Sent on behalf of the Division of Public Health
1. Infection Prevention Guidance Updates
- We/CDC recommend use of appropriate PPE including NIOSH-approved N95 respirator (or equivalent or higher level respirator), gown, gloves, and eye protection when caring for patients with suspected or confirmed SARS-CoV-2 infection.
- For source control, we/CDC recommend universal use of well-fitting source control for everyone in a healthcare setting (including long-term care facilities). Personnel options for source control include:
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N95 respirators or equivalent or high-level respirators OR
- A respirator approved under standards used in other countries that are similar to NIOSH-approved N95 filtering facepiece respirators OR
- A well-fitting facemask (e.g., selection of a facemask with a nose wire to help the facemask conform to the face; selection of a facemask with ties rather than ear loops; use of a mask fitter; tying the facemask’s ear loops and tucking in the side pleats; fastening the facemask’s ear loops behind the wearer’s head; use of a cloth mask over the facemask to help it conform to the wearer’s face)
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Updated quarantine guidance for vaccinated persons. This guidance states that vaccinated persons with an exposure to someone with suspected or confirmed COVID-19 are not required to quarantine if they meet all of the following criteria:
- Are fully vaccinated (i.e., ≥2 weeks following receipt of the second dose in a 2-dose series, or ≥2 weeks following receipt of one dose of a single-dose vaccine) AND
- Are within 3 months following receipt of the last dose in the series AND
- Have remained asymptomatic since the current COVID-19 exposure.
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LTCF staff: These updated quarantine criteria could be applied when considering work restrictions for fully vaccinated healthcare personnel with higher-risk exposures as a strategy to alleviate staffing shortages.
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Residents of LTCFs: Vaccinated inpatients and residents in healthcare settings should continue to quarantine following an exposure to someone with suspected or confirmed COVID-19. This exception is due to the unknown vaccine effectiveness in this population, the higher risk of severe disease and death, and challenges with social distancing in healthcare settings.
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Residents of LTCFs: New admissions, regardless of vaccination status, should continue to be placed in quarantine.
2. Reminder on Visitation and Compassionate Care Guidance
As a reminder, current visitation guidance is available at the links below and outline when facilities can conduct outdoor, indoor, and compassionate care visitation.
As a reminder on compassionate care visitation specifically, while end-of-life situations have been used as examples of compassionate care situations, the term “compassionate care situations” does not exclusively refer to end-of-life situations. Examples of other types of compassionate care situations include, but are not limited to:
• A resident, who was living with their family before recently being admitted to a nursing home, is struggling with the change in environment and lack of physical family support.
• A resident who is grieving after a friend or family member recently passed away.
• 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).
Allowing a visit in these situations would be consistent with the intent of, “compassionate care situations.” Also, in addition to family members, compassionate care visits can be conducted by any individual that can meet the resident’s needs, such as clergy or laypersons offering religious and spiritual support. Furthermore, the above list is not an exhaustive list as there may be other compassionate care situations not included. NC DHHS also recognizes the critical role that family members or other close caregivers have in the care and support of residents. We encourage facilities to consider how they can best protect their residents while recognizing that compassionate care is not limited to end of life or to the specific examples provided by CMS. Facilities may utilize the role of individuals who support residents with safe activities of daily living and provide additional support for the residents’ physical and mental wellbeing to promote individualized care.
Compassionate care visits may be facilitated regardless of a facility’s or resident’s COVID-19 status. Visitors to a resident on transmission-based precautions for COVID-19 should adhere to the additional PPE requirements. Compassionate care visits can occur indoors or outdoors depending on the resident’s needs.
Lastly, at all times, visits should be conducted using social distancing; however, if during a compassionate care visit, a visitor and facility identify a way to allow for personal contact, it should only be done following all appropriate infection prevention guidelines, including providing access to appropriate PPE, and for a limited amount of time. Through a person-centered approach, facilities should work with residents, families, caregivers, resident representatives, and the Ombudsman program to identify the need for compassionate care visits.
3. LTC Vaccination 101 Webinar Recordings
Missed a previous webinar for LTCF Staff? See links to the recordings below.
· Vaccine Q&A (English):
· Vaccine 101 Webinar (Spanish):
· Vaccine Q&A (Spanish):
4. LTC Vaccination Provider Enrollment
If your long-term care pharmacy wishes to enroll as a COVID-19 vaccine provider go to the CVMS Vaccine Support page and click the Register link at the top right of the page to start the process. Follow this link for CVMS Enrollment Instructions/Training it has a large amount of training information including training videos as well.
As a reminder, COVID-19 vaccine providers must be qualified under the CDC agreement to prescribe COVID-19 vaccines and authorized under the appropriate NC licensing authority. Enrolled COVID-19 vaccine providers must be credentialed/licensed in North Carolina. Please understand that while currently qualified providers are welcome to enroll, requests will be addressed in an order aligned with the prioritization phases and the timeline for approval will vary. The state will continuously reassess enrollment prioritization based on needs.
