The Pennsylvania departments of Health and Human Services issued updated guidance to ensure a safe return to activities, visitation and other events for residents in nursing homes, personal care homes, assisted living residences and private intermediate care facilities.
“We continue to practice a careful, measured approach in long-term care facilities so all staff and residents can safely welcome visitors and return to a more normal routine,” said Secretary of Health Dr. Rachel Levine. “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. We will continue to work with and support facilities to ensure they adhere to these measures.”
“COVID-19 has presented a tremendous challenge, but long-term care facilities have felt these challenges acutely due to the often fragile health of residents at these facilities. Precautions and restrictions implemented at these facilities were necessary to keep residents and staff safe, but we recognize that they are not permanently sustainable,” said Human Services Secretary Teresa Miller. “Resuming operations for long-term care facilities should be done gradually and deliberately, and most importantly, this must be done safely. Guidance issued today will help this process begin, and we will continue to support our long-term care facilities through every step.”
In order to cautiously lift restrictions in long-term care facilities, the departments of Health and Human Services will now require all LTCFs to meet several prerequisites before proceeding into the official three-step process of reopening:
– Develop an implementation plan and post that plan to the facility’s website, if the facility has a website, that specifies 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’s orders for skilled nursing facilities issued on June 8 and for personal care homes, assisted living residences and private intermediate facilities issued on June 26
– Develop a plan to allow visitation that includes scheduling and other safety measures
– Develop a plan for cohorting or isolating residents diagnosed with COVID-19 in accordance with PA-HAN 509
– Establish and adhere to written screening protocols for all staff during each shift, each resident daily, and all persons 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 the governor’s Reopening Plan
Once a facility meets the required prerequisites, the facility will enter a three-step process of reopening:
– Step One: From the date the facility enters step one, a facility 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: While in 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 progress into the final step
– Step Three: The final step allows LTCFs 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
If a new COVID-19 case is known, facilities will cease implementing their reopening plan and wait until they have no new COVID-19 cases for 14 consecutive days before re-entering step one.
Each step of the plan includes specific criteria for conducting dining, activities, non-essential personnel, volunteers, visitors and outings.
Visitations will only be allowed in steps two and three as long as the facility determines a resident is able to safely see visitors and will prioritize those with diseases causing progressive cognitive decline and residents expressing feelings of loneliness.
A facility must designate visitation hours, locations (preferably outside or a pass-through not typically occupied or frequented by residents), and screenings to permit a visitor into the building. During the entirety of the visit, social distancing and infection control protocols must be followed, along with enforcing the proper hand hygiene with alcohol-based hand sanitizer and universal masking. Facility staff will monitor visits so all safety guidelines are met and enforced. After each visit concludes, staff will need to sign out the visitor and properly disinfect the designated visitation location. Guidance for visitors is available here.