LeadingAge Member Snap Survey: COVID-19 Needs

Question Title

* 1. What is the status of COVID-19 cases among residents/clients? (all that apply)

Current diagnosed case(s)

Current suspected case(s)

Past diagnosed case(s)

Past suspected case(s)

Deaths from diagnosed case(s)

Deaths from suspected case(s)

No cases to-date

Question Title

* 2. What is the status of COVID-19 cases among staff/care workers? (all that apply)

Current diagnosed case(s)

Current suspected case(s)

Past diagnosed case(s)

Past suspected case(s)

Deaths from diagnosed case(s)

Deaths from suspected case(s)

No cases to-date

Question Title

* 3. Please indicate the estimated status of your supplies (based on current use rates).

	Enough for 6+ months	Enough 1-5 months	Enough for 2-3 weeks	Enough for 1 week or less	Do not have	Do not need
N95 masks	N95 masks Enough for 6+ months	N95 masks Enough 1-5 months	N95 masks Enough for 2-3 weeks	N95 masks Enough for 1 week or less	N95 masks Do not have	N95 masks Do not need
Surgical masks	Surgical masks Enough for 6+ months	Surgical masks Enough 1-5 months	Surgical masks Enough for 2-3 weeks	Surgical masks Enough for 1 week or less	Surgical masks Do not have	Surgical masks Do not need
Eye protection, including face shields or goggles	Eye protection, including face shields or goggles Enough for 6+ months	Eye protection, including face shields or goggles Enough 1-5 months	Eye protection, including face shields or goggles Enough for 2-3 weeks	Eye protection, including face shields or goggles Enough for 1 week or less	Eye protection, including face shields or goggles Do not have	Eye protection, including face shields or goggles Do not need
Gowns	Gowns Enough for 6+ months	Gowns Enough 1-5 months	Gowns Enough for 2-3 weeks	Gowns Enough for 1 week or less	Gowns Do not have	Gowns Do not need
Gloves	Gloves Enough for 6+ months	Gloves Enough 1-5 months	Gloves Enough for 2-3 weeks	Gloves Enough for 1 week or less	Gloves Do not have	Gloves Do not need
Alcohol-based hand sanitizer	Alcohol-based hand sanitizer Enough for 6+ months	Alcohol-based hand sanitizer Enough 1-5 months	Alcohol-based hand sanitizer Enough for 2-3 weeks	Alcohol-based hand sanitizer Enough for 1 week or less	Alcohol-based hand sanitizer Do not have	Alcohol-based hand sanitizer Do not need

Question Title

* 4. What are your biggest staffing challenges? (all that apply)

Stress and fear among workers

Protecting the health and safety of workers

Resignations and no-shows

Recruitment of new workers

Finding enough staff to cover shifts

Workers juggling home and family life

Finding enough staff to help with virtual family visits

Funding hero pay, overtime, or incentives

Covering for workers out on sick leave

I'm not having new or significant staffing challenges

We are not open or do not need staff

Other (please specify)

Question Title

* 5. How have your staffing costs changed over the past nine months?

Costs have significantly declined

Costs have declined

Costs have not changed

Costs have increased

Costs have significantly increased

I don't know

Question Title

* 6. If your organization does not have new COVID-19 cases, for how long can you support your current COVID-related expenses without further assistance?

6+ months

1-5 months

2-3 weeks

1 week or less

Question Title

* 7. Without further assistance, could you support the expenses of new COVID-19 case in your organization?

Definitely could

Probably could

Probably could not

Definitely could not

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* 8. Provider Type (select all that apply) and Contact Information

Adult Day

Affordable Housing

PACE

Assisted Living

Home Health

Hospice

Life Plan Community

Nursing Home

Question Title

* 9. Contact Information

Name

Company

State/Province

Email Address

Phone Number