Long-term care facilities may begin a three-phased approach to reopening to the public on Monday, under an amended executive order issued Friday by Gov. Kevin Stitt.
Health care experts say most Oklahoma facilities are in Phase 3, the least restrictive phase that would allow limited visitation for most residents.
Nursing and skill nursing facilities, assisted living, adult day care, residential care and intermediate care facilities for individuals with developmental or intellectual disabilities have been closed to most visitors since March, when the State of Oklahoma began implementing orders designed to stem the spread of COVID-19. Stitt amended his initial order in late April, allowing for a three-phased reopening for most businesses and activities. Phase 3, the least restrictive, began June 1.
However, that Open Up and Recover Safely specifically excluded senior living facilities and hospitals, and continues to encourage members of vulnerable populations — those with health issues and those over the age of 65 — to take precautions that would keep them safe from COVID-19, to include continued quarantine or limited interaction with those outside their homes.
The Open Up and Recover Safely Plan had been staged to move from one phase to the next every 14 days, as long as hospitalizations and COVID-19 incident rates remained at manageable levels, meaning the state’s health care system can handle them. June 15 marks two weeks from the beginning of Phase 3.
Friday, Stitt issued his amended executive order allowing for restricted visitation at long-term care facilities under guidelines issued by the Oklahoma State Department of Health. In a statement, Stitt said the guidelines were based on best practices from the Centers for Medicare and Medicaid Services, Centers for Disease Control and Prevention, and state trade associations.
“It is important we take a measured and responsible approach to allowing visitors to our nursing homes and long-term care facilities, just as we did with the rest of our state,” Stitt said. “This guidance will allow us to continue to protect the health and lives of Oklahomans while allowing them to safely resume valuable interactions with their loved ones.”
Each of the three phases is based on the prevalence of COVID-19 in each facility and its surrounding community; availability of personal protective equipment (PPE); staffing levels at the facility; and local hospital capacity.
The department of health said its guidelines are specifically targeted toward nursing homes; other facilities may choose to have their infection preventionist follow a plan of their own, using the OSDH plan as a template. Facilities may be more restrictive in certain areas, OSDH guidelines specify.
The most restrictive phase is Phase 1, designed “for vigilant infection control during periods of heightened virus spread in the community” and one that prohibits all but compassionate care visits. Phase 3 — the stage most facilities in Oklahoma are in, according to OSDH guidelines — is the least restrictive, allowing all residents to have limited visitation.
But, restrictions apply, to include visitation schedules, hours and locations. The policy means visits will be allowed to residents/patients by appointment only in specific locations within the facility, and under mandates for protective equipment (such as masks) and social distancing. Visitors will be screened and facilities may limit the number of visitors a patient may have.
Phase 3 also would allow limited entry by non-essential healthcare personnel, to include barbers and beauticians; non-medically necessary trips (although the recommendation is to limit such trips); communal dining if social distancing is practiced; and limited group activities.
Phase 3 is reached when it has been 14 days since the resolution of symptoms from the last COVID-19 positive or suspected positive case within the facility; staffing levels are adequate; and a downward trend in cases is reported by the county over the last 14 days. However, should a patient or staff member be confirmed as positive for COVID-19 and another has symptoms, the facility will return to Phase 1.
It may return to Stage 2 only when 14 days have passed with no additional residents or staff testing positive and the facility has demonstrated it can mitigate the spread of COVID-19. Phase 2 allows the same limited visitation as Phase 1, along with limited entry by non-essential healthcare professionals. Non-medically necessary trips are to be avoided as much as possible and communal dining still is restricted.
The policy sets strict sanitation protocols and protective equipment for staff, visitors and residents in all phases. And, it specifies that facilities falling under this order must submit specific information to the state health department, to include contact information for the licensed health care professional designated infection preventionist; evidence that person has completed a CDC training course; and a monitoring plan for infection surveillance, staff training and infection prevention and control.
Additional information is available through the Oklahoma Department of Health website: health.ok.gov.
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June 14, 2020 at 01:00PM
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Long-term care facilities may begin allowing visitors - The Lawton Constitution
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