COVID-19 Response Timeline Below is a historical look, depicting Atria’s COVID-19 protocols (a series of communications governing our outbreak response), procurement and initiatives to support the safety of our residents and employees. FEBRUARY 27 FEBRUARY 27 24 documented COVID-19 cases in United States First crisis response planning meetings at the Support Center in Louisville, Kentucky MARCH 3 Issued coronavirus response action plan and outbreak preventive protocol checklist • MARCH 6 All visitors screened for possible exposure • Heightened infection control training and communication • Preventive protocol checklist FEDERAL GUIDANCE Centers for Disease Control and Prevention (CDC) issued initial guidance on long-term care facilities MARCH 9 Published directives on reduced resident contact with MARCH 11 visitors and guests and restricted company travel • Transportation services limited to scheduled NYC St. Patrick’s Day Parade postponed appointments and scenic drives • Closed all resident self-service dining venues NBA suspends remainder of 2020 basketball season • Strongly recommended families not take residents out of communities for public STATE GUIDANCE gatherings California Department of Public Health published • Postponed/canceled all community events “Guidance for Limiting the Transmission of COVID-19 with expected 3 or more external visitors in Long-Term Care Facilities” New York State Department of Health sent letters to nursing homes and adult care facilities, providing guidance on preventing exposure to and spread of virus Florida Division of Emergency Management issues orders restricting visitation in long-term care facilities, including assisted living MARCH 12 MARCH 12 Directed communities to reduce access to employees, MLB cancels 2020 spring training residents and essential visitors who meet stepped-up screening and delays start of season indefinitely protocols • Introduced 14-day quarantine for residents returning MARCH 13 to a community following travel • Transportation services limited to scheduled medical President Trump declares National Emergency appointments only • Postponed/canceled all community events with Schools begin closing expected visitors FEDERAL GUIDANCE CMS updates nursing home guidance focusing on restrictions MARCH 14 for visitors and wearing personal protective equipment (PPE) Introduced staff and resident temperature screening requirements • Prior to access, required all visitors and staff to have their MARCH 15 temperature taken and recorded • Restricted group programs to fewer than 9 residents FEDERAL GUIDANCE CDC releases guidance recommending in-person events with more than 50 people be postponed for the next 8 weeks STATE GUIDANCE California Governor Newsom signs Executive Order, prioritizing nursing homes and calls for higher focus on residents Florida Division of Emergency Management issued order prohibiting visitation to certain facilities for 30 days MARCH 16 Kentucky Derby postponed to September MARCH 17 MARCH 17 Established scalable process to supply PPE to all employees NCAA cancels 2020 Tournaments • Warehouse established and staffed in Louisville, Kentucky • Initiated weekly re-supply shipments process MARCH 18 Promoted social distancing through suspension of communal dining and all group programs • Implemented in-apartment dining • Required employees to wear face masks when within 6 feet of a resident • Strongly encouraged residents to stay in their MARCH 20 apartments, only leave when necessary and practice social distancing when outside their apartments FEDERAL GUIDANCE • Required all visitors to wear face masks when in CDC issues guidance titled “Preventing the Spread of COVID-19 community in Retirement Communities and Independent Living Facilities (Interim Guidance)” STATE GUIDANCE New York State Department of Health puts out nursing home MARCH 21 advisory recommendations to protect nursing home residents Implemented new resident engagement strategy • #SpreadLoveNotGerms campaign rolled out • Daily engagement newsletter launched MARCH 22 Implemented full community quarantine and frequent symptom screening • Began checking resident temperatures twice a day and employees 3 times per shift MARCH 24 • Revised protocol to check essential visitors’ temperatures when entering communities 2020 Tokyo Summer Olympics postponed to 2021 MARCH 26 Issued additional screening question: “You or anyone in your household has traveled to the greater New York City metropolitan area in the last 14 days” MARCH 27 MARCH 27 Contracted for private EMT services for New York City, Disney closes theme parks Westchester County, Long Island and Fort Lauderdale MARCH 28 FEDERAL GUIDANCE MARCH 29 CDC issues Travel Advisory regarding Deployed vitals tracking app for temperature and oxygen recording Greater New York