An executive directive issued by New Jersey Department of Health (DOH) details the criteria long-term care facilities, assisted living residences, comprehensive personal care homes, residential healthcare facilities, and dementia care homes (collectively "LTCFs" or facilities") must meet to proceed through a phased reopening process, which includes mandates concerning infection control.
Among the benchmarks LTCFs must comply with to enter a reopening phase are as follows:
Contract with an infection control service within two months or hire a full-time infection control employee if they have more than 100 beds or hemodialysis.
Develop an updated outbreak plan with lessons learned from the COVID-19 pandemic. This plan must include a communications strategy that outlines regular communication with residents and families about cases and outbreaks or any other emergency and methods for virtual communication in the event of visitation restrictions.
Implement a respiratory protection program that complies with Occupational Safety and Health Administration (OSHA) standards, including medical screenings and fit testing of employees using respirators (N95 masks), within nine months.
Must be fully staffed and have a plan in place for additional staffing in the event of an outbreak or emergency.
Weekly staff COVID-19 testing.
Secure enough personal protective equipment (PPE) for present use and a stockpile for emergencies.
Must not have an active outbreak.
The reopening plan is comprised of four phases, which are tied to the state's planned stages for reopening. All facilities started in Phase 0 on August 10.
The executive directive was issued in conjunction with an announcement that the state is making $155 million available to help LTCFs safely reopen. Of this $155 million, about $25 million will go to assist LTCFs with the weekly testing.
New Medicaid funding worth $130 million will be available to LTCFs beginning in October and running through June 30, 2021. Of that, $52 million is intended to help LTCFs in supporting COVID-19-related infection control and compliance. However, the funding would be subject to recoupment if a facility fails to meet the DOH-specified requirements or is found to have repeated infection control failures. The remaining $78 million will go toward increasing wages for certified nurse aides.
Phenelle Segal, RN, CIC, FAPIC, founder of Infection Control Consulting Services, which provides a range of services to all long-term care facilities, says she expects other states will take a similar approach as New Jersey in supporting LTCFs as they reopen and will also hold these facilities accountable.