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Clinical Data Dashboards AND One Year of COVID-19

BrightSpring Health Services SVP and Chief Medical Officer, Dr. William Mills, presents ResCare Community Livingu2019s Best-In-Industry Clinical Data Dashboards AND One Year of COVID-19: The BrightSpring Experience. July 21, 2021.<br>

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Clinical Data Dashboards AND One Year of COVID-19

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  1. Community Living’s Best-In-Industry Clinical Data Dashboards& One Year of COVID-19:The BrightSpring Experience July 21, 2021

  2. Agenda • Welcome • Company Overview • Clinical Dashboard and COVID-19 Update • Q&A • Summary and Next Steps John.Mudgett@rescare.com M: 516-322-8761

  3. Combined Company Snapshot

  4. Differentiated Platform and Capabilities

  5. ResCare Community Living  ResCare Community Living is the leading provider of comprehensive and community-based health services to complex populations. We continue to focus on providing quality outcomes, through best-in-class services throughout the COVID-19 pandemic.  ResCare serves more than 11,000 people with intellectual and developmental disabilities (IDD) across the United States. Our Community Living programs are committed to the foundational pillars of:  • •Quality  • •Innovation  • •Person-Centered Care 

  6. Why are we here - New Research

  7. Community Living has Best-in-Industry Clinical Data Dashboards

  8. Q2 2021 Community Living: Stays, Days, Hospitalization Rate By State Q2 2021 Community Living Stays, Days and Hospitalization Rate by State

  9. Community Living – Hospitalization Rate by Quarter 15% decrease from Q1 to Q2 (fewer COVID-19 related hospitalizations)

  10. Q2 2021 Community Living: Average Days Spent at Home By State Community Living enabled individuals served to spend an average of 359 days at home / in the community per year Q2 2021 data annualized

  11. Q2 2021 Community Living: Inpatient Days Per 1,000 By State Mean Days at Home by ED

  12. One Year of COVID-19:The BrightSpring Experience

  13. A New Respiratory Illness is Reported Washington State New York Wuhan, China

  14. Response Overview

  15. Keys to BrightSpring’s Response Impact Planning Organization Education Formal Outbreak Plan Triage Communication Infection Control & PPE Training Teamwork

  16. Summary of Brightspring’s COVID-19 Response Since the COVID-19 pandemic began in early 2020, BrightSpring-PharMerica has focused on implementing best practices in infection control, visitor management, employee screening, and streamlined reporting and triage protocols to optimally support clients, patients, employees, families and communities. BrightSpring Numbers of Interest: • 11,000 potential / actual exposures and cases triaged internally • $10M investment in PPE • 50% lower infection rate than US average • Revenue within 2% of budget and 10% higher than prior year • EBITDA within 1% of budget and 11% higher than prior year • Over 50 citations of our work by scientific publications • Over 30 press mentions • 1 unified enterprise outbreak plan

  17. Quality Team: 24/7 Triage and Support A dedicated team supported over 11,000 patient and employee exposures in the first year of COVID-19, implementing best practices and leveraging new technology across the enterprise.

  18. Human Resources – Uncharted Territory • How do we enable Work From Home? Collaborative effort between HR and IT • Can we require health screenings? Normally forbidden by the ADA, the EEOC granted an exception and we started requiring this. • What kind of time off can we offer? Are we required to give paid time off under the Families First Act or are we an integrated employer with over 500 employees and exempt from the Act? • Can we require employees to use PTO and go into a negative PTO balance? What impact does that have on the exempt status for exempt employees? What are our options if we try to recoup that money if they end up leaving? • Dozens of new types of union requests (PPE, etc) • Furloughs, reductions-in-force, etc. To date, no lawsuits have resulted. • Salary reductions • How do we deal with people who refuse to come back to work? • What are our return-to-work policies? E.g.We receive a letter from the Attorney General of New York asking us to justify why we have people working in our pharmacies. • How do we make our workplaces safe to return? • Can we require vaccines? • What if our customers require our employees to be vaccinated? New Pandemic Guidance New Employee Case Database

  19. Government Relations – COVID-19 Outbreak Support • Government Relations COVID-19 Outbreak Support:   • Helped secure $67.6M in temporary rate enhancements through February ’21 • Helped secure $29.9M in disbursements from HHS Provider Relief Fund and $13.8M in state-level grants to date • Leading the national campaign to make long-term pharmacies eligible for Provider Relief Fund disbursements • Helped secure state eligibility for a 10% FMAP bump for HCBS services effective 4/1/21 to 3/31/22 (CMS guidance still pending) • Helped secure federal, state and local operational flexibilities and relief through regulatory and legislative efforts • Assisted with acquisition of over 40K government purchased COVID-19 tests for use in our operations  • Mobilized state and national associations on vaccination prioritization and education efforts for our front-line workforce and clients/patients • Continued leadership in the collection and dissemination of information on COVID-related orders, regulations and compliance

  20. Case Data

  21. Employee Epi Curve: New Daily COVID-19 Cases Between March 2020 and March 2021 45 40 35 30 25 20 15 10 5 Mar-2021 Mean = 6.6 new cases per day Mar-2020

  22. Enterprise – Employee Cases at One Year 9 employee deaths

  23. Employee COVID-19 Infections By Division: One Year USA Infection Rate 3/30/21 = 9.2% https://coronavirus.jhu.edu/map.html

