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Can I visit a nursing home or long-term care facility? How are these facilities reopening? What safety precautions must they take?

Last Updated: 11/17/2020

Yes, long-term care facilities in New Jersey may permit visitors.

However, please check with a specific facility for visiting hours and policies as there are strict health and safety requirements that depend on their outbreak status.

In addition, for the holiday season, the Department of Health has issued additional safety guidance and requirements for holiday visits and gatherings for long-term care facilities. See below for more details.

NOTE: To protect the health of your loved ones, the Department of Health strongly recommends against taking residents out of long-term care facilities for holiday celebration events or gatherings. Residents of long-term care facilities are particularly susceptible to COVID-19. Bringing your loved ones home could put them at risk. Instead, the Department recommends visiting loved ones outdoors at facilities, or indoors in facilities that meet the requirements for indoor visitation.

REOPENING GUIDANCE FOR LONG-TERM CARE FACILITIES

The Department of Health has issued detailed guidance for the phased reopening of long-term care facilities.

The phased-in reopening is based on the outbreak status of a facility, its ability to meet criteria, including, but not limited to, testing of staff and residents, infection control protocols, and adequate staffing and Personal Protective Equipment (PPE), and is tied to the timing of the state's reopening plan.

For more information about specific safety protocols and visitation policies, contact a long-term care facility directly. To learn more about the Department of Health's guidance and the phased reopening process, refer to Executive Directive No. 20-026.

Indoor Visits

Indoor visitation by appointment is permitted in every phase subject to the requirements in Executive Directive No. 20-026.

All facilities with no new onset of COVID cases in the last 14 days and that are not conducting outbreak testing may allow indoor visitation, provided they meet other criteria as outlined in the directive.

In addition, indoor End-of-Life, Compassionate Care, and Essential Caregiver visitation is allowed for all residents, including pediatric and those covered by the Americans with Disabilities Act (ADA) or the Law Against Discrimination (LAD), in all phases pursuant to DOH requirements.

End-Of-Life Visitation

During end-of-life situations, healthy visitors are permitted indoor visits within long-term care facilities, assisted living residences, dementia care homes, pediatric transitional care homes, and comprehensive personal care homes.

Healthy is defined as individuals with no signs of respiratory illness such as fever, cough or shortness of breath. They should not have had contact with anyone with or suspected of having COVID-19 or any respiratory illness and individuals should be wearing the appropriate protective equipment.

For a full list of safety requirements refer to Department of Health Executive Guidance 20-017.

If residents or their families need emotional support as a result of difficulties related to the pandemic—such as an extended absence from each other—there are resources available to help.

You can call New Jersey's toll-free hotline and speak with counselors 7 days a week at 1-866-202-HELP (4357).

Compassionate Care

Indoor Compassionate Care situations visits are allowed with transmission-based precautions, pursuant to the requirements of Executive Directive No. 20-026 and Executive Guidance 20-017.

The term "compassionate care situation" does not exclusively refer to end-of life situations. Examples include:

  • A resident who was living with their family before recently being admitted to a nursing home, the change in their environment and sudden lack of family can be a traumatic experience. Allowing a visit from a family member in this situation would be consistent with the intent of the term "compassionate care situations." Similarly, allowing someone to visit a resident whose friend or family member recently passed away, would also be consistent with the intent of these situations.
  • A resident receiving hospice care whose health status is sharply declining, or when a resident is not enrolled in hospice, but their health status has sharply declined.
  • A resident who needs cueing and encouragement with eating or drinking, previously provided by family and/or caregiver(s), is experiencing weight loss or dehydration.
  • A resident, who used to talk and interact with others, is experiencing emotional distress, seldom speaking, or crying more frequently (when the resident had rarely cried in the past).

For a full list of safety requirements and details, refer to Executive Directive No. 20-026 and Executive Guidance 20-017.

Indoor Essential Caregiver Visitation

All residents may receive indoor essential caregiver visitation in facilities where there has been no new facility-onset COVID-19 cases in the last 14 days AND the facility is not currently conducting outbreak testing per CDC, CMS, and CDS guidance.

An essential caregiver could be an individual who was previously actively engaged with the resident or is committed to providing assistance with activities of daily living.

For a full list of safety requirements and details, refer to Executive Directive No. 20-026.

Indoor Visitation of Pediatric, Developmentally Disabled, and Intellectually Disabled Residents

In addition to outdoor visits, parents, family, and legal guardians of pediatric, developmentally disabled, and intellectually disabled residents may visit their loved ones indoors at long-term care facilities.

