Executive order aims to protect long-term care facilities residents, staff amid COVID-19 outbreak

Coronavirus

RALEIGH, N.C. (WNCN) – With more than a dozen nursing homes reporting COVID-19 outbreaks in North Carolina, Gov. Roy Cooper signed an executive order Thursday that mandates nursing homes and other long-term care facilities take certain steps that had previously just been recommendations.

Read Executive Order No. 131

“We want to make sure that we are now stepping up our effort to really do everything possible,” said Dr. Mandy Cohen, Secretary of the North Carolina Department of Health and Human Services, in an interview with CBS17.

The requirements include: all nursing home staff must wear a mask when interacting with patients, all facilities must close communal areas and restrict all non-essential personnel, staff must be screened daily to detect disease as early as possible, and nursing homes must require notification to local health departments of confirmed or suspected cases.

As of Thursday morning, DHHS said there have been 16 outbreaks reported at nursing homes across the state. An outbreak is defined as two or more laboratory-confirmed cases.

The agency said on Wednesday that at least 60 people had tested positive for COVID-19. Two people have died and seven have been hospitalized, DHHS officials said.

CBS17 asked Cohen with outbreaks occurring in other parts of the country, including in Washington state, why the recommendations did not become mandates in North Carolina sooner.

“Well, we hadn’t seen very many outbreaks here in North Carolina at the beginning part of this, of the spread of the virus. And, we did very, very early on implement a restriction of visitor policy to make sure that we weren’t having visitors come in and out bringing in the virus. And, I think that helped us. And, it certainly helped on the front end of this, keeping outbreaks down. Now that we’re seeing more virus here in North Carolina and now additional outbreaks, we feel like we need to take this next step,” Cohen said.

When asked if she and other state leaders are considering additional requirements for nursing homes, she said, “I think we’ll have to see as we go along here. I mean, there aren’t many more tools to step up to, unfortunately, as we know that we don’t have medicines. We don’t have a vaccine.”

The state and CDC have issued recommendations regarding testing as the country has faced a lack of testing and medical supplies.

CBS17 asked Dr. Cohen once someone at nursing home tests positive, if testing should then be done on everyone else at the nursing home.

“We are recommending broad testing. We want to prioritize that testing, obviously, for the folks who are having symptoms first to get those results back quickest,” she said.

Some states have moved patients who have tested positive for COVID-19 from nursing homes as one step to try to prevent further spread of the disease.

Cohen  said state officials did discuss that, but ultimately decided not to make a recommendation.

“We’ve been looking at the data on that. The bottom line is the virus moves so quickly that it makes it really hard to think about moving patients in any way. We actually did try to think about logistics, should we move? Should we move positive patients? Should we move the negative patients? And the reality of it is because things move so quickly, we really have to focus on prevention, prevention, prevention,” she said. “We have to focus on that prevention because once the virus is in these nursing homes and long-term care settings, it is incredibly hard to contain the outbreak.”

Mary Bethel, a board member with the North Carolina Coalition on Aging, spoke to state lawmakers Thursday about a wide variety of ways the epidemic is impacting seniors, including at nursing homes.

“Rigorous things are being done in order to control the virus. I think, probably, part of what you have, if the virus gets into a group care facility, it is very hard to control,” she said. “Facilities have to have disaster plans or infection control plans, or things like that that they have to have in place anyway. So, I think once early March or even February when they were thinking about the possibility of having a pandemic here, things really ratcheted up. So, the state has been issuing guidance for a good while on this.”

Ben Whitley, an attorney with the Whitley Law Firm in Raleigh, has handled cases involving nursing homes.

“They had this information in the beginning part of March, and then now we’re seeing this kind of explosion in these cases, that’s going to have to be looked at. And, that’s the concern, that these homes were on notice of what they needed to be doing,” he said.

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