Given the grim statistics and news about COVID-19, it’s easy to paint long-term care with a broad brush: Providers are doomed, the industry won’t survive.

But probe a bit beneath the surface and you’ll see that all is not lost. There are not only players standing amidst the wreckage but standing tall.

Here’s one: John Knox Village, based in Pompano Beach, FL. The second-largest life plan community in Florida, which offers independent and assisted living, and Green Houses for skilled nursing, by objective measures has set a high bar in terms of care, skill and professionalism. As proof of its efforts, the community, which has 194 SNF residents, has suffered fewer than five resident deaths from the coronavirus and not a single staff death.  

The secret to its good fortune?

“We are continuing to have a more conservative stance,” Bill Pickhardt, chief operating officer of the organization, told me recently. “I think that is the key to how successful we have been.”  

That conservative stance means being tougher on opening than the surrounding Broward County, whose daily positivity rate is above 5%, he said. As of last week, John Knox Village still had its dining room and fitness room open and was testing staff weekly.

John Knox COO Bill Pickhardt

“If our county went to a no face mask rule, we wouldn’t go there,” Pickhhardt noted.

Choices at the outset

It’s also clear after talking to Pickhardt that the long-term care community was on top of its game from the beginning. Actions included screening every entrant in early March, insisting residents not go off-campus, and screening and teaching independent living residents about safety. Did I mention they hired consultants to create a crisis management plan in late 2019 before the pandemic appeared on anyone’s radar?

Some bold moves didn’t hurt, either. These included developing a relationship with the Broward County epidemiologist, which allowed them to have critical insight regarding testing and isolation units. The community also allowed staff early on to reach out to all suppliers and sources for personal protective equipment.

“We were getting PPE when a lot of competitors and colleagues were unable,” Pickhardt said.


Of course there were many other smart decisions, such as developing a screening app for mobile devices and implementing touchpoint cleaning. The latter involved using blacklights to identify fingerprints left behind on surfaces such as door handles.

PIckhardt noted four specific measures that have made a difference in managing the pandemic since March:

  • Consistent and diligent screening
  • Self-quarantining of employees, making it clear that they would get paid if they had to be out of work
  • Restricting activity so people were not exposed. This included no guests on campus, suggesting residents not sit in lobby areas, and shutting down dining when necessary
  • Staying current on the latest information, in part through diligently attending LeadingAge’s regular calls

The case of John Knox Village is not to show that life can be perfect for long-term care. But it provides an example of how facilities, with the proper resources and attention to detail, can manage this virus. The key, for better or worse, is to stay vigilant.

“I feel excellent,” Pickhardt answered when asked about his community’s handling of COVID-19. “But I also am a realist and know that we can’t take our eye off the ball, because the second we do, it will fall.”

Liza Berger is Senior Editor at McKnight’s Long-Term Care News. Follow her @LizaBerger19.