NJ develops long-term-care-facilities plan; Edison Field Hospital takes shape

The long term care population in the state continues to be particularly vulnerable to the COVID-19 virus.

At a press conference Tuesday, Health Commissioner Judith Persichilli described in detail a statewide plan to assist nursing homes experiencing large outbreaks and shortages of staff and equipment.

Some of the basics of the plan include the development of a statewide response to control the spread of COVID-19 in long term care facilities to prevent the transmission of COVID-19 to residents who have not been exposed; to provide safe and appropriate care for those that are suffering from COVID-19; and to provide appropriate protective equipment for staff members.

“We have reviewed all of their outbreak plans that they were required to put together after the Wanaque situation, we require them to assess all employees and vendors coming into the facilities for symptoms. We’ve curtailed visiting, we have distributed guidance on pandemic planning and we’ve advised all facilities on their obligation to report outbreaks,” said Persichilli.

Going forward, the commissioner said that the plan is to survey all long term care facilities and their ability to cohort patients on a separate wing or separate floor, and their ability to place residents in private rooms with private bathrooms.

The department is also taking inventory of their personal protective equipment and surveying employee capacity and reviewing facility staffing plans.

“We are identifying employees that are available to work, those home on quarantine, those symptomatic and isolated and those that are positive and hospitalized.”

Persichilli added that the department is classifying residents based on the following criteria: asymptomatic no exposure, asymptomatic with exposure at a facility with an outbreak, symptomatic tests negative, could have a respiratory illness, not COVID-19, symptomatic and tests positive, and positive transfers in or back from an acute care hospital.

Determining the ability of the facility to cohort employees is an important aspect of the health department’s plan. That includes limiting the movement of staff between negative and positive residents and to isolate residents exhibiting signs of respiratory illness.

“We are evaluating the compliance with the guidance for monitoring residents per shift for fever, respiratory and other COVID-19 symptoms such as malaise, vomiting, diarrhea, coughing, shortness of breath,” said Persichilli.

Facilities that cannot conform to the Centers for Disease Control and Prevention or Department of Health guidance will be prioritized for transfer of patients based on the prevalence of the disease in the facility.

“The transfer of patients will go to COVID positive facilities. We are developing statewide contracts with two to three systems to accept transfer of these patients. We will regionalize the transfer of patients and develop an enhanced reimbursement plan with the Department of Human Services using existing transport and EMS or developing contracts if we have to transport a significant number of individuals.”

Persichilli said that the department is aware that any movement of this population will be disruptive and hopes that the plan can be implemented with the least amount of stress as possible.

“Our goal is to keep those who haven’t been exposed safe and to ensure that those who are exposed or who have tested positive get the care they need.”

Support system

Persichilli and Gov. Phil Murphy toured the second field medical station in Edison, which includes 500 beds, on Tuesday morning.

Persichilli said that the field medical stations would support regional hospitals.

“We need them for low acuity medical/surgical patients who cannot yet be discharged to home and need some kind of convalescing.”

The initial priority will be for non-COVID conditions then expanded to those with COVID-19 illness as our resources permit.

Some examples of individuals who would be in the field hospitals are patients that need antibiotics or IV fluids and need to be monitored on an hour-by-hour basis, or patients who have had an operation.

Patients who need critical care will remain in the acute care hospitals, said Persichilli who added that the site would not serve critical care patients. Pediatric and pregnant patients will not be appropriate for the medical field service and any patient who requires a higher level of intensive care nursing.

There are currently 7,026 hospitalizations that include COVID-19 positive patients and persons under investigation. Additionally, there are 1,617 individuals who are in critical care and 1,576 of those individuals are on ventilators bringing the percentage of critical care patients who require a ventilator to 97 percent.

As of Wednesday, there were 3,088 new cases of COVID-19 bringing the statewide total to 47,437; 275  new deaths were reported bringing that total to 1,504.

There are now 231 long term care facilities in the state that have reported at least one COVID-19 case; of newly reported deaths, 48 were residents of long term care facilities.

Persichilli said that of the seven labs sending the DOH COVID-19 results, 94,525 tests have been performed of which 41,550 are positive for a positivity rate of 44 percent—which means more than half of the results have been negative.