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By Sarah Hall

As of this writing, there are more than 1.8 million confirmed cases of COVID-19 in the United States, and more than 100,000 confirmed deaths. According to a state-by-state analysis of reported COVID-19 fatalities compiled for the Freedom for Research on Equal Opportunity, some 42 percent occurred in nursing homes and residential care facilities, even though patients in such facilities only make up 0.6 percent of the American population.

“The tragedy,” said study co-author Avik Roy, “is that it didn’t have to be this way.”

Thanks to good planning, good people and strong leadership, the largest elder care agency in Central New York was able to avoid that tragedy. To date, Loretto has managed to keep positive cases down to roughly 1 percent overall out of 10,000 residents and 2,500 employees.

“We have 19 sites across Onondaga and Cayuga counties,” said Loretto CEO Dr. Kimberly Townsend. “With 10,000 vulnerable people in our care, it makes it a challenge to keep people safe. All you need is somebody to go to Target in Fayetteville at the wrong time.”

So how did Loretto manage to protect its vulnerable population? Townsend said the organization’s senior leadership took on planning for the pandemic as a long-term effort.

“COVID is not a spring 2020 problem,” she said. “It will be with us for months to come. Pace yourself—it’s a marathon, not a sprint… What we are looking at from an organizational perspective is just continued vigilance and keeping people safe.”

Longtime leader

Townsend came on as CEO at Loretto in January of 2014. She said her longevity at the company has been a blessing in this trying time.

“By now, I know all the players. I know all of our ins and outs,” she said. “It has a been a huge mobilization of every single member of Loretto to keep people safe. I’m really grateful that I’ve been here for a while and really know the organization inside and out, because it’s hard.”

Even before joining Loretto, Townsend was a well-respected leader in the healthcare field. She spent 14 years at Welch Allyn, first as an attorney, then as Associate General Counsel. When she left the medical devices firm for the job at Loretto, she was the Senior Director of Government Affairs. 

“Welch Allyn really was a seedbed of leadership greatness,” Townsend said. “Welch Allyn… was wholly focused on community engagement, and really heavily focused on providing opportunities for their employees to excel in many different ways to build their education and experience.”

Townsend benefitted directly from that generosity. Though she had several impressive qualifications going into the job—a law degree, a CPA and an MBA—Welch Allyn supported her as she got a Master’s in Public Administration from the Maxwell School in Health Economics and Policy. She has also earned a Doctorate in Executive Leadership from St. John Fisher College.

“All of those things, plus the experiences that I had at Welch Allyn, interacting with large customers, the senior leadership team, who’s just a really fine group of leaders, really enabled me to do the job that I’m doing today,” she said.

Top priorities

Right now, that job looks different than Townsend could ever have imagined.

“The word unprecedented really has been overused at this point, but it is unprecedented,” she said. “At the end of the day, the most important thing is that we care for the people who work for us and that we care for the people whose lives are entrusted to us. We are planning just how we continue to do that, but it’s a challenge.”

Once news of the pandemic hit, Townsend and her executive staff knew they had to act quickly to protect their residents. What wasn’t as clear was what actions were necessary.

“I think as we looked at it and really understood how enormous the tasks were, when you’re looking at a global pandemic, that we came down as a senior leadership team to three critical things that we had the ability to control,” she said.

Those three things involved focusing on basic needs first: personal protection equipment (PPE) for the staff, restricting visitors and early and aggressive screening.

“We could have focused on a hundred different things, because certainly there were a hundred different facets to the crisis,” she said. “But those are all the three focus areas, the priority areas that I think has helped us have very good outcomes today.”

Once tests were available, Loretto performed widespread testing, which became a critical priority for the organization. Loretto coordinated mandatory testing of all nursing home residents with the State Department of Health, supported the executive order to conduct mandatory testing of staff twice a week, and offered testing for certain other residents throughout the organization. This put additional strain on staffing access to PPE, developing a process to conduct testing safely for employees, and a major cost impact to the bottom line.

“But we never hesitated, not even for a single minute, because it’s the right thing to do for the safety and security of our staff and residents,” Townsend said.

‘One has to be somewhat comfortable with uncertainty’

Because the COVID-19 pandemic is a constantly evolving situation, additional planning is difficult, to say the least.

“There is so much we don’t know,” Townsend said. “I think one has to be somewhat comfortable with uncertainty, right?”

That said, Townsend and her staff are hardly flying blind. The team did extensive scenario planning and financial modeling to best prepare themselves and made sure everything was flexible enough to respond to rapid changes in circumstance.

“Our screening tool was a living document,” Townsend said. “As you know more, you have to evolve your processes.”

But she said the most important task at hand is to keep all stakeholders informed at all times.

“Communicate, communicate, communicate,” Townsend said. “You cannot communicate too much with our families, with our residents, with our staff with our managers, even with the media. It’s important that we are honest with people in terms of what we know and honest with them about what we don’t know.”

She said it’s also important to acknowledge moves the team has made that could have been handled better. For example, Townsend said they could have been more efficient in procuring PPE.

“In late February, early March, we just went out into the market and we just started buying PPE from everywhere,” she said. “As it turned out we were able to get everything that we needed, but there were things that didn’t pan out. There was a lot of energy put into it that might have been put into other areas.”

Townsend said it’s important to highlight the failures along with the successes to maintain a good relationship with the people she serves.

“Just having that organizational honesty is important to continue to maintain trust, reach those expectations,” she said. “But you can’t just do it in a crisis. If you didn’t have people’s trust prior to COVID-19, you’re probably not going to get it now.”

Helping employees

Townsend said it’s also critical to maintain a culture of trust and integrity between Loretto’s leadership and its employees.

“Here at Loretto, it’s part of our leadership paradigm,” she said. “We try to be open, and good listeners, and good leaders. We try to listen to the needs of our staff and to meet those needs.”

The company distributed 400 emergency food bags, and its free diaper program, started two years ago, continues to give out 13,000 diapers every month.

“We heard from employees with their children home from school, employees had less than a day’s worth of food on hand. They’re working all day or working double shifts. They get to the grocery store, the shelves are empty,” Townsend said. “We try to do things that meet people’s needs.”

While the experience has been stressful, Townsend said it’s also shown her how many great people are associated with Loretto.

“It has really reinforced my faith in all the members of the Loretto family, in my organization—that’s our staff, that’s our leadership, that’s our residents and their families,” she said. “It just reinforces my faith in the lengths that people will go to, to show up and bring their best self to a situation for the care of someone other than themselves.”

While Loretto leadership is still closely monitoring the health and safety of employees and residents in each of its facilities, neither a specific date nor specific protocols have been finalized for when and how the facilities will reopen for visitors.