  24. Patient/Client Epi Curve: New Daily COVID-19 Cases Between March 2020 and March 2021 45 40 35 30 25 20 15 10 5 Mar-2021 Mean = 4.1 new cases per day Mar-2020

  25. Enterprise – Patient / Client Cases at One Year 134 patient/client deaths

  26. Patient/Client COVID-19 Infections By Division: One Year USA Infection Rate 3/30/21 = 9.2% https://coronavirus.jhu.edu/map.html U.S. Congregate Care Setting Infection Rate* ~ 67% * 1,400,000 Assisted Living Resident Cases + Nursing Home Resident Cases) 2,100,000 Assisted Living Residents + Nursing Home Residents https://covidtracking.com/nursing-homes-long-term-care-facilities

  27. Publications & Press

  28. COVID-19 Outbreak Mitigation: Publishing Outcomes in Four Different Spaces in Peer-Reviewed Journals Home Health Care/Personal Home Care Intellectual/Developmental Disability * #2 Most Read Article in the Journal in the last 6 mo * * Top 5% of all Research Articles Ever Tracked by Altmetric * Primary Care and Assisted Living Pharmacy and Long-Term Care

  29. A Partial List of Sources that have Cited our COVID-19 Work

  30. Google Search for “BrightSpring Health COVID”: Many Pages of Positive Hits

  31. COVID-19-Related Positive Press

  32. Enabling Ongoing Organizational Success 1. Educate / Ongoing Infection Control 2. Vaccinate 3. Keep cases low 4. Enable continued quality & growth “It’s not enough that we do our best; sometimes we have to do what’s required.” -Winston Churchill-

  33. Positive Long Term Business Impacts From Outbreak Response Outbreak Impacts Expected to Have Longer Term Benefits to BrightSpring • Interdisciplinary team quickly developed strategy and executed on tactics to suppress virus transmission • Intranet education and My Policies built out (over 150 resources) • Enhanced Enterprise wide-infection control policy, live, cross country education roll out • Consolidated Crisis Communications • Tracking of Enterprise-wide average daily census of cases • Development of a Central Supply function and mass procurement and distribution of scarce PPE supplies • Agile, rapid development and launch of three new technologies within four weeks (COVID-19 tracking, Employee Screening app, Enterprise “War Room” Business Intelligence dashboard), vaccine tracking app • Enterprise location map • Development of Point of Care Diagnostic Testing Capabilities • Telehealth offerings expedited • Use of Novel Predictive Modeling (community-based thermometers to predict outbreak clusters, hospital utilization models, etc) • Pharmacy / Service business partnerships expedited Innovation & Teamwork

  34. References • Creasy SM, Sender S, Lichtefeld J, Romano N, Price M, Phipps J, White L, Howard S, Mills WR. Anti-Infective Prescribing Trends and Pharmacist-Led Outbreak Preparedness in Long Term Care Pharmacy During COVID-19. Annual Conference of The American Society of Consultant Pharmacists. • Gouin KA, Creasy S, Beckerson M, Wdowicki M, Hicks LA, Lind JN, Geller AI, Budnitz DS, Kabbani S. Trends in Prescribing of Antibiotics and Drugs Investigated for COVID-19 Treatment in U.S. Nursing Home Residents During the COVID-19 Pandemic. Clin Infect Dis. 2021 Mar 10:ciab225. doi: 10.1093/cid/ciab225. Epub ahead of print. • Mills WR,  Sender S,  Lichtefeld J,  Romano N,  Reynolds K,  Price M,  Phipps J,  White L,  Howard S, Poltavski D, Barnes R. Supporting individuals with intellectual and developmental disability during the first 100 days of the COVID‐19 outbreak in the USA. Journal of Intellectual Disability Research 2020;  64: 489-496. https://doi.org/10.1111/jir.12740 • Mills WR, Sender S, Reynolds K, Lichtefeld J, Romano N, Price M, Phipps J, White L, Howard S, Domico, R. An Outbreak Preparedness and Mitigation Approach in Home Health and Personal Home Care During the COVID-19 Pandemic. Home Health Care Management & Practice 2020; 32: 229-233. https://doi.org/10.1177/1084822320933567 • Mills WR, Buccola JM, Roosa J, Lemin L, Cappelli L, Schraer B. Variation in Value-Based Outcome Measures Among Assisted Living Communities Served by a Home-Based Primary Care Practice During COVID-19. Home Health Care Management & Practice. 2021;33(1):45-48. doi:10.1177/1084822320963094 • Mills WR, Buccola JM, Sender S, Lichtefeld J, Romano N, Reynolds K, Price M, Phipps J, White L, Howard S. Home Based Primary Care Led-Outbreak Mitigation in Assisted Living Facilities in the First One Hundred Days of COVID-19. Journal of the American Medical Directors Association 2020; 21: 951-953. https://doi.org/10.1016/j.jamda.2020.06.014 • Mills WR, Creasy S, Sender S, Lichtefeld J, Romano N, Reynolds K, Price M, Phipps J, White L, Howard S. Hydroxychloroquine Sulfate Prescribing Trends and Pharmacist-Led Outbreak Preparedness in Long Term Care Pharmacy During COVID-19. Journal of the Medical Directors Association 2020; 21: 1000-1001. https://doi.org/10.1016/j.jamda.2020.06.012

  35. Q & A Click to add text

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