Near-Term Recommendations
1. Develop a plan and provide guidance for how New Jersey nursing homes can comply with and implement
federal guidance on reopening. Through the LTC EOC, seek and incorporate feedback from stakeholders including
nursing homes, hospitals, and other providers on feasibility and clinical considerations.
• The guidance should provide, as a condition of reopening, that every facility have the following:
o Adequate isolation rooms/capabilities and the ability to cohort both staff and patients;
o An adequate minimum supply of PPE and test kits; and
o Sufficient staffing and a staffing contingency plan and appropriate staff training to carry out its responsibilities.
• The guidance should define acceptable models of cohorting (e.g., single rooms, separate wings/floors), the
staffing levels that must be in place, and how PPE and testing will be made available to facilities that are
unable to obtain them on their own.
• Implement a centralized FAQ resource, education sessions and focus groups to support nursing homes in
implementing this guidance.
• Require facilities to attest to meeting all requirements before opening their facility to new residents and
others, including family members, and if – at any time after opening – the circumstances change, they are
obligated to report any gaps that need to be addressed through the emergency center communications
mechanism.
• Do not permit hospitals to discharge patients to nursing homes unless such attestations are in place.
• The LTC EOC, with support or “strike” teams, will regularly check in on facilities’ capacity to reopen or stay
open, and where necessary, provide assistance to the facility during the public health emergency.
• Plan for the changes in policy and operations that may be needed if the flexibilities currently authorized
under federal 1135 waivers expire before future waves.
Design and Implement a “Reopening” Plan and Forward-Looking Testing
Strategy for Nursing Homes: Recommendations
New Federal Guidance
On May 18, the U.S. Department of
Health and Human Services issued
nursing home reopening guidance
(
link) for States focused on a phased
approach:
o Criteria for relaxing certain
restrictions and mitigating the
risk of resurgence and factors
to inform decision-making.
o Considerations allowing
visitation and services in each
phase
o Recommendations for
restoration of survey activities
On May 19, the CDC updated and
expanded its guidance for nursing
homes, related to tiered
requirements by phase, testing
plans, and infection control (
link).
Examples From Other States
• Maryland has three types of statewide
strike teams support nursing homes:
testing teams (test and provide
instruction on cohorting), assistance
teams (assess equipment and supply
needs, triage residents), and clinical
teams (provide medical triage and
stabilize residents in the nursing home
to prevent transport to hospitals).
• Pennsylvania deployed a Medical
Assistance Team to provide staffing
support to facilities in need. The State
also developed detailed
guidance on
cohorting in response to test results.
• Minnesota designated nearly a dozen
LTC facilities as “COVID support sites.”
Facilities must be vetted by the state to
ensure they have adequate staffing,
supplies and infection-control
standards to accept COVID-19 patients,
including the ability to cohort
residents.
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