Review/Revision Dates:  August 2020, August 2021, July 2022

Lessons Learned from the COVID-19 Pandemic 

1. Our workers truly are essential. They are our most valuable resource (though we already knew this), and they deserve all of the credit and appreciation in the world for their dedication and performance. CareOne staff are truly healthcare heroes and we wholeheartedly thank them for their dedication and tireless efforts during an unprecedented time.
2. PPE to protect our most valuable resource is not guaranteed, and when assistance with obtaining PPE is available it is often prioritized to acute care settings. Our healthcare heroes MUST be protected with the appropriate PPE and deserve nothing less.
3. Our residents, while among the most vulnerable to this virus, are also among the most resilient among us. Despite a sudden restriction on visitation, cessation of communal dining and activities, and staff wearing full PPE, most were able to comprehend the necessity of these measures. Many had seen worse (like our residents who survived the holocaust; and the Spanish flu; and served in active duty during times of war); most have seen their share of hardships during their lifetimes, and they did their best to focus on our skilled care services and innovative therapy programs to make the most of their time with us. While the pandemic surged, we were also helping many patients to recover, regain their prior level of function and return to their prior level of independence. #IGotBetter
4. Food nourishes the body, but can also nourish the spirit. The comfort and pleasure of great food was enjoyed by residents who had to adjust to so many changes in their environment, yet could still enjoy chef prepared meals featuring Jersey Fresh ingredients and our refreshing summer sippers and were sometimes treated to meals from local restaurants. Our staff members were shown appreciation for their service in their communities by so many local eateries; a true bright spot for them during such trying times. 
5. Family – While it’s true that residents had to rely on the technology of video chats and physical barriers like window visits to see their families; and staff members spent more time away from their families as they worked long shifts, or had to quarantine, the CareOne family pulled together to support residents and staff. Our leaders deployed into our Centers to support daily operations, we provided additional mobile devices to support virtual visitation, put staff members up in hotel rooms when needed, increased flexibilities with our sick time policies, and supplemented staffing when needed. 
6. Education and Training is the foundation of the care and services that we provide and its value cannot be understated. While our staff members are well trained, they required new training, updated training, re-training, and ongoing training. All of this training takes preparation, implementation, measurement of success, and auditing of new or changed processes (see #1).To inform training content, we kept a careful eye on guidance and regulatory changes from a variety of sources including CDC, WHO, CMS, NJ DOH, NJHA, NIOSH, and OSHA; as well as current research from JAMA, NEJM, MMWR, and others. 
7. The importance of keeping open communication during uncertain times is also critically important. We adopted a practice of transparent communications with staff, residents, families, local boards of health, and the department of public health. Our internal rapid response protocol enabled us to communicate directly and transparently with leaders and subject matter experts to guide us in implementing the ever changing recommendations and guidance. 
8. We quickly realized the importance of data. Whether it was data on how much PPE we had, were using, and would need; data on the number of COVID patients we had at a given time; data on staff member quarantines; data from symptom monitoring, and so many other data points. We quickly established mechanisms to monitor, measure, centralize, and analyze the data that we and our regulators needed during the pandemic. Once established, these reporting mechanisms allowed us to quickly identify needs and prioritize our resources. 

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The CareOne Outbreak Response Plan (ORP) is customized at each of our Centers and is based upon national standards and developed in consultation with the Center’s infection control committee (in Centers with an established infection control committee). The ORP includes the following:

Our protocol for isolating and cohorting infected and at risk patients in the event of an outbreak of a contagious disease until the cessation of the outbreak which is described in the following proprietary policies, procedures, and protocols: 

• Coronavirus Disease (COVID-19) Identification and Management of Ill Residents
• Coronavirus Disease (COVID-19) Infection Prevention and Control Measures 
• Coronavirus Disease (COVID-19) Prevention and Control
• Influenza Outbreak 
• Isolation – Categories of Transmission-Based Precautions
• CareOne COVID-19 Preparedness and Response Key Actions Protocol Summary
• CareOne Cohort Plan – COVID-19 

