On April 7, 2021, Commissioner Toomey of the Georgia Department of Public Health (DPH) issued an Administrative Order that provides new reopening guidance for long-term care facilities, which includes intermediate care facilities, personal care homes, skilled nursing facilities, nursing homes, inpatient hospice, assisted living communities, and all facilities providing assisted living care. While distribution of COVID-19 vaccines widen, facilities must carefully evaluate how to ease restrictions while remaining mindful of ongoing risk. The full text of the Order is available here.
The new guidance maintains many existing restrictions, including the following, among others:
- All resident, staff, and visitors continue to wear a mask regardless of vaccination status and follow additional core infection control measures;
- Facilities maintain an observation unit for admission and readmissions;
- Visitors should still maintain social distancing practices from other residents and staff. However, the guidance allows that fully vaccinated residents may be in close contact with their visitors while following infection control practices;
- Non-medically necessary trips outside the visits should still be limited; and
- Facilities should continue to screen residents three times a day.
The guidance also allows for more flexibility and autonomy in facility policies and includes the following guidance:
- Residents who have fully recovered from COVID-19, or who are fully vaccinated may be placed in the general populations;
- Quarantine is no longer recommended for residents who leave the facility for outpatient treatments, such as dialysis;
- Facilities may determine visitation policies, with restrictions primarily for outbreaks in Phase I facilities. DPH still maintains recommendations on the number of visitors permitted, time constraints, and location of visits;
- Facilities may limit visitors based on their complicity with core infection prevention practices; and
- Residents may participate in occasional social excursions from the facility while following infection control protocols.
The guidance identifies two stages of reopening: Phase I is for vigilant infection control during heightened viral spread, which should be maintained in counties where the county positivity classification for testing frequency is twice a week and less than 70% of the facility’s residents are vaccinated, or where there is a new facility-onset case of COVID-19. Phase II is for less restrictive operation once baseline testing has been conducted, there has not been a new facility-onset case in 14 days, and greater than 70% of the facility’s residents are vaccinated; or where the county positivity classification for testing frequency is once a week or once a month. Facilities in Phase I may not allow visitation when there has been an outbreak; outside of an outbreak, visitation may be determined by the visitor’s vaccination status. Facilities in Phase II may conduct indoor visitation, with recommendations that the facility’s visitation policy takes into account ways to maintain social distancing, log visitors, and encourage that visitors be vaccinated.
This guidance gives facilities more autonomy in their operations and visitation policies, but reflects the continued concern for safety of long-term care facility residents and their staff. While this is certainly a step toward more normal operation, facilities should keep an eye on these updates to ensure they are operating consistent with current DPH guidance.