COVID-19 Information Center

A Message From Our CEO

Here at Solvere Living, we manage retirement communities around the country – from active adult and independent living environments to assisted living and memory care residences. We have dedicated our careers to this field because we are passionate about the individuals who reside in senior living, and this passion fuels our response to this unprecedented coronavirus pandemic. Please allow me to take a moment to explain how our company is protecting those we are entrusted to serve.

To begin, let me assure you that we are constantly updating our protocols based on the newest guidance by federal, state and local officials, as well as implementing additional best practices recommended by our industry. Our primary areas of focus at this time are prevention, education and communication. We are acting with an abundance of caution, reinforcing our policies and procedures and infection control measures with our team members.

Key steps include diligent hand hygiene, adhering to all cleaning and disinfecting protocols using approved materials, and practicing physical distancing whenever possible. We are also restricting visitors except essential healthcare personnel, with the goal of preventing residents from being exposed COVID-19. These personnel are being thoroughly screened daily for any symptoms and any known contact with or exposure to COVID-19. Additionally, residents are being screened daily for any symptoms, including temperature checks and questions about potential COVID-19 exposure.

We understand how frustrating and nerve-racking not being permitted to visit a loved one can be. However, this is a necessary step and one recommended by the CDC, the White House and various state and federal agencies to protect vulnerable older adults. Still, there are other ways to maintain connections and they are very important. We are eager to assist family members to sustain bonds by setting up Skype and FaceTime calls along with phone calls and other methods for keeping in close touch. Please let your community team know you are interested and they will be delighted to help.

The physical isolation necessitated by coronavirus doesn’t mean residents are alone. Far from it! We are holding speed events via video and providing more one-on-one and small-group programming. We have even brought back the old-fashioned US post office mail method of pen pals, connecting residents throughout our sister communities. These are just some of the ways we are living our mission to inspire people to realize their full potential during this pandemic.

To our wonderful residents, our deepest thanks for your understanding, cooperation and support during this unusual time. You never cease to amaze all of us and you continue to do so now.

To our families, thank you for your understanding and the kind offers of help and support you have extended to us.

And to our incredibly talented and hard-working team members across the country, I am so thankful for all you do every day, and especially these last few weeks. You are the foundation of our communities and I applaud you.

We remain committed to our core values of building relationships through integrity, transparency, loyalty and entrepreneurship. For more information and ongoing updates, please keep visiting this page. The mandate for physical distancing doesn’t mean we distance ourselves from our humanity. Together, we will get through this. I encourage each of you to share your questions, thoughts and concerns at any time with any member of the Solvere family, beginning with myself.

Thank you,

Kristin Ward
Chief Executive Officer

May 21, 2020

Dear Residents, Team Members, Family and Friends:

We are all encouraged to see states beginning to reopen, and are looking forward to the day when things can return to normal for all of us. We’re happy to report that the majority of our communities have remained free of COVID-19, but we also understand that we must continue to remain vigilant for the safety of residents at Solvere-managed communities.

Each community continues to implement the latest protocols that have been developed based on the CDC recommendations and the local and state agencies for each community, and we continue to work closely with local and state health departments to implement these guidelines. As many states “phase in” the re-openings of retail stores and other businesses, we must continue to prioritize the safety of the residents and team members to minimize the opportunity for COVID to be introduced into a community.

At Solvere, we understand the uniqueness of every community and that it’s not a “one size fits all” solution. Each community is evaluated based on its individual needs and services, resident needs, and directives from governing agencies based on their location. We thank you for your understanding as we determine the appropriate timing of re-opening amenities, allowing visitors, and altering any protocols that are currently in place, which we will do as safely and thoughtfully as possible based on the information we have. We will continue to provide protocol updates and communicate with residents and families of each community individually as we transition through the various phases of re-opening within each state and each community.

To learn more about specific protocol updates and phases of re-opening for each community, we encourage you to contact your community of choice directly. Click on the community of your choice below to be directed to contact information for a community team member:

April 27, 2020

Dear Residents, Team Members, Family and Friends;

We are committed as always to full transparency and compliance with the latest COVID-19 guidelines and recommendations from the CDC, state and local governing authorities as well as best practices that will keep residents and team members safe and in good health.

Below are additional protocols as well as reminders from previous protocols that have been enacted. We extend our most sincere appreciation to our team members for their continued commitment and effort in caring for residents and each other during this difficult time.

