Phil Fogg Jr., president and CEO of Marquis Companies, which owns and operates 25 assisted living facilities in Oregon, Nevada and California, is not the type of executive to govern from the boardroom.
He grew up in the long-term care industry and cut his teeth in his father’s company, Prestige Care, before setting off to manage his own skilled nursing care facility at the age of 26.
He said he knew from a very early age that it was work he wanted to spend the rest of his life doing.
“I just loved working with the residents,” says Fogg, who is in the fourth generation of the family business. “The wisdom that can be gained is incredible. We’re serving a population that is on the latter part of their life journey, and they need our support. We’ve been able to rally around the idea that you can help people live the best rest of their lives, no matter where they’re at in that journey.”
On a recent Saturday, Fogg, dressed down in a sweatshirt, a light windbreaker, jeans and an N95 respirator, was on-site at the facility his company owns in Canby, a combination assisted living and post-acute rehab center, which has seen more confirmed cases of the novel coronavirus than all but one long-term care home in the state of Oregon.
Fogg spoke with the Canby Now Podcast outside the facility on June 20, during the peak of the outbreak, which has since grown to 112 cases. Thirty-three of the facility’s 38 residents have tested positive, and 10 have died, along with 43 staff members.
We asked him what it’s like to be in charge of a facility experiencing such a severe outbreak of Covid-19.
“It’s, like, the worst thing that could ever happen,” Fogg replied haltingly, likening it to a form of torture. “This virus — it’s unique because it spreads very rapidly. But, unlike the Spanish flu, which took young people first, this is taking the elderly and a population of people with weaker immune systems.”
It has long been known that those who are older and have underlying health conditions are at much greater risk for serious complications or death related to the novel coronavirus and for that reason, Fogg said, his facilities have been strictly following the public health protocols and recommended guidelines that are in place.
But even the strictest containment procedures may not be 100 percent effective for a virus like this, which can infect a staff member and spread invisibly for days or even weeks before the first symptoms arise.
“It’s been a really, really challenging time period, because you do everything you can to keep this virus out of the communities,” he said, “but once it’s there, you have to really fight it.”
Most of the infection prevention protocols that are in effect at Marquis and long-term care facilities across the country are the same general practices that have been used for years to combat other contagious diseases that can disproportionately affect vulnerable populations in congregate settings, including the flu and norovirus.
What has been different about fighting Covid, Fogg said, and what he believes is one of the main things that has helped them turn the tide in Canby, is aggressive, widespread and repeated testing.
Based on lessons learned in the Canby outbreak, Marquis has adopted a testing regimen even stricter than the governor’s new guidelines for long-term care facilities requiring all staff to be tested at least once a month. One key element of Marquis’ strategy involves weekly surface testing.
“So, that means you’re swabbing surfaces and high-touch areas because we see this as a lead indicator of whether you have it,” Fogg said. “A positive indicator would trigger 100 percent testing of all staff.”
Although the state’s testing capacity has grown significantly in recent weeks, the timeliness of getting results back can still be a challenge. When Marquis tested all 74 residents and 46 staff members at the adjacent assisted living facility to ensure the virus had not spread there, it took four days to get the results.
“You can imagine, those poor people in the assisted living facility, the anxiety and stress you get during those four days,” he said. “You can’t have that.”
Marquis has since engaged a private contractor that is able to return results within 24 hours.
The other key to Marquis limiting the spread of the virus once the outbreak had been confirmed, Fogg said, was the heroic diligence of the facility’s staff.
“The term ‘hero’ gets thrown around, sometimes a little too generously, but in this environment, what our team members have been working through — there’s no other word for it,” Fogg said, noting that some employees who tested positive but were asymptomatic continued to work with Covid-positive residents, while others put themselves at risk to provide care to the sick. “I think the world of them.”
Marquis has been able to address staffing shortages by shifting staff from other facilities within the company, including 16 employees who agreed to temporarily relocate to a new memory care wing — which had finished construction, but had not yet been licensed to open before the pandemic hit.
“They all committed to three weeks here, and they’re just staying here,” Fogg said. “They’re supplementing all of our team members here, enabling them to self-quarantine and then come back when they’re ready. They’ve been true heroes as well.”