Long-term care facilities gradually ease restrictions
Long-term care facilities will slowly start to ease coronavirus-related restrictions on visitation, activities and other events for residents.
The state Health and Human Services Department released updated guidance for nursing homes, personal care homes, assisted living residences and private intermediate care facilities to safely and gradually resume activities for residents.
“We continue to practice a careful, measured approach in longterm care facilities so all staff and residents can safely welcome visitors and return to a more normal routine,” said Dr. Rachel Levine, secretary of health, in the depart-
ment’s announcement. “We developed this guidance through collective input from residents and families, stakeholders, academia and facility representatives to allow safe visitations with strong public health measures to balance the mental and physical well-being of Pennsylvania’s most vulnerable residents.”
Under the new rules, long-term care facilities must do the following before beginning the process of reopening:
• Develop an implementation plan and post that plan to the facility’s website. The plan must specify how the reopening and visitation requirements will be met.
• Administer tests within 24 hours of a resident showing COVID-19 symptoms and complete baseline testing as required in the secretary of health’s orders for skilled nursing facilities issued on June 8 and for personal care homes, assisted living residences, and private intermediate care facilities issued on June 26.
• Develop a safe plan to allow visitation.
• Develop a plan for cohorting or isolating residents diagnosed with COVID-19 in accordance with the department of health’s testing guidance.
• Establish and adhere to written screening protocols for all staff during each shift, each resident daily and all people entering the facility.
• Have adequate staffing and supply of personal protective equipment for all staff.
• Be located in a county that is either in the yellow
or green phase of Gov. Tom Wolf’s reopening plan.
Once the prerequisites are met, the facility begins the three-step process of reopening:
• Step one: From the date the facility enters this step, it must maintain no new COVID-19 cases among staff or residents and have no spread in the facility for 14 consecutive days in order to enter step two.
• Step two: Facilities are required to maintain no new cases of COVID-19 among staff or residents and have no spread in the facility for 14 consecutive days to reach the final step.
• Step three: The final step allows facilities to operate as outlined for the remainder of the governor’s COVID-19 disaster declaration as long as there are no new COVID-19 cases among staff and residents for 14 consecutive days.
Facilities will stop implementing the reopening plan if a new COVID-19 case is known. The facility must then wait until there are no new cases for 14 consecutive days before re-entering the reopening plan at step one.
“Resuming operations for long-term care facilities should be done gradually and deliberately, and most importantly, this must be done safely,” said Teresa Miller, human services secretary, in a release. “Guidance issued today will help this process begin, and we will continue to support our long-term care facilities through every step.”
Specific criteria for dining, activities, nonessential personnel, volunteers, visitors and outings are included for each step of the process.
Steps two and three allow for visitations as long as the resident is able to safely
see visitors as determined by the facility’s staff. Visitations will be prioritized for residents with diseases causing progressive cognitive decline and residents expressing feelings of loneliness.
Social distancing and infection control protocols must be followed during the entirety of the visit. Proper hand hygiene and universal masking will be enforced. Staff will monitor visits to ensure all safety guidelines are met and enforced.
Facilities must designate visitation hours, locations and screenings. State health officials prefer the visitation locations be outside or in an area not typically occupied or frequented by residents. Staff will need to sign visitors out at the end of the visit and properly disinfect the designated visitation location.
Guidance for visitors is
available at health.pa.gov/ topics/disease/coronavirus/ Pages/Guidance/LTCF-Visitors.aspx.
Prior to these guidelines, limitations and restrictions in long-term care facilities were to remain in place for at least 28 days after the facility’s county entered the green phase. The guidelines issued Saturday supersede the previous guidance. Berks and other southeastern Pennsylvania counties entered the green phase on Friday.
Additional resources regarding COVID-19 and nursing homes is available on the Department of Health’s COVID-19 information for nursing homes website. Information on personal care homes, assisted living residences and private intermediate care facilities is available on the Department of Human Services website.