Updated Protocol:

Limiting Community Access
Keep the front door locked to control access to the community and to ensure proper screening is occurring. Team members waiting to be screened for their shift should physically distance 6 feet apart.

**This includes when a resident is readmitted back to the community from another healthcare facility. They should be met at the door and the care of the resident taken over by our healthcare personnel.**

The only exceptions are:
1) EMS responding to a resident emergency
2) If EMS is required via stretcher transfer for the safe admission or readmission of the resident (and they should be screened first).

Masks

All community team members are to wear CE or Surgical face masks at all times, except for the situations described below.

All residents are to wear face masks if they leave their apartment for any reason.

• All communities that have known positive COVID-19 cases should implement the following:

• All team members must wear the re-useable KN95 masks at all times

• Residents must wear re-useable KN95 masks during ADL support care and with close face to face contact.

• Refer to Attached KN95 washing and disinfecting protocol

• All communities must develop a Cohort plan for residents who are isolating in the community with known positive COVID-19 disease, COVID-19 symptoms or have a potential exposure to COVID-19.

• The cohort plan must include the process and needed plan for implementation for designating team members to care for residents who are in cohort areas related to COVID-19.

• When meals are delivered, gloves are to be changed before entering each individual resident apartment
  • Hand sanitizer should be on meal service delivery cart and hands should be washed before and after entering each resident apartment to deliver a meal.

• When refreshment cart is being passed with snacks, gloves should be changed when handing a refreshment to each individual resident.
  • Hand sanitizer should be available on the refreshment cart and hands should be washed before and after each resident receives a snack

• If a resident responds “yes” to a screening question and it is believed to be due to a chronic or on-going issue, notate this on the screening log and place the resident on isolation utilizing the individualized screening tool until discussed with a member of the COVID-19 response team.

• Residents are permitted to move into a Valeo neighborhood or into an all Valeo memory care community if there have been no known cases of COVID-19 by any residents living in the community
• Residents who require being transferred from the AL or IL community into the Valeo neighborhood will be permitted if there has not been a positive case of COVID-19 in the neighborhood.

• The same process is in place when moving a resident out of the community as when moving a resident into the community
• Residents are permitted to have one family present to assist with moving out
• Residents family member and movers, if present, must be screened prior to moving items out of the resident apartment
• Moving company should be informed prior to move that movers will be screened and to provide the least number of movers possible for the move.

Family member and movers are to not access any common areas of the community.

Download PDF Version

KN95 Mask Washing & Disinfecting Instructions

April 14, 2020

Dear Residents, Team Members, Family and Friends;

We are committed as always to full transparency and compliance with the latest COVID-19 guidelines and recommendations from the CDC, state and local governing authorities as well as best practices that will keep residents and team members safe and in good health.

Below are additional protocols as well as reminders from previous protocols that have been enacted. We extend our most sincere appreciation to our team members for their continued commitment and effort in caring for residents and each other during this difficult time.

Updated Protocol:

• Reminder: all community team members are to wear CE or surgical face masks at all times
  • N95 and KN95 masks are worn only when caring for a resident who is positive for COVID-19 or if a resident is having COVID-19 symptoms and receiving nebulizer treatments. All other parameters for wearing a N95 or KN95 mask must be discussed with the COVID-19 response team.
  • Refer to the below FIT Testing Procedures link to use when team members require using a N95 or KN95 mask. A FIT Test must be performed prior to use and is performed annually and with any significant physical change in the team member wearing the mask.
• Move-ins
  • Residents are not permitted to move into a Valeo^TM neighborhood or into an all-Valeo memory care community until further notice. This includes resident transfers unless previously discussed with the COVID response team.
• Essential workers vs. non-essential workers
  • Only essential workers, other than community team members working their scheduled shift, are permitted into the community. Essential workers include hospice crisis care healthcare staff, skilled nursing services that cannot be provided by the licensed nurse in the community and private duty caregivers who provide 1:1 care to residents due to behavioral or cognitive support needs. All ADL care needs, even if formerly provided by a private caregiver or companion, are now to be provided by the community team members. Any exception to this needs to be reviewed by the COVID response team.
• Deliveries
  • All deliveries are to be placed and left inside of a bin or cart outside of the community main entrance. All delivery packages must be disinfected prior to being carried into the community.
• Community common areas
  • All common areas are closed and not to be used by any residents or team members
• Morning stand-up department head meeting
  • Meet in a location in the community that will allow all department head team members to maintain physical distancing of 6 feet apart during morning stand up
• Cleaning protocols
  • Each community must implement a daily cleaning protocol that includes cleaning multiple common areas and high touch areas of the community on a schedule each day
    • Please refer to the below Cleaning and Housekeeping Protocols link for details
• Isolation protocols
  • Residents who have been on isolation for 14 days may be removed from isolation if:
    • They are no longer exhibiting symptoms
    • They have not had a fever and they have not used fever reducing agents for 72 hours prior to being taken off isolation
• First floor windows
  • Ensure first floor resident apartment windows and common area windows are secured and unable to be opened from the outside
  • Be sure to follow all state mandated window height requirements particularly in Valeo when securing the windows to ensure this height restriction is maintained
• Postings
  • An elevator sign should be posted for each community limiting the number of individuals to ride the elevator at one time. This is in an effort to reinforce physical distancing parameters.
• Daily logs
  • Additional screening questions will be added to the resident screening logs. Updated resident and individual screening logs to follow.

