Elucidating COVID-19 Decision-Making at Deerfield

When it comes to Deerfield’s COVID-19 response, decision-making is a complex process involving an interdisciplinary team known as the COVID-19 Task Force.

Deerfield was ahead of the curve among aging services facilities in our region for recognizing the legitimate threat of COVID-19 and implementing an aggressive initial response. In the earliest days of COVID-19 in the United States, department directors at Deerfield joined together to engage in a whirlwind of research, innovative problem-solving, and the swift implementation of sweeping and unprecedented campus-wide operational changes. In the absence of regulations or formal guidance, we worked cooperatively to blaze trails for our community. The Deerfield Task Force relied on World Health Organization reports, limited information from the Centers for Disease Control, and reputable scientific journals to inform what we sought to be a data-driven response plan.

The situation is radically different now, just two months later. The Centers for Medicare and Medicaid Services (CMS), has produced unequivocal regulatory guidance for COVID-19 prevention and management in both skilled nursing facilities and adult care homes (the distinction under which our assisted living facility falls). The Centers for Disease Control and Prevention (CDC) has released volumes of COVID-19 guidance, now exceedingly specific in most cases; of particular usefulness has been their guiding documents on independent living and retirement communities, home quarantine and isolation, home care of individuals with COVID-19, and employee health. The state of North Carolina and the county of Buncombe have released public health orders aimed at mitigating the spread of COVID-19 and protecting, restricting, and guiding citizens. There now exists a voluminous collection of medical and scientific literature.

Today, at Deerfield, a core COVID-19 Task Force comprised of the Medical Director, Infection Preventionist, Director of Health and Wellness, Director of Nursing, Assistant Director of Nursing and Executive Director collaborate to review each and every COVID-19-related policy or protocol prior to its implementation. This team is expanded to include others depending upon the specific issue at hand. The Director of Operations and leading members of the Operations team are involved when dining, housekeeping, resident life, or other operational needs are addressed. The Director of Facilities and leading members of the Facilities team are critical to working out matters of security and campus access.

The interdisciplinary team works to devise well-reasoned policies and protocols that are guided by regulatory obligation, guidance from public health authorities, orders from state and county government, as well as scientific data. We remain cognizant of Deerfield’s unique situation and of our high-risk resident and staff populations. With our primary objective being to safeguard the health and welfare of our Deerfield community, we strive to ensure that our interpretation of guiding documents is relevant to and appropriate for the CCRC setting. In many cases, Deerfield policy will purposefully lag several steps behind government policy that was devised with the general population in mind.

Taryn Tindall, RN, on behalf of the Deerfield Leadership Team