Best Practices in Assessing and Improving Air Quality in Senior Care Communities

John Bohlmann, founder and CEO, HawkenAQ

Air quality has always been a concern in senior care settings, but the COVID-19 pandemic has highlighted the importance of air quality. Whether upgrading an old system to the newest technology or evaluating the effectiveness of a ventilation system, there are multiple ways that facilities can improve air quality to maximize staff and resident health and safety.

Common Air Quality Challenges in Senior Care Settings

The layout of your typical senior care facility is predisposed to air quality issues. John Bohlmann, founder and CEO of HawkenAQ, notes that poor ventilation, poor circulation, and pollutants in the air can contribute to the spread of airborne viruses, like COVID-19.

“The CDC has a set of recommendations specifically for indoor air quality, aimed at preventing the spread of these viruses,” he says. “Many buildings do not meet the minimum CDC requirements for healthy indoor air.”

John Higgins, president and CEO of illumiPure, explains that the close proximity of residents in these settings, paired with the presence of visitors from the outside community means it’s difficult to monitor what’s happening to the air within the buildings.

“HVAC systems have a filter, but if that filter isn’t changed consistently and constantly, which is difficult to do, then you’ll just push around the viruses, germs, and mold spores in the air,” Higgins explains. “Monitoring your air and figuring out what your problem is if the first solution to figuring out what your long-term plan needs to be.”

Ways to Improve Your Facility’s Air Quality

To improve air quality and help to prevent COVID-19 transmission, Bohlmann suggests that facilities focus on maintaining good ventilation with plenty of fresh air. “In addition, maintaining temperature and humidity levels within a certain range has shown to help prevent the spread,” he says.

He notes that when testing air quality, HawkenAQ combines national standards for air quality from institutions including the CDC, ASHRAE, EPA, and more, producing a full picture of a building’s air quality. Some signs of poor air quality may be reflected in resident complains of odd smells, stuffy air, headaches and migraines, and afternoon tiredness.

Higgins explains that no one type of system or protection is the answer for all of the problems a building might have. “The CDC made a statement a while back that the answer to all COVID-19 problems was to bring in clean air from the outside to circulate.” Higgins notes there are multiple problems with that.

By bringing in fresh air, you’re just diluting the air that’s inside the building, he says, rather than actually removing the virus. In some locations, such as cities, bringing in “fresh air” will also bring in VOCs that are floating around outside, he says. “Before you open those dampers, you should know what’s going on in your facility. COVID-19 is one of hundreds of problems you have. Right now it’s just the immediate problem you have,” says Higgins.

He explains that there are recognizable signs a facility might have air quality problem. Corrosion on surfaces, mold and mildews, odd smells, and more can alert staff to issues. Higgins also encourages facilities to look to a more unusual location for signs of air quality problems: Their plants. “No one wipes the leaves of the plants down, so look at the dust on the leaves,” he suggests. “Dust doesn’t settle on a photosynthesized leaf or plant like it would settle on a table or desk. It doesn’t have static electricity. If your plants are dusty, it’s been a long time or you have a very serious dust problem.”

When it comes to addressing air quality issues, the right solution will really depend on the problems that have been identified within a facility. Higgins highlights the importance of understanding the difference between filtration and elimination. Historically, most air quality products were designed to filter out pathogens. However, when pathogens, like COVID-19, are at the microscopic level, filtration is ineffective. In these cases, you need a solution that kills the disease, rather than just filtering the air. As a result, Higgins suggests using UV light to kill off viruses like COVID-19.

Bohlmann says that some common solutions include improving ventilation, adjusting thermostats, and making simple changes like installing HEPA filtration.

Improving Air Quality on a Budget

Walter E. Bennet, HVAC specialist

Improvements can also be made on a limited budget that doesn’t allow for a whole reworking of a ventilation system. Walter E. Bennet, a Dallas, Texas-based HVAC expert, suggests installing portable air filtration systems that can be used in different locations within the building, or installing an indoor air purifier that decreases the number of outdoor toxins coming into contact with the skin and lungs.

“Facilities can make a huge difference by doing relatively simple and inexpensive things such as making small adjustments to their thermostats or opening windows to let in more fresh air,” says Bohlmann. “Once our system is installed, we sent out notifications to staff to help them make the best decisions for their particular community, and improve air quality for everyone.”

Higgins says that with a very regimented maintenance program, facilities can start to improve their air quality, but the cost of doing so long-term may be equal or greater to what a facility would pay to start installing more practical solutions. “You don’t have to retrofit an entire facility to make it better,” he says. “Do key areas at one time, like areas where people are crowded together.”

Improving air quality requires diligence and a financial investment, but it can result in improved health for everyone who spends time in the building. “Indoor air quality is a hidden pandemic – it’s one of the leading causes of death in many countries,” explains Bohlmann. “If we work together to improve our air quality, it will greatly improve the health and wellness of everyone in our facilities.”

Editor’s note: CMS recently issued updated visitation FAQs, four of which relate directly to air quality issues. The FAQs are available here.

Paige Cerulli

Paige Cerulli is a contributing writer to i Advance Senior Care.