As COVID cases surge again, many clients have expressed concerns about loved ones requiring long-term care. Families are naturally hesitant to consider facility placement. Facilities are definitely better prepared now than in the spring, and most have so far been able to keep cases under control. Many systemic problems remain, but two recently-passed bills are good news for residents and families in this regard.

New Jersey Prepares for Next Surge of COVID-19

S2712 requires minimum direct care staff-to-resident ratios in New Jersey long-term care facilities. Staffing minimums are essential to ensure proper resident care as facilities face staffing challenges due to both COVID and seasonal flu. Too many facilities operate at the margins, with staffing levels barely sufficient to meet patient needs. In fact, New Jersey is ranked 43 out of 50 in direct care staffing hours per nursing home resident. A state-commissioned review revealed that longstanding staffing shortages were one of the primary systemic issues that led to the horrors we saw take place in the spring. The new law requires the following:

• One CNA to every eight residents for the day shift
• One direct care staff member (RN, LPN, or CNA) to every ten residents for the evening shift
• One direct care staff member (RN, LPN, or CNA) to every 14 residents for the night shift

Additionally, the legislation will establish a Special Task Force on Direct Care Workforce Retention and Recruitment. The task force will address job supports, training and education, wage increases, and certification reciprocity. There is a great need for additional reforms to increase staffing shortages and turnover.

Preventing Social Isolation in Long-Term Care Facilities

S2785 requires long-term care facilities to institute policies that prevent the social isolation of residents. Limitations on visitation have been largely reinstated in response to recent case increases. The resulting isolation devastated many residents; this resulted in steep declines, especially of residents with underlying cognitive impairment. The bill requires facilities to create social isolation prevention policies to authorize residents of the facility to engage in in-person contact, communications, and religious and recreational activities with other facility residents and with family members, friends, and other external support systems, except when prohibited, restricted, or limited. The bill also requires policies to promote virtual visitation and resident recreational activities during periods where in-person engagement is limited or prohibited. In addition, facilities must maintain technology to facilitate virtual engagement, which may require them to invest in tablets, Wi-Fi, and internal broadcasting capabilities. If you or a loved one is considering facilities, be sure to ask how they are meeting this mandate.

Other pending legislation addresses other areas noted by the review commission. These include transparency in facility ownership, infection control policies, testing, and PPE stockpiles. The governor has also laid out requirements for facilities addressing outbreak plans, testing schedules, communication obligations, and criteria for opening and closing. For example, facilities are required to hold conference calls or webinars to update families at least weekly.