City metropolitan area MARCH 31 Expanded PPE usage in Greater New York City metropolitan area • Began providing full scrubs • Provided N95 masks and gloves to employees for public transportation purposes APRIL 6 APRIL 6 Implemented strict person under investigation (PUI) and The Masters moves to November 2020 PPE protocols APRIL 10 Launched social distance dining pilot program in limited locations APRIL 12 Began drive-up visits for residents and families in select APRIL 15 communities (as regulator guidance permitted) Tour de France is postponed CDC issues guidance specific to assisted living facilities APRIL 18 Expanded New York City metropolitan PPE to all New England APRIL 20 communities • Provided N95 masks and gloves for employees’ families The NYC Pride March is canceled (first time in history) APRIL 23 Began COVID-19 testing for all employees APRIL 25 New York Times reports testing remains scarce as governors weigh reopening states APRIL 27 Number of COVID-19 cases in Westchester (NYC suburb) is on the decline, county executive George Latimer reports APRIL 28 First release of Atria COVID-19 response timeline APRIL 30 APRIL 30 CDC updates guidance on return-to-work criteria for Completed 173 virtual Quality Enhancement “snapshot” audits healthcare personnel diagnosed with COVID-19 from 7 to 10 days (Atria uses 14 days) MAY 1 MAY 2 Additional PPE requirements introduced for housekeepers, Secretariat wins the virtual Kentucky Derby, including N95 masks and glove numbering against 12 fellow Triple Crown winners More than a dozen U.S. states begin to loosen restrictions imposed to limit the spread of COVID-19 MAY 4 California Governor Newsom signs Executive Order allowing individual counties to implement less-restrictive measures than California as a whole MAY 5 MAY 5 Testing of Life Guidance® memory care neighborhoods begins Major supermarket chains limit meat purchases in response to shortages stemming from virus outbreaks MAY 6 MAY 6 April unemployment rate likely to hit 15% or higher, by far Atria begins testing new hires prior to start dates in the highest since the Great Depression; two months earlier, weekly testing clinics the rate was 3.5%, a 50-year low (New York Times) Quality Enhancement audits expand to include review of employee PPE criteria via virtual process MAY 7 600 new COVID-19 cases appear in New York, predominantly from people at home and not working (CBS) MAY 8 ~15k tests have been administered to employees across U.S. communities U.S. communities begin roll out of social distancing walking program 17 Atria Retirement Canada communities begin to relax quarantine protocols for residents Yolo County, CA, issues recommendations to assisted living providers regarding “drive-up” visitation, using Atria’s protocol verbatim MAY 8 Second release of Atria COVID-19 response timeline MAY 10 MAY 10 New York Governor Cuomo issues Executive Order requiring Atria designs and prints 21,000+ custom Mother’s Day cards to nursing homes and adult care facilities to begin testing celebrate Atria moms all personnel for COVID-19 MAY 11 New York Governor Cuomo announces 3 regions of New York ready to begin reopening on May 15 “As States Rush to Reopen, Scientists Fear a Coronavirus Comeback” (New York Times) New York State Department of Health requires hospitals to test all patients for COVID-19, and obtain a negative result, before discharging them to an adult care facility MAY 12 MAY 12 Atria CEO John Moore issues update and FAQs in response to MLB proposes early July Opening Day April 28 letter CDC issues specific guidance for memory care units Atria continues its protocols with respect to memory care in long-term care facilities neighborhoods, which have been in place since early March and New Jersey Department of Health announces requirement exceed CDC guidance for testing of residents and employees in nursing homes and First round of employee testing complete; identified more than assisted living communities 100 COVID-19 positive asymptomatic employees MAY 13 MAY 13 More than 15,000 people (~half of total Atria population) have 32 states have partially reopened been tested; <1% have been COVID-19+ MAY 14 More than 4,100 pen pal letters sent to Atria residents since March 17 MAY 15 MAY 15 States continue to ramp up regular COVID-19 Atria’s 27 reviews in 6 states completed to-date are infectious disease control audits deficiency-free Atria submits proprietary mobile app to Apple App Store; the app will provide residents and families real-time communication and monitoring of potential COVID-19 resident symptoms Social distance dining rolls out at 50+ communities MAY 15 Third release of Atria COVID-19 response timeline MAY 16 MAY 16 For the first time, the U.S. House of Representatives
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