healthwise, we have stabilized; we have seen a positivity rate of 10% and they have been asymptomatic (not sick). We are not taking care of sick people right now; there’s nothing to treat.
What, if anything, could CSL have done better?
You can always look back and say you could have done better. We reacted faster than the state did, but still everything was 2-3 weeks too late. The virus was in our buildings long before we had idea that it was. It could have been a staff member or a family member who came to visit, or a resident who contracted it on the outside. We just don’t know. By the time we locked down, it was already in, and we didn’t know it because COVID takes so long to manifest. We (everyone in NJ) were 3-4 weeks into the crisis before everyone was wearing masks.
One thing we have done is to put a “PPE czar” in place, someone to oversee the supply and demand for the company and it has worked well. The 15 Chelsea locations in New Jersey have never been short of PPE.
What, if anything, could Gov. Murphy and the State of New Jersey have done better?
Our industry has not been asked for input, nor has it been welcome when it’s been offered by the industry associations. We were directed to do vital signs on well residents every shift. We took their temperatures, as we were instructed. The frequent contact could potentially lead to illness. We were the ones having to do it, not the nursing homes. It made no sense.
The state’s response has been anti-nursing home, and unfortunately, we are bunched with them. For instance, Andover Nursing Home, where 70 people died as body bags piled up, according to the New York Times, was a bad nursing home way before the coronavirus hit. That continued during it, and sadly, we saw the results.
How are you handling family visitations going forward?
We are putting in a plan for outside visitations. Initially, we will limit to two family members keeping socially distant. Residents are able to go outside, and they can exercise in the hallways. All of this of course with the new normal of wearing masks. They’ve been locked in for months and they need to see their loved ones...not virtually or through a window.
Residents on the Independent Living section of our facilities have been able to come and go, and they have to wear masks. We are not a nursing home; we offer independent living with a social aspect. Our residents miss the socialization.
How are you helping families manage during this period of time?
It is awful being the police and the caregiver at the same time. While we have not allowed visitors since mid-March, we send out frequent communication to the families. We try to put a positive spin as best we can.
We try to be reasonable. We understand that this has been heart-wrenching for our residents and their loved ones.
What are some changes that Chelsea Senior Living has instituted, both short-term and long-term?
Regarding safety, one thing we are doing is looking into installing temperature kiosks and utilizing new technology, which is less labor intensive.
We also learned to bolster Wi-Fi very quickly. Some of our residents learned to use Facetime to connect with their families, watched events on Facebook Live, and watched movies and shows on Netflix. All this activity slowed the response time of our internet capabilities, so we worked to improve it.
How do you think the COVID pandemic will impact the future of the industry?
I don’t think there will be a change to the model. It works. Some changes will be made: screening people. quarantining after admission, and the testing the staff will be our “new normal.” We reacted quickly. PPE is part of our inventory, we are incorporating technology, and are using proper cleaning chemicals.
Anything else you would like to add?
People might be delaying their decisions to move to assisted living a little bit right now, but ours is a “needs-driven business.” Chelsea has a 30-year history of caring for senior citizens as a pioneer of assisted living. We know how to provide safe and healthy environments for senior citizens.
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