Download PDF Version

Respirator Mask - FIT Testing Procedures

Cleaning and Housekeeping Protocols

April 6, 2020

Dear Residents, Team Members, Family and Friends;

We are committed as always to full transparency and compliance with the latest COVID-19 guidelines and recommendations from the CDC, state and local governing authorities as well as best practices that will keep residents and team members safe and in good health.

Below are additional protocols as well as reminders from previous protocols that have been enacted. We extend our most sincere appreciation to our team members for their continued commitment and effort in caring for residents and each other during this difficult time.

Updated Protocol:

All screening and sign in logs must be filled out in their entirety. The information requested is important in helping to determine potential risks of COVID-19 being transmitted into the community.

Team Member Screenings:

• A team member is not permitted to work if they answer “yes” to one or more of the symptoms asked on the screening tool. After 14 days of self-isolation, they must acquire a note from their physician indicating they are free from communicable disease and must be symptom-free in order to return to work.
• If the physician’s note permits them to return to work prior to the 14 days of self-isolation, the note must state they are free from communicable disease and the team member must be symptom-free. If team members need assistance in obtaining a doctor’s note, they should contact their General Manager who will then involve the Solvere Living Regional Vice President and Vice President of Team Engagement and Values (Human Resources).
• If the team member exhibits any of the symptoms from the screening log due to a previously determined or chronic condition, and the team member discloses said symptoms to the community, they may continue to work. Please document that it is a chronic condition related to their symptom on the screening log.
• General Managers to review the symptoms on the team member daily logs and advise their Regional Vice President and Human Resources when anyone is sent home or calls out sick.
• The COVID response team must be contacted prior to the team member returning to work.
• Team members that call out sick for non-COVID related or other symptoms outside of COVID related symptoms are treated just like a normal call out due to illness. They can return to work as soon as they’re cleared to return to work. Self-isolation requirements are not required.

Resident Screenings/Self-Isolation:

• A resident must be placed on self-isolation if they answer “yes” to one or more of the symptoms on the resident screening log. All residents on self-isolation are required to be screened every 4 hours using the individualized screening tool.
• All individualized screening logs as well as the other screening logs and sign in sheets must be emailed to the COVID response team daily by 12 Noon ET.
• If a resident’s condition does not improve during isolation or the resident experiences a decline in their condition, contact the COVID response team immediately or send the resident to the hospital and then contact the COVID response team immediately.
• If any resident leaves the community for a routine yet necessary health-care need, they are to be placed in continual self-isolation and screened every 4 hours. If the resident is symptom- free, an opportunity should be provided for them to leave their apartment, accompanied by a team member following physical distancing protocol of 6 feet of separation.
• Residents are not to be sent to the hospital because they are exhibiting a sign or symptom from the screening tool unless the sign or symptom is an immediate threat to the resident’s health.
• Call ahead to the hospital to inform them if a resident is coming to hospital due to a case of suspected COVID disease so they can prepare.
• Notify EMS prior to their arrival if they will be attending to or transporting a resident with suspected COVID disease. Emergency responders may not stop for screening due to urgency, however every attempt to screen should be made, as available. If EMS personnel are not wearing PPE, ask them to don PPE with the exception of requesting them to apply N95 masks.