Clear policies for the notification of residents, residents’ families, visitors, and staff in the event of an outbreak of a contagious disease at a facility which are described in the following proprietary policies, procedures, and protocols: 

• Coronavirus Disease (COVID-19) Reporting Facility Data to Residents and Families
• Infectious Disease Threat Communications Plan
• Coronavirus Disease (COVID-19) Prevention and Control
• CareOne COVID-19 Preparedness and Response Key Actions Protocol Summary

Information on the availability of laboratory testing, protocols for assessing whether facility visitors are ill, protocols to require ill staff to not present at the facility for work duties, and processes for implementing evidence-based outbreak response measures which are described in the following proprietary policies, procedures, and protocols: 

• Lab and Diagnostic Test Results – Clinical Protocol
• Test Results
• CareOne COVID-19 Testing Protocol
• CareOne COVID-19 Preparedness and Response Key Actions Protocol Summary
• Coronavirus Disease (COVID-19) Education and Training
• Coronavirus Disease (COVID-19) Identification and Management of Ill Residents
• Coronavirus Disease (COVID-19) Reporting Facility Data to the Centers for Disease Control and Prevention
• Infection Prevention and Control Program
• Outbreak of Communicable Diseases
• Surveillance for Infections
• Coronavirus Disease (COVID-19) Visitors
• Limited Visitation During the COVID-19 Pandemic
• Test Results

Policies to conduct routine monitoring of residents and staff to quickly identify signs of a communicable disease that could develop into an outbreak which are described in the following proprietary policies and procedures: 

• Coronavirus Disease (COVID-19) Infection Prevention and Control Measures
• Coronavirus Disease (COVID-19) Identification and Management of Ill Residents
• Coronavirus Disease (COVID-19) Prevention and Control
• Infectious Disease Threat Surveillance and Detection
• CareOne COVID-19 Preparedness and Response Key Actions Protocol Summary
• Infectious Disease Threat, Infection Control Measures During
• Employee Infection and Vaccination Status
• Surveillance for Infection

Policies for reporting outbreaks to public health officials in accordance with applicable laws and regulations which are described in the following proprietary policies and procedures:

• Coronavirus Disease (COVID-19) Reporting Facility Data to the Centers for Disease Control and Prevention
• Coronavirus Disease (COVID-19) Identification and Management of Ill Residents
• Coronavirus Disease (COVID-19) Prevention and Control
• CareOne COVID-19 Preparedness and Response Key Actions Protocol Summary
• Reporting Communicable Diseases
• Infection Prevention and Control Committee
• Infection Prevention and Control Program
• Infectious Disease Threat Surveillance and Detection
• Outbreak of Communicable Diseases 

Methods to communicate information on mitigating actions implemented by the facility to prevent or reduce the risk of transmission, including if normal operations of the facility will be altered. Notifications shall not include personally identifiable information; these are described in the following proprietary policies, procedures, and protocols: 

• Infectious Disease Threat Communications Plan
• Coronavirus Disease (COVID-19) Reporting Facility Data to Residents and Families 

Methods to provide cumulative updates for residents, their representatives, and families of those residing in the facilities at least once weekly in particular during a curtailed visitation period. 

• Infectious Disease Threat Communications Plan
• Coronavirus Disease (COVID-19) Reporting Facility Data to Residents and Families 

Written Standards, policies and procedures that provide for virtual communication (e.g. phone video-communication, Facetime, etc.) with residents, families, and resident representatives, in the event of visitation restrictions due to an outbreak of infectious disease or in the event of an emergency which are described in the following proprietary policies, procedures, and protocols: 

• Facilitating Communication and Virtual Visits During Restricted Visitation Due to the COVID-19 Global Pandemic
• Cleaning and Disinfection of Mobile Technology Devices protocol
• Coronavirus Disease (COVID-19) Visitors

A documented strategy for securing more staff in the event of a new outbreak of COVID-19 or any other infectious disease or emergency among staff which is described in the following proprietary policies, procedures, and protocols:

• Planning for Additional staffing needs
• Coronavirus Disease (COVID-19) – Surge Capacity Staffing

If you would like additional information about our response to COVID-19 or other infectious disease threats please contact us using our COVID hotline.