Due to how medically fragile these residents are, visits are by appointment only, health screenings and temperature checks are required, and may only occur at facilities that have had no new probable or confirmed COVID-19 cases in the last 28 days. Visitors must wear face coverings.

For a full list of safety requirements, refer to Department of Health Executive Directive No. 20-025.

Outdoor Visits

As of June 21, New Jersey's nursing homes, Assisted Living residences, dementia care homes, pediatric transitional care homes, and comprehensive personal care homes, can welcome reunions with loved ones in a designated outdoor space.

Individuals should check with long-term care facilities for specific visitor policies. The Department of Health has issued a Directive with measures that must be in place to reduce risks, including:

  • A resident who is suspected or confirmed to be infected with COVID-19 or quarantined for a COVID-19 exposure cannot have visitors. A resident who has tested positive is allowed visitation after they have met the criteria for discontinuation of isolation.
  • There will only be two visitors permitted at a time and the visitors must remain at least 6 feet away from the resident. Both visitors and residents must wear face coverings.
  • A staff member, wearing a surgical mask, must remain with the resident during the visit.
  • A designated area should be established for visitors to be screened that maintains social distancing and infection control standards. If the individual has any COVID-19 symptoms, they will not be permitted to visit with a resident.
  • Visitors are not allowed beyond the reception area of the facilities and restrooms will not be available to them.
  • When staff are transporting the resident outdoors, they cannot be moved through any space where either positive or suspected COVID patients are cohorted. A safe distance of 6 feet distance must be maintained between other residents and staff.
  • Long-term care facilities should communicate the visitor policy to residents, families, staff and others. They should receive informed consent from the resident and the visitor in writing that they are aware of the possible dangers of COVID-19 exposure and that they will comply with the facility's policies during the visit. As part of the consent form, the visitor must agree to notify the facility if they test positive for the virus or have symptoms within 14 days of visiting.

For a full list of safety requirements, refer to the Department of Health Executive Directive 20-017.

Additional Guidance for Holiday Visits

Residents that leave their long-term care facilities for holiday celebrations with family must be quarantined upon their return to the facility.

  • If the resident lives in a private residence or room, the resident may be quarantined in their private residence or room.
  • If the resident has a roommate, the resident should be quarantined in an observation room for 14 days upon their return.
  • If an observation room is not available, the facility should notify the family that the resident will not be permitted to return to the facility until a room is available or until the facility is otherwise able to cohort returning residents in compliance with current CDC and Department guidance and directives.

Facilities should develop and implement a plan in preparation for the return of residents leaving the facility for holiday visits/gatherings that includes the following:

  • Estimate how many residents can be cohorted for a 14-day quarantine period based on current census and projected census from Nov. 25 through Dec. 31, 2020.
  • Create a reservation process for residents who want to leave and visit families for the holiday. Reservations should be tied to the number of individuals the facility can quarantine on their return.
  • Reservations and any changes to reservations must be confirmed 36 hours before the resident leaves the facility.
  • Facilities should create a waiting list for residents who request a reservation after the established limit has been reached.
  • Residents/families should be informed of the possibility that if a resident leaves without a reservation or on a waiting list—they may not be guaranteed readmittance to the facility.

Residents and families must certify that:

  • they are aware of the possible dangers of exposure to COVID-19 for both the resident and family;
  • they will follow masking, social distancing and hand hygiene practices;
  • and they will notify the facility if anyone present at the holiday gatherings tests positive for COVID-19 or exhibits symptoms of COVID-19 within 14 days of the resident's visit/stay outside the facility.

Prior to taking a resident out of the facility, family members should contact the facility's administration to make sure that an observation room will be available upon the return of the resident or they can make a reservation as delineated above. Facilities may require families care for their loved ones until there is a room available to quarantine the resident. Families should work with the facility's administration to have a plan for quarantining the resident and for the resident's return.

In addition, long-term care facilities should plan to accommodate increased virtual communications for residents and their loved ones during the holidays.

For more information, refer to the Department of Health's Guidance for Holiday Visitation.

Source: Governor Murphy's Remarks 5/21/20; Executive Directive 20-017; Commissioner Persichilli's Remarks 7/6/20; Executive Directive No. 20-025; Commissioner Persichiili's Remarks 7/22/20; Executive Directive No. 20-026; Department of Health's Guidance for Holiday Visitation