Coronavirus timeline

What we’ve done across the United States to protect patients, residents and our staff:

When the outbreak began in China, our senior management team and clinical leadership immediately began meeting regularly to address concerns about the potential for a pandemic. Upon the outbreak’s spread to the U.S., we fully mobilized in crisis response mode.

We have been following recommended protocols and guidelines from the Centers for Disease Control and Prevention (CDC), and Centers for Medicare and Medicaid Services (CMS), often getting out in front of them.

 

TIMELINE

January 27 

Sent out our first communication to all of our centers in preparation for an outbreak. 

February 3 

Formed a formal coronavirus task force, including senior leadership, clinical leadership, and Chief Medical Officer.

February 11 

Started monitoring standard facemask inventory and acquiring additional personal protective equipment (PPE), such as isolation gowns, eye protection and N95 respirators, in anticipation of an outbreak in the United States.

February 18 

Ensured all centers had availability of masks, N95 respirators, and fit testing kits for the respirators. Centers were required to fit test N95 masks on key clinical personnel in each building.

February 25 

Started a PPE inventory management process  across the organization to determine where we had excess inventory and where we could divert PPE to centers with lower supply.

March 3 

Posted signs discouraging visitors if they had symptoms, had been exposed to someone with COVID-19, or had travelled to a COVID-19 outbreak area. Also, began daily temperature assessments of all residents.

March 5

Directed all visitors and employees to enter through the front entrance ONLY to ensure everyone entering the building is screened by the receptionist for attestation of travel history, no known exposure to someone with COVID-19, and no symptoms of fever, sore throat, sneezing, cough, or shortness of breath.


Also, mandated enhanced screening in outbreak areas of all visitors and employees including direct assessment of temperature readings.

March 10 

Fully implemented active screening and mandatory temperature checks for all entrants, exceeding CMS March 9 guidance that visitors could be offered temperature checks.

March 10 

Implemented a no visitation policy for areas with community spread of COVID-19.

March 12 

Centers in areas of community spread of COVID-19, as defined by local public health authorities, were required to restrict visitor access per CMS guidelines.  Also, implemented the cancellation of non-urgent outside appointments in communities experiencing community spread of coronavirus.

Early on March 13 

Implemented twice daily resident screening for temperature, respiratory symptoms (cough, shortness of breath), and pulse oximeter (blood oxygen level) readings. 

Late on March 13 

CMS issued further guidance for Restricted Visitation, which we had already fully adopted, and active Patient Screening without specified frequency, which we had already exceeded.

In addition, we fully adopted CMS guidance to cancel communal dining and all group activities, such as internal and external group activities.

We also implemented video conferencing capabilities to support family engagement.

March 14

Communicated new guidelines regarding the reuse of facemasks and extended use of gowns, given the national shortage of PPE.

March 16

All consultant pharmacists were directed to perform consulting functions remotely, to further reduce the risk of virus entry to the building.

Upon our first confirmed COVID-19 case in a Genesis center, implemented a structured and standardized process for managing potential outbreaks, including:

  • Full infection precaution review

  • PPE inventory review and procedures for urgent shipment of additional supplies

  • Contact tracing and risk assessment

  • Family communications

March 18

Mandated facemask reuse throughout the system to preserve supply.

March 19

Staff were directed to leave mail entering a facility untouched for 24 hours, and follow appropriate sanitary protocol while handling all mail and packages.

March 23

Implemented universal mandatory use of facemasks and eye protection in outbreak hotspots.

March 24

All centers were provided with primary care telehealth capability. Also, virtual wound care by specialists was initiated.

March 26

All staff in patient care areas began wearing universal facemask and eye protection at all times, across the entire system.

Also, the frequency of patient screenings was increased from twice daily to three-times daily monitoring of temperatures, blood oxygen levels, and any new respiratory symptoms.

April 2

Staff were directed to leave mail entering a facility untouched for 24 hours, and follow appropriate sanitary protocol while handling all mail and packages.

April 3

Introduced an Enhanced Clinical Review process, utilizing a standardized pre-acceptance screening tool for all potential admissions into Genesis facilities, to reduce the risk of an outbreak.

April 4

All centers were provided with primary care telehealth capability. Also, virtual wound care by specialists was initiated.

April 6

Designated an Infection Prevention (IP) Designee for every shift in every center, to ensure 24x7 focus on adherence to infection prevention practices.

April 8

Worked with state and local officials to develop our first COVID-Only Dedicated Facility at PowerBack, Piscataway, in NJ.

April 11

Procured reusable, washable cloth gowns to ensure that staff and residents were protected, as single-gown use became hard to procure.

April 14

Established our second COVID-Only Dedicated Facility at PowerBack, Center City serving the Philadelphia metropolitan area.

April 15

Released the Genesis Advance Care Planning Guide, a conversation guide to support health care providers when assisting patients/residents and their families to make informed decisions about future care.

April 17

Established three additional COVID-Only Dedicated facilities at Canyon Transitional Rehabilitation Center in Albuquerque, NM; PowerBack, Voorhees, in Voorhees Township, NJ; and PowerBack, Lakewood, in Lakewood, CO.

April 20

Established Admission Quarantine Units in order for admissions and readmissions to be under infection precautions and observation for 14 days, prior to being transitioned to the general patient population within the facility.

Patients requiring medically necessary transfers out of the center for outpatient procedures (dialysis, chemotherapy, etc.) were also placed on the Admission Quarantine Unit.


After acquiring significant additional supplies, eliminated the need to reuse standard facemasks over multiple shifts.

April 24

CMS issued further guidance for centers to separate patients who leave the center for appointments, by placing them on a unit for at least 14 days, reinforcing a policy that we had already fully adopted on April 20, 2020.

April 27

Established our sixth COVID-Only Dedicated facility at Loch Raven Center in Baltimore, MD.

April 29

CMS and CDC announced the Long Term Care Facility COVID-19 Module for reporting case data. We began work immediately to automate fully transparent data collection and reporting for all Genesis Centers.

April 30

CDC issued guidance for cohorting nursing home residents in Centers where COVID-19 is present, mirroring Genesis policies that had already been adopted on April 9, 2020

May 11

Completed an analysis of 189 Focused Infection Control Surveys conducted during the pandemic by state and federal officials at Genesis centers throughout the country, achieving a 96% zero-deficiency rate.

May 13

CMS suggested that nursing homes consider adopting an Infection Prevention designee for backup during all shifts, which is a practice that Genesis had already adopted on April 6, 2020.