Lessons Generations Healthcare Learned Through the Pandemic

By Thomas Jurbala (picture : Edwin Cabigao, PhD, RN, is the director of clinical services at Generations Healthcare
)

“In the midst of . . . crisis, nothing is as clear or as certain as it appears in hindsight,” said historian Barbara W. Tuchman.

This is especially true in the medical field, where solutions often seem so obvious when we look back on a clinical situation or logistical issue. We think to ourselves, “I wish I knew then what I
know now!”

That’s why it’s so important to proactively learn from our difficult experiences. I sat down with Edwin Cabigao, PhD, RN, director of clinical services at Generations Healthcare, to talk about the lessons he learned from helping guide Generations Healthcare through the pandemic. He shared three lessons that can help any medical professional or organization as they face future challenges:

Prioritize People Over Profits

From the very beginning of the pandemic, Generations prioritized their staff and patients. No one could predict exactly how things would turn out, but the leadership team knew that no matter what, putting people first would always be the right decision.

“If I needed supplies, PPE, or testing kits, they didn’t question the cost,” Cabigao says. “They authorized me to purchase the necessary supplies so we could take care of our people.”

Cabigao recalled that Generations also provided the following solutions:

• Reserved hotel rooms for staff working in COVID units.
• Placed RV units outside facilities so staff members could take showers after their shift before going home.
• Offered sick hours above and beyond what the state required.
• Sent DoorDash and UberEats gift cards to provide food for staff experiencing COVID.

Horizon Ridge Skilled Nursing & Rehabilitation Center, a Generations facility in Henderson, Nevada, opened a COVID-19 unit at the beginning of the pandemic. This unit cared for hospital patients who were still COVID-positive until it was safe for them to return home.

“Generations didn’t limit spending on protective equipment for our COVID unit,” says Rhett Jensen, administrator of Horizon Ridge. “This enabled us to provide our employees with a safe environment so they felt comfortable coming to work. To this day, very few of our COVID unit employees have ever tested positive for COVID!”

“As a company, we realized that everything boils down to the mission of caring for a lifetime. That includes caring for our staff through respectful interactions,” Cabigao says. “You seldom see the harmonious collaboration among clinical staff, leaders, and operations personnel that we had. It really was the key to our success.”

Support Other Organizations

Across the company, facility leadership and staff reached out to support one another.

“Admins and DONs would frequently communicate with each other,” Cabigao says. “They would share best practices and send supplies when another facility was short. They truly became a community.”

In March 2020, for example, Bradley Court, a skilled nursing facility in El Cajon, California, had just been acquired by Generations—just in time for those residents to receive the safety-conscious care they would need over the course of the pandemic. With the logistics of the acquisition and the burgeoning pandemic, the facility was in dire need of help. As the pandemic hit, several residents were sent out due to signs and symptoms of COVID. At the same time, many concerned staff members were taking leaves of absence. Staffing was low, but the facility’s needs were still high.

But then the administrator of Horizon Ridge called Bradley Court. The State of California had just approved a staffing waiver for licensed nurses and CNAs to come in from other states and help during the pandemic.

The administrator reached out to his nursing staff, asking if anyone could go to California to help Bradley Court. Within minutes, 20 licensed staff members were making plans to head off to help their sister facility in need.

Respect Guidelines and Best Practices

Cabigao acted as the single point of contact for COVID guidelines across the company. The pages and pages of slightly differing guidelines from the CDC, the state, and county health departments were confusing for staff. Cabigao took all of these guidelines and crafted an overall policy that met all of the requirements and was simple for teams to understand and implement.

“My guidelines were more strict than CDPH and CDC,” he says. “I wanted to err on the side of caution. They started with 10 days of quarantine; I started with 14 days. Then they moved to 14 days, so it was easy for us to follow that guideline!”

Sorting through all the information available, responding to specific questions from facilities 24/7, and dealing with the overall stress of the pandemic was a difficult job, but Cabigao says he learned a lot.

“Make sure that you are confident and also have a good heart. It’s for the good of everyone!”

Another instrumental team member was Generations’ general council, Marissa Brandel. Staying on track with legal matters was crucial to keep the company running well and maintain peace of mind. Brandel was key to making sure Generations achieved just that with every new variant.

The pandemic was a test, but the people of Generations Healthcare became stronger through the challenge.

“We emerged with pride that we do live up to our mission,” Cabigao said.

Arthur Conan Doyle said, “It is easy to be wise after the event.” Let’s take this wisdom and commit to applying it to future scenarios. While the COVID-19 pandemic has caused tragedy and unequaled stress, we can take comfort that the lessons we learned are priceless and will help us deliver excellent, person-centered care as we move forward.

Thomas Jurbala is the director of project development at Generations Healthcare, with 30 years of experience in building and program development in skilled nursing, assisted living, memory care and behavioral health facilities. He holds a master’s degree in international business from Loyola Marymount University and a bachelor’s degree in business from Purdue University.