ANNAPOLIS, MD—Governor Larry Hogan on Sunday enacted an emergency order to protect residents and staff at Maryland nursing home facilities, and bolster the state’s mitigation and suppression efforts amid outbreaks of COVID-19.

Effective immediately, new directives will require facilities to direct all staff who interact with residents to wear personal protective equipment, create separate observation and isolation areas for residents, and expedite all testing through the Maryland State Public Health Laboratory.

“As we have been saying for several weeks, older Marylanders and those with underlying health conditions are more vulnerable and at a significantly higher risk of contracting, getting more severely ill, and dying from this disease,” said Governor Hogan. “Of major concern is that we currently have cases or clusters of cases at 81 nursing homes and long-term care facilities across the state. Our highest priority is keeping Marylanders safe, and we will use every tool at our disposal to protect the most vulnerable among us.”

On March 10, the Maryland Department of Health (MDH) issued strong guidance to long-term and continuing care facilities to restrict visitation and begin implementing infection control protocols. Today’s directives requires nursing home facilities to adjust and strengthen their policies, protocols, and procedures in line with all state and federal guidance related to COVID-19, and immediately adopt a series of enhanced protective measures:

PERSONAL PROTECTIVE EQUIPMENT FOR STAFF

All personnel who are in close contact with residents of nursing homes shall wear personal protective equipment (PPE), including a face mask, appropriate eye protection, gloves, and gown. The PPE should be worn at all times while providing care to residents in the facility and personnel should follow CDC guidance for using personal protective equipment. Facilities must use the process established by MDH to request PPE from the state.

EXPEDITED TESTING FOR SYMPTOMATIC RESIDENTS

All facilities must use the most expeditious means available for testing. This includes using either a COVID-19 test kit provided by the state laboratory or another lab to send specimens to the state laboratory for expedited COVID-19 testing of residents and staff. Symptomatic residents of nursing homes and long-term care facilities are among the patient groups prioritized by the state laboratory, alongside hospitalized patients and symptomatic health care providers and first responders.

SEPARATE OBSERVATION AREAS

All facilities must designate a unit of staff who are assigned to care for known or suspected COVID-19 residents; designate a room, unit, or floor of the nursing home as a separate observation area where newly admitted and readmitted residents are kept for 14 days on contact and droplet precautions while being observed every shift for signs and symptoms of COVID-19; and designate a room, unit, or floor of the nursing home to care for residents with known or suspected COVID-19.

PLACEMENT OF DISCHARGED PATIENTS

MDH’s Office of Health Care Quality will assist acute care hospitals, if necessary, in discharging patients who require nursing-home level care. Facilities must cooperate with the Office of Health Care Quality and hospitals in the placement of discharged patients.

RIGHT OF RETURN FOR RESIDENTS

Nursing home residents admitted or seen at a hospital for COVID-19 must be allowed to return to the nursing home as long as the facility can follow the approved CDC recommendations for transmission-based precautions. If the residents must temporarily go to other facilities, every effort must be made by the receiving and original nursing homes to transfer the residents back to their original nursing homes as soon as possible.

Governor Hogan’s order makes compliance with these directives mandatory. Anyone who knowingly and willfully violates this order is guilty of a misdemeanor and upon conviction is subject to imprisonment not exceeding one year, or a fine not exceeding $5,000—or both.