Maryland Governor Larry Hogan has announced a plan to allow limited outdoor visits to the state’s nursing home facilities. It also allows for limited communal dining and small group activities to resume with proper precautions in place. Following universal testing of nursing homes, state health officials will require weekly retesting of nursing home staff. Residents will be retested weekly at facilities that continue to report facility-acquired coronavirus cases.
At present, there are active COVID-19 cases in 107 of the state’s facilities.
Facilities must meet a series of prerequisites to begin relaxing any restrictions, including:
- The facility must not be experiencing an ongoing outbreak of COVID-19, defined as one or more confirmed cases of COVID-19 in a resident or staff member.
- Absence of any facility-onset COVID-19 cases within the last 14 days. If a new case is detected, the facility shall return to the highest level of mitigation (pre-Phase 1) and begin again.
- No staffing shortages and the facility must not be under a contingency or crisis staffing plan as described in the CDC’s Strategies to Mitigate Healthcare Personnel Staffing Shortages.
- Universal source control is in place, requiring all residents, staff, and anyone else entering the facility to wear a facemask or cloth face covering at all times while in the facility.
- Staff must have access to adequate personal protective equipment (PPE).
- Nursing homes must be able to conduct COVID-19 testing among residents and staff at sufficient frequencies to fulfill the CDC’s Testing Guidance for Nursing Homes.
Provided a facility has met the prerequisites for reopening, limited outdoor visitation is allowable if:
- Visitors and residents wear a face covering at all times.
- Visitors and residents maintain proper social distancing at all times.
- There is not an ongoing outbreak at the facility.
- Additionally, it is strongly recommended that there are no more than two visitors at a time per resident per visit.
Read the Maryland’s Department of Health’s outdoor visitation guidance here.
A number of restrictions at nursing home facilities will remain in place for the foreseeable future and will not be relaxed at any time during the reopening process, including:
- Facilities must continue to screen all people who enter the facility, and screen all staff at the beginning of each shift.
- Facilities must continue to screen all residents at least daily, including performance of temperature checks, pulse oximetry checks, observing for signs and symptoms of COVID-19, and asking questions about signs and symptoms of COVID-19.
- Facilities must continue to dedicate space for cohorting and managing care for residents with COVID-19 separate from the general population. Additionally, facilities must continue to dedicate space to quarantine new admissions and readmissions in private rooms for 14 days for the purposes of monitoring these residents for the development of signs or symptoms of COVID-19.
- All staff must wear appropriate PPE, including use of procedure or surgical facemasks (i.e. not cloth face coverings) when they are interacting with residents.
Maryland’s early and aggressive response to address COVID-19 in nursing homes began in early March, when state officials met with representatives of long-term care facilities and issued strong guidance to shut down visitation and ramp up infection control protocols. State officials have established strike teams to provide a higher level of triage and care, PPE requirements for staff, universal testing for residents and staff, weekly reporting on facility outbreaks, and bridge teams to supplement staffing shortages.