New Jersey Unveils Benchmarks for Long-Term Care Facilities to Reopen

New Jersey state officials unveiled steps for nursing homes and long-term care facilities to safely reopen to visitors and resume normal activities.

Nearly half of New Jersey’s 15,890 coronavirus-related deaths were reported at such facilities since March. According to the latest statistics, there have been over 25,000 confirmed cases among residents and 13,000 infected staffers.

On Aug. 10, Gov. Phil Murphy and New Jersey Department of Health (NJDOH) Commissioner Judy Persichilli introduced a series of mandatory benchmarks that facilities must meet in order to fully reopen.

New Rules

The standards—which are based on guidance from the state health department and Centers for Disease Control and Prevention—include weekly testing for staff, mandates for resident testing, updated outbreak plans, a thorough communication strategy during an emergency with residents and their families, increased infection control measures, detailed cleaning procedures and requirements for stockpiling personal protective equipment (PPE).

“We must proceed with caution as we reopen these facilities,” Persichilli said as she presented measures during a media briefing. “There are still more than 260 active COVID-19 outbreaks at long-term care facilities in our state, and we know that the virus is still circulating in our communities.”

According to Murphy, the goal is for long-term care facilities to “not only meet the current challenges, but to ensure both high-quality care and the safety of residents and staff going forward.” Each phase of the plan will be based on time since a facility’s last outbreak and aligned with “the broader reopening stages of our statewide road back,” he added.

Benchmarks For Reopening

Meeting the benchmarks will move facilities into phases that will allow for scheduled indoor visitations with residents. In order to move between phases, a long-term care facility will have to show it has not had any worsening of conditions for at least 14 days.

According to Persichilli, Phase 0 allows for essential caregiver to visit for two hours once a week with residents who are COVID-19 negative, asymptomatic and have recovered from the virus.

During Phases 1 and 2, visits will be permitted twice a week for a total of four hours once facilities show they have enough staffers, PPE and have been virus-free for at least 28 days.

Outdoor Visits

Visitation was suspended in March due to the COVID-19 outbreak. As of June 21, NJDOH allowed outdoor visits to resume by appointment only. Another directive issued in July permitted parents, a family member, legal guardians and support persons of pediatric, developmentally disabled and intellectually disabled residents to arrange indoor visits by appointment.

“Reuniting families with their loved ones in these facilities is critical for the mental, physical, social and emotional well-being of our most vulnerable residents,” said Persichilli. “With the virus still circulating in our communities, we must balance the health and well-being of residents with proper infection control and employee safety protections. The restart plan will give long-term care facilities, residents and families direction for resuming normal activities.”

Funding for Reopening, Wages

“Please bear in mind that facilities may need time to provide attestations to the Department of Health that they have met the requirements. The attestations be coupled with enforcement activities. And if someone attests, and they do not adhere to the requirements of the attestation survey they will be fined,” she added.

Additionally, the state Department of Human Services unveiled a proposal that would provide long-term care facilities with a total of $155 million to support them in efforts to reopen.

According to officials, increases in Medicaid funding would be used to increase wages for front-line certified nursing aides and support compliance with infection control standards.

Medicaid Funding

It calls for $130 million in new Medicaid funding—$62 million from the state and the remainder in matching federal funds—to be available to facilities for the next fiscal year, from Oct. 1 to June 30.

An additional $25 million in state and federal funds would be used to cover COVID-19 testing programs, Murphy said.

“With this funding we would be able to increase wages, specifically for certified nursing aides, while also ensuring that our facilities can continue to fully support their current staffs and meet the more stringent criteria that are being put in place,” Murphy said.

Raises for Workers

Murphy said 60% of the funding must go to the nursing homes’ workforce and the remainder would go to facilities once they have reliably met the benchmarks

According to Department of Human Services Commissioner Carole Johnson, the $130 million includes a 20% wage increase for certified nursing aides.

“Wage enhancements will help support the critical frontline certified nurse aide workforce and help contribute to decreasing the risk of exposure for staff and residents,” said Johnson. “Funding for enhanced infection control—that is tied to clear accountability measures and compliance with health and safety requirements—will further help to increase facilities’ tools to support residents.”

Manatt Recommendations

As of now, the state has implemented several recommendations from the independent Manatt Health report, which reviewed New Jersey’s response to the outbreak in facilities.

According to officials, 30 million pieces of PPE have been distributed, testing has been administered to 310,000 residents and 495,000 staffers, 450 infection control surveys have been completed and 3,600 complaints have been resolved.

Another recommendation implemented is the creation of a Long-Term Care Operations Center that will provide “a centralized command structure to manage the emergency response to COVID in long-term care facilities.”

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