Monmouth County Second in State with Most Active Cases of COVID-19 in LTC Facilities

TRENTON, NJ — With nearly one-half of all coronavirus-related deaths in New Jersey occurring at long-term care facilities, New Jersey health officials and Gov. Phil Murphy believe there’s a way some can soon open their doors to visitors safely. 

Health Commissioner Judith Persichilli signed a directive on August 10 for “phased in” reopenings at nursing homes across the state, with concerns continuing to mount for elderly residents largely kept locked in for the past five months.

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“We must proceed with caution as we reopen these facilities,” Persichilli said as she outlined measures during Murphy’s coronavirus press 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.”

At long-term care facilities statewide, nearly 7,000 COVID-19 related deaths of residents and staff have been reported — nearly one-half of a total of 14,025 coronavirus deaths in New Jersey. Confirmed cases have reached nearly 25,000 among residents and 13,000 among employees, according to the state’s latest statistics.

Since the outbreak began, positive cases have been reported at 620 of 679 long-term care facilities in New Jersey, and currently 261 facilities are reporting at least one active case.

Of the total 759 lives claimed in Monmouth County due to COVID-19, 520 of those deaths have occurred at 59 long-term care facilities — or more than 68 percent, according to the state Department of Health. Currently, 23 facilities in Monmouth have active cases — ranking it second among all counties. These active cases are among 1,284 residents and staff members, placing the county third in the state — behind Bergen with 2,381 and Camden with 1,619.

“Over the past nearly five months, one of the most-impacted communities in our state has been the residents and staff of our long-term care facilities,” Murphy said. “They have borne an outsized burden of this pandemic. We cannot understate the enormity of either the spread or the loss of life within these facilities."

Persichilli explained that as part of Phase 0 of the reopening, a new designation has been created for essential caregivers visits, which would be capped for two hours once a week with residents who are COVID-19 negative, asymptomatic and have recovered from the virus. In Phases 1 and 2, visits will be allowed twice a week for a total of four hours a week, after facilities show they have enough staff, personal protective equipment (PPE) and a virus-free center for at least 28 days. 

"We recognize the importance of care for residents from their families and loved ones, but we must also consider the safety of the visitors, staff, and residents as we slowly expand indoor visitation," Persichilli said. “Please bear in mind that facilities may need time to provide attestations to the Department of Health that they have met the requirements that I have outlined including having updated outbreak plans and enough staff and PPE before they can begin scheduling visits.” 

She later added, “The attestations will 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."

Outdoor visits at long-term care facilities were allowed on a case-by-case basis in June, followed by parent/legal guardian allowances last month.  

The announcement of the reopening plan was paired with news that the state will make $25 million in federal and state funds available to long-term care facilities to test employees for COVID-19. 

Another $130 million in federal and state money will be accessed to “stabilize and support our nursing facility workforce and critical infection control practices in the facilities ... with 60 percent to flow directly to our nursing home workforce,” Murphy said.  

Human Services Commissioner Carole Johnson said her department will guarantee the money goes to employees in long-term care facilities across New Jersey. In the event compliance isn’t met, the state can withhold future funds in the interest of making up for it. She noted that a bill is currently pending in the state Legislature in order to allow for a review process.

“Certified nurse aides are the front line of the nursing facility workforce and spend their days and nights helping our loved ones with what we call activities of daily living,” Johnson said in reference to the 60 percent lump sum dedicated toward that workforce. “These are the essential tasks that include things like bathing, dressing, transferring someone in and out of bed, toileting and eating. This is challenging work, and we have seen the dedication and commitment of this workforce to our older residents throughout the pandemic.”

According to Johnson, the value of the increased funding will depend on the current certified nursing assistant (CNA) wages at each facility — but an average hourly wage increase of roughly 20 percent is anticipated. 

In addressing visits, Persichilli said long-term care facilities must have enough PPE on hand, as well as a stockpile for emergencies that isn’t touched in daily-use. An updated outbreak plan must also be written out, including lessons learned from COVID-19 and “communication strategy” that describes what is regularly communicated with residents and families. 

“The plan must also include methods for video communications in the event of visitation restrictions,” Persichilli said. “Once visitation begins, there will be rigorous infection prevention and control protocols, the facility must follow.” 

Among the rules that will be observed, according to the directive:

  • Visitors must be screened including temperature checks upon entering facilities.
  • Facilities must require that visitors practice routine infection prevention and control precautions, including wearing a mask and social distancing.
  • Facilities must have a plan to limit the hours of visitation and the number of visitors that will be allowed in the facility at any one time.
  • Residents are allowed only two visitors at a time.
  • Facilities may provide visitation in the residence room if they are in a single room.
  • If a resident is in a shared room the facility needs to identify a visitation area that allows for social distancing and deep cleaning.
  • The facility must receive informed consent from the visitor and, if appropriate from the resident, acknowledging that they are aware of the risks of exposure to COVID-19 for both the resident and the visitor, and that they must follow the rules set by the facility.
  • Visitors should be instructed to monitor for fever and other COVID-19 symptoms for at least 14 days after the visit (if they experience symptoms, they must immediately notify the facility and provide details on their visit).
  • For residents residing in facilities that meet Phase 2 requirements, additional activities for more social interaction will be allowed. 
  • Limited communal dining will be allowed for individuals who are COVID negative, asymptomatic or recovered

Click here for the full Department of Health Executive Directive #26.

Click here for a complete list of long-term care facilities in New Jersey with COVID-19 outbreaks.

Below is the video of Gov. Murphy's August 10 press briefing:

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