Residents must be free from symptoms for 72 consecutive hours prior to being removed from self-isolation.

PPE Preservation

• Please refer to the PPE Preservation Protocol best practices for preserving PPE
• PPE is to be used by each team member for any resident in self-isolation
• Efforts to obtain PPE from state and local health departments must be emailed to the COVID response team immediately.

**Please be aware of updated screening logs provided to the community which includes:

• Health care providers sign-in logs to date from other communities they have visited
• Travel restrictions from NY, NJ and CT for communities in FL and MD only

Essential Health Care Personnel:

• Only essential health care personnel are permitted into the community.
• Optimize the use of TeleHealth or SKYPE visits for physician visits with communities
• Any individuals that are not essential to the current health care needs of the residents are not permitted to enter the community.

Download PDF Version

PPE Preservation Protocol

March 24, 2020

Dear Residents, Team Members, Family and Friends;

We continue to be committed to keeping you informed on the latest COVID-19 guidelines and recommendations from the CDC, state and local governing authorities. These protocols can be challenging to follow and even unsettling to hear at times, and we are keeping each resident engaged, active and socialized through these transitions.

As you may be aware, federal and state agencies continue to provide stringent protocols around visiting senior living communities, self-isolation and physical distancing. We have elected to update our protocol according to these guidelines in the interest of protecting residents and team members.

New Entry And Visitation Protocols

We continue to restrict all visitors from entering the community, with the exception of:

• Our team members
• Private caregivers
• Necessary skilled nursing or therapy groups
• Family members of residents who are on hospice and end of life care
• Deliveries of essential goods and services'

The individuals who meet these criteria continue to go through our screening for symptoms and recent travel before being permitted to enter the community.

We strongly discourage any resident from leaving the community.
Effective immediately, any resident who leaves the community premises will be required to self-isolate for 14 days. Likewise, any resident moving into the community or returning from an emergency room visit, hospital admission or sub-acute rehab stay will also be required to self-isolate for 14 days upon their return. During the 14-day isolation, residents will receive enhanced screening for symptoms related to COVID-19. Our community teams are prepared to work closely with each resident and to provide assistance in meeting any needs a resident may have outside of the community including shopping and medication pickups.
 
New Dining Protocol

At this time, residents will no longer receive meals in the community dining room. To ensure the physical distancing recommendation of six feet between each resident is maintained, meals will be delivered three times a day to residents’ apartments. We will also be providing snacks and refreshments to each resident three times a day during wellness and activity check-ins.

Communicating With Family And Friends

Weekly Skype sessions are being made available and facilitated for each resident with their family members or friends.
We understand this is a difficult time for many. Thank you for your continued support as we implement these safety measures on behalf of the residents and team members. You can see updates here and on our community Facebook page as well.

Sincerely,
Rebecca Townsend
Chief Operating Officer
Lorie A. Dancy
SVP of Wellness/Chief Compliance Officer

Download PDF Version

March 18, 2020

Dear Residents, Team Members, Family and Friends;

As we continue to hear breaking news regarding COVID-19, we want to keep you fully updated about our safety precautions. Federal and state agencies continue to add more stringent orders and protocols around visiting senior living communities, including the frequency in screening anyone who enters the community, as well as residents. There are also new guidelines pertaining to the recommended number of individuals to be present at one time in a group setting. We have elected to update our protocol in the interest of protecting residents and team members.

Effective immediately, all team members will be screened at the beginning of each shift. Temperatures will be taken on all team members and essential healthcare personnel entering the community. Residents will also be screened daily for symptoms and exposure. We strongly discourage any resident from leaving the community. Leaving the community increases the exposure of COVID-19 to the resident who left the community, therefore, increasing the likelihood of bringing COVID-19 into the community. This would create an extreme threat to all other residents living in the community by increasing their likelihood of contracting COVID-19 and transmitting it to others. Any resident who has underlying conditions such as heart disease, pulmonary disease, liver disease, cancer and many more illnesses increases the risk of them being able to combat COVID-19 successfully, if contracted. Any resident who still chooses to leave the community will be discouraged from doing so and screened upon each re-entry to the community.

