Despite End of State of Emergency, DHSS Guidance for Visitation at Delaware’s Long-Term Care Facilities Will Continue

NEW CASTLE (July 12, 2021) – With the end of the State of Emergency in Delaware on Tuesday, July 13, the Department of Health and Social Services (DHSS) is affirming that Delaware’s 86 long-term care facilities (LTCs) will continue to follow the state’s existing visitation and testing guidance in order to keep residents healthy and safe during the COVID-19 pandemic.

When the State of Emergency ends, long-term care facilities – including nursing homes and assisted-living facilities – will still operate under Delaware’s COVID-19 Updated Reopening Plan in Long-Term Care Facilities. While visitation by loved ones is encouraged, the type of visitation that is allowed depends on each facility’s current status in terms of positive cases of COVID-19 among residents, the county’s overall COVID-19 positivity rate and the percentage of residents who are vaccinated. Visitors are encouraged to check with their loved one’s facility on the current visitation status before they arrive.

Delaware’s LTC reopening guidance is in alignment with visitation and testing requirements from the Centers for Medicare & Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC), both of which came in response to reductions in COVID-19 infections and transmission and increased vaccination rates in the LTC population. Consistent with CDC and CMS recommendations, Delaware’s guidance for visitors includes active screening for COVID-19 regardless of vaccination status, the use of face coverings or masks by unvaccinated visitors and by all in each facility’s common areas, social distancing, frequent handwashing or the use of hand sanitizer, and the signing of a visitor’s log among other core principles.

“Our highest priority is to ensure that residents of nursing homes and assisted-living facilities continue to be as safe as possible,” DHSS Secretary Molly Magarik. “While we are grateful for the reduction in COVID-19 cases and hospitalizations among the residents of these long-term facilities and for the high rates of vaccination among residents, our staff from the Division of Health Care Quality and the Division of Public Health will continue to work with the leadership of long-term care facilities to make sure that they have strong screening, infection and isolation measures in place. In partnership with the long-term care facilities, we will do everything we can to continue to facilitate indoor visitation for residents and their family members or close friends, but that will depend on each facility’s status.”

Highlights of the guidance include:

Indoor visitation

  • LTC facilities should allow and support indoor visitation for all residents regardless of vaccination status, with certain exceptions when visitation should be limited for the following residents because of a high risk of COVID-19 transmission:
    • Unvaccinated residents, if the county positivity rate where the facility is located is greater than 10 percent and fewer than 70 percent of residents in the facility are fully vaccinated;
    • Residents with confirmed COVID-19 infection, whether vaccinated or unvaccinated, until they have met the criteria to discontinue transmission-based precautions;
    • Residents in quarantine, whether vaccinated or unvaccinated, until they have met criteria for release from quarantine.
  • LTC facilities should consider how the number of visitors per resident at one time and the total number of visitors in the facility at one time (based on the size of the building and physical space) will affect the ability to maintain the core principles of infection prevention consistent with CDC guidance. If necessary, facilities should consider scheduling visits for a specified length of time to help ensure all residents are able to receive visitors.
  • Visitors should go directly to the resident’s room or designated visitation area, and visitor movement in the LTC facility should be limited.
  • Visits for residents who share a room should not be conducted in the resident’s room, if possible. For situations where there is a roommate and the health status of the resident prevents leaving the room, facilities should attempt to enable in-room visitation while adhering to the core principles of COVID-19 infection prevention.
  • If a resident and their visitor are fully vaccinated, they can choose to have close contact (including touch) with the visitor without a face mask. Regardless, visitors must physically distance from other residents and staff in the facility.

Outdoor visitation

  • Outdoor visits are preferred even when the resident and visitor are fully vaccinated against COVID-19. Visits should be held outdoors whenever practicable.
  • Aside from weather considerations or an individual’s health status, outdoor visitation should be routinely facilitated.
  • LTC facilities should have a process to limit the number and size of visits simultaneously to support safe infection prevention practices.

Required visitation

  • An LTC facility may not restrict visitation without a reasonable clinical or safety cause, consistent with federal and state regulations regarding rates of COVID-19 positivity in the county and the facility, and the rate of immunization among residents.
  • Residents who are on transmission-based precautions for COVID-19 should only receive visits that are virtual, through windows, or in-person for compassionate care situations, with adherence to transmission-based precautions.

Compassionate care visits

  • Compassionate care visits should be allowed at all times regardless of a resident’s vaccination status, the county’s positivity rate, or an outbreak.
  • The term “compassionate care visit” 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 LTC facility, 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).
  • 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 lay persons offering religious and spiritual support.
  • Compassionate care visits should be conducted using social distancing; however, if a visitor and facility identify a way to allow for personal contact, it should only be done following all appropriate infection prevention guidelines, and for a limited amount of time.
  • Fully vaccinated residents and visitors can choose to have close contact (including touch) with their visitor without a face mask.
  • Visitors must physically distance from other residents and staff.
  • LTC facilities should work with residents, families, resident representatives, and the state’s Long-Term Care Ombudsman program through a person-centered approach, to identify the need for compassionate care visits.

Visitor testing and vaccinations

  • Visitors should not be required to be tested or vaccinated (or show proof of such) as a condition of visitation.
  • Although not required, facilities in medium- or high-positivity counties are encouraged to offer testing to visitors, if feasible.
  • Facilities may encourage visitors to be tested on their own prior to coming to the facility (e.g., within 2–3 days).

