Repurposing PACE day center in response to the novel coronavirus pandemic

Abstract

BACKGROUND: On March 10, 2020, the first two cases of COVID-19 were reported in Michigan. Gov. Gretchen Whitmer then declared a state of emergency to address the situation. (1) The US Surgeon General characterized the Detroit area as a national "hotspot" (2). As a domino effect, most subacute rehabilitation facilities were anticipated to fill as recovering patients were discharged from the hospital. It was also anticipated that most assisted living and group homes would be placing holds on any admissions due to fear of spreading the virus. INTERVENTION: The impact of the COVID pandemic was significant on Huron Valley PACE, located in Ypsilanti, MI. In response to this situation, we created a multidisciplinary committee to prepare, plan and enact a response by repurposing our Day Center to be able to provide temporary 24/7 rehabilitation and respite care for participants who have no other options available for an alternate living situation. Operation Safety Net is our attempt to mitigate the many overarching risks this pandemic poses. We anticipated multiple scenarios in which this plan would be needed: 1. Positive COVID 19 participants with mild symptoms, but not needing hospitalization. 2. Participants discharged from the hospital and in need of subacute rehab. 3. Respite Care for participants with caregivers at risk of burnout. 4. Respite Care for participants with caregivers hospitalized with COVID. The Day Center at Huron Valley PACE is large and lends itself nicely to being divided into two separate but equal areas for participant care and oversight. With nursing/physician support scheduled onsite 24/7, this new model of care launched at Huron Valley PACE on April 10, 2020, and to date, Operation Safety Net has provided temporary subacute/respite care for 6 of our participants, one of whom had COVID. Response from participants and their families has been very positive. SUMMARY: Operation Safety Net represents an innovative use of the PACE Day Center, given the lack of access to many traditional long-term care settings facilities during the current pandemic, and is a model for other PACE programs nationwide during this pandemic.