We are taking steps to implement activity programs and dining that minimizes the number of residents in one group setting at a time but, rather, focuses on small group or individual activity and engagement. We continue to restrict all visitors from entering the community with the exception of essential healthcare personnel. Essential visits would include our team members, private caregivers and outside healthcare for providers such as skilled nursing or therapy groups who provide services to residents necessary for their continued well-being, family members of residents who are on hospice and end of life care, and essential deliveries of goods and services to the communities. The individuals who meet these criteria continue to go through our screening for symptoms and travel questions with every visit before being permitted to enter the community.

We continue to work closely with state and local authorities, as well as our vendors, in accessing the necessary Personal Protective Equipment (PPE) that is needed. We are currently executing on plans to ensure the communities have the necessary PPE to keep each resident and team member safe.

We recognize the difficult situation this is for many of the residents and family members. Each community is dedicating time to ensure family members and residents who wish to connect via phone, FaceTime or Skype are provided the opportunities and support to do so.

We continue to meet daily and are staying informed and implementing recommended directives and guidelines to avoid the transmission of infection as much as possible. Our COVID-19 response team is available for any questions or concerns and will continue to update you as new information comes out. We appreciate your support, patience and cooperation during this challenging time.

Respectfully yours,

Rebecca Townsend
Chief Operating Officer

Lorie Dancy, MSN, RN, CRNP
SVP of Wellness/Chief Compliance Officer

Download PDF Version

March 13, 2020

Dear Residents, Team Members, Family and Friends;

As we continue to hear breaking news regarding COVID-19, we want to keep you fully updated about our safety precautions. Federal and state agencies have begun to add more stringent orders and protocols around visiting senior living communities, and we have elected to update our protocol in the interest of protecting residents and team members.

Effective immediately, we are prohibiting all visitors to our communities except for essential visits. These include:

The individuals who meet this criteria will need to go through our screening for symptoms and travel (now including any international travel), before being permitted to enter the community. We know this is an emotional hardship for our residents and family members. We encourage you to communicate by phone, FaceTime, or Skype, to continue to interact with and comfort your loved ones.

We are meeting daily and continue to have our COVID-19 response team available for any questions or concerns and will continue to update you as new information comes out. We appreciate your support and cooperation during this challenging time.

Rebecca Townsend
Chief Operating Officer

Lorie Dancy, MSN, RN, CRNP
SVP of Wellness/Chief Compliance Officer

Download PDF Version

March 10, 2020

Solvere-Operated Community Residents, Team Members, Family and Friends;

As COVID-19 continues to spread across the United States, we are taking precautionary measures following guidance from the Centers for Disease Control and Prevention (CDC) and state health agencies as appropriate. These agencies have released guidelines for employers and healthcare providers to help contain the spread of coronavirus.

In addition to the steps we’ve taken to date related to hand hygiene, cleaning/disinfecting and supplies at the community, we are implementing additional team member and visitor screening. In an effort to ensure that the residents and team members stay in optimal health, we are asking anyone with a fever, cough or other flu-like symptoms, or who has traveled to an area of known infections within the last 30 days, to refrain from visiting our communities. We will also be asking questions related to the above symptoms to prevent the possible transmission of infection. Please be patient and candid in providing answers and listening to directives, to ensure that we are gathering the necessary information and responding appropriately. Finally, we are also considering limiting larger group events on a case-by-case basis to protect residents and avoid the possible spread of infection and apologize for any inconvenience caused.

Protocols

Community Access and Visitor Protocol
All Solvere-operated communities are restricting visitors to only essential healthcare personnel, who are being screened and documented. This process includes using screening logs for symptoms and questions about travel to or contact with areas of potential COVID-19 exposure.

Community Programs
Large group activities have been suspended for the near future until physical distancing of six feet is no longer necessary.  However, physical isolation at our community doesn’t mean residents are alone! Not only are our team members interacting with residents regularly, we’re engaging with them in new and creative ways by facilitating family and friend communication on Skype and FaceTime, holding specialized events via video and doing more one-on-one and small-group programming. We have also brought back the old-fashioned US post office mail method of pen pals among our sister communities. These are just some of the small ways we are living our mission to inspire people to realize their full potential.

Community Dining
We have suspended communal dining in order to practice physical distancing and are delivering meals to each apartment or suite. We are also utilizing refreshment carts to provide in-between meal snacks and specialty items. We are even having a contest to see how creative our teams can be! A few examples are door-to-door rolling omelet stations, ice cream carts and “drive by” happy hour via service cart to name a few.

Outings
All community and individual outings are suspended. We strongly discourage residents from leaving the community for any reason. Any resident that leaves for any reason will be required to self-isolate for 14 days upon their return to ensure the safety of all residents and team members. The team is available to assist residents with obtaining remote or delivery services as much as possible to prevent the need to leave.

Infection Control
Solvere has added new COVID-19 in-service trainings to our training portal and are tracking regular and ongoing trainings for all team members. In addition, we have provided additional training on good hygiene practices. All communities continue to practice good hand hygiene (washing with soap and water for at least 20 seconds) and are practicing physical distancing. In the event of an active case, all communities are stocked with the appropriate personal protective equipment, or PPE.

Resident Screening
All Solvere communities are screening all residents daily. Residents with any symptoms are being screened every 4 hours to monitor for possible COVID-19 infection. We have implemented the infection control protocols recommended by the CDC, including use of personal protection equipment, or PPE.

Our team is meeting daily to stay current, direct resources and to support the residents and each community. We will continue to follow recommendations for infection prevention from the CDC and will communicate any changes as they arise. Should you have any questions, please reach out to your community General Manager or Wellness Director.

Thank you for your support as we strive to keep the residents, their loved ones and team members safe.

Rebecca Townsend
Chief Operating Officer

Lorie Dancy, MSN, RN, CRNP
SVP of Wellness/Chief Compliance Officer

Download PDF Version

Resources

Solvere Living has compiled important links and information to help you stay apprised of any updates that become available. The website links below will provide a resourceful mix of important COVID-19 updates as well as activities to help individuals remain socially, culturally and intellectually stimulated and engaged during this period of home quarantine.

National Updates & Recommendations

• Centers For Disease Control (CDC)
• Johns Hopkins COVID-19 Map
• National Institutes of Health (NIH)
• ICAA Coronavirus Response Center
• CDC Recommendations for COVID-19 Prevention
• WebMD Coronaviruses Disinfection Tips by Surface Type
• CDC Cloth Face Covering Instructions
• OSHA-Accepted Respirator Mask FIT Testing Procedures
• Vitality Society™

State-by-State Departments of Health for Solvere-Operated Communities

• Florida
• Virginia
• Texas
• New Jersey
• New York
• Georgia
• California
• Oklahoma

Activities for Both Residents and Prospective Residents

• Watch Broadway Musicals Online
• Watch Creative Programming Online (such as painting, yoga, meditation, etc.)
  • Follow their Facebook page for more fun!
• Free Online Courses, Audio Books, eBooks, Movies, Coloring Books & More
• Virtual Field Trips
• Get Ideas for Creative Activities Online or Have Activity Boxes Shipped Straight to You!
• Watch Metropolitan Opera Performances for Free Online
• Virtual School Activities for All Ages
• Virtual Adventures You Can Experience at Home
• Virtual Field Trips You Can Take with Kids
• Explore Google Earth
• Virtual Museum Tours
• Virtual National Park Tours
• Free Online College Courses

COVID-19 Task Force

Solvere Living has formed a task force to respond to community and family questions and concerns around-the-clock during this pandemic. Its purpose is to ensure comprehensive and timely responses as well as to continuously update protocols and communicate with residents and families. Here are the task force members and their background:

Rebecca Townsend is the COO for Solvere Living and oversees all services for our managed communities. Rebecca has more than 28 years of experience in operating and overseeing senior housing communities.

Lorie Dancy is the SVP of Wellness and Compliance Officer for Solvere Living and oversees all care, compliance and programs for our managed communities. Lorie has over 25 years of experience in nursing and healthcare and is an RN and licensed Nurse Practitioner.

Marquette Leach is the Managing Director of Wellness for Solvere Living and is responsible for the day-to-day management of Solvere communities’ wellness departments. Marquette is an RN with 20 years of experience in nursing, leadership and healthcare and will be awarded his Doctor of Nursing Practice degree in August 2020.

Sarah Casey is outside general counsel for Solvere Living and is a 10-year practicing attorney who specializes in healthcare and advises on legal and compliance matters for long term care, provider groups and healthcare technology companies nationwide.