The plan also includes sections on communal dining and activities and on indoor visitations during a COVID-19 outbreak. The state defines an outbreak as a single new COVID-19 infection in a facility staff member or any LTC facility onset COVID-19 infection in a resident. A resident admitted to the facility with COVID-19 does not constitute a facility outbreak.

If members of the public find that visitation is not occurring as per the guidance, complaints can be filed with the Division of Health Care Quality:

  • Phone: 1-877-453-0012
  • Fax: 1-877-264-8516
  • Online: https://dhss.delaware.gov/dhss/dhcq/mailform.html

If residents of long-term care facilities or their loved ones have concerns about their care, treatment or living conditions, they can call DHSS’ Long-Term Care Ombudsman program at 1-800-223-9074.


Delaware Surpasses 1,000 Total Deaths Related to COVID-19; New Positive Cases Remain Elevated

DOVER (Jan. 15, 2021) – The Delaware Division of Public Health (DPH) is providing an update on the most recent statistics related to coronavirus disease 2019 (COVID-19) in Delaware, as of 6 p.m. Thursday, January 14, 2021.

A total of 1,002 Delawareans have passed away due to complications from COVID-19. The state reported 45 additional deaths since last week’s update. The total number of individuals who have died from COVID-19 ranges in age from younger than 5 to 104 years old. Of those who have died, 511 were female and 491 were male. A total of 499 individuals were from New Castle County, 186 were from Kent County, and 317 were from Sussex County.

“On this day that we pass the heartbreaking milestone of 1,000 COVID-related deaths in Delaware, our hearts go out to all the families and friends who have lost a loved one to this disease,” said DPH Director Dr. Karyl Rattay. “Even as our response continues to slow the spread of COVID-19 and to increase the pace of our vaccinations, we pause today to remember all of the precious souls lost to COVID-19. May their memory be a blessing to their families and friends.”

A total of 68,727 positive cases of COVID-19 among Delaware residents have been reported to DPH since March 11, 2020. The seven-day average of new positive cases decreased to 755.3 as of Thursday, Jan. 14.

The seven-day average for the percentage of persons who tested positive for COVID-19 as of Thursday, Jan. 14, was 23.5%, a decrease from 27.3% as of Thursday, Jan. 7. DPH publishes both positivity rates – persons tested and total tests conducted – on its COVID-19 data portal. As of Tuesday, Jan. 12, the seven-day average for the percentage of total tests that were positive was 8.6%, a decrease from 10.3% as of Tuesday, Jan. 5. There is a two-day lag for presenting data related to percent of tests that are positive to account for the time delay between the date of the test and the date that DPH receives the test result.

In addition, 451 individuals are currently hospitalized due to COVID-19 in Delaware, which is the same number of hospitalized individuals reported as of this time last week. Fifty-six of the hospitalized persons are critically ill, down three from last week.

As of midnight, Thursday, Jan. 14, 36,634 administered doses of the COVID-19 vaccine have been reported to the state’s immunization information system, DelVAX. Delaware’s latest COVID-19 vaccination statistics can be found under the Vaccine Tracker dashboard at de.gov/healthycommunity. Additional information about COVID-19 vaccine rollout is available at de.gov/covidvaccine. Questions can be directed to the Vaccine Call Center at 1-833-643-1715. People who are deaf and hard of hearing should call 2-1-1 or text their ZIP code to 898-211. Individuals can email their questions concerning the vaccine to Vaccine@Delaware.gov.

Update on COVID-19 Outbreaks in Long-term Care Facilities:

The Division of Public Health continues to investigate COVID-19 outbreaks in long-term care facilities throughout the state. The following facilities have experienced significant outbreaks since late September. Resident and staff tallies represent cumulative case totals between Sept. 25, 2020, and Jan. 14, 2020, and may not represent the number of active cases at each facility at this particular point in time:

  • Atlantic Shores Rehabilitation & Health Center in Millsboro; 30 residents and 26 staff
  • Brookdale in Dover; 58 residents and 36 staff
  • Cadia Healthcare Broadmeadow in Middletown; 20 residents and 29 staff
  • Cadia Healthcare Renaissance in Millsboro; 40 residents and 23 staff
  • Cadia Healthcare Silverside in Wilmington; 66 residents and 48 staff members
  • Cadia Healthcare Capitol in Dover; 60 residents and 38 staff
  • Cadia Healthcare Pike Creek in Wilmington; 15 residents and 32 staff
  • Churchman Village in Newark; 64 residents and 47 staff
  • Delmar Nursing and Rehabilitation Center in Delmar; 42 residents and 38 staff
  • Dover Place in Dover; 39 residents and 23 staff
  • Foulk Manor South in Wilmington; 30 residents and 30 staff
  • Harbor Healthcare and Rehabilitation Center in Lewes; 63 residents and 25 staff
  • Hillside Center in Wilmington; 26 residents and 21 staff
  • Kutz Senior Living in Wilmington; 33 residents and 20 staff
  • Lofland Park in Seaford; 20 residents and 19 staff
  • ManorCare Health Services in Wilmington; 11 residents and 24 staff
  • Milford Center, Genesis Healthcare in Milford; 49 residents and 15 staff
  • Oak Bridge Terrace at Cokesbury Village in Hockessin; 16 residents and 14 staff
  • Regal Heights Healthcare and Rehabilitation Center in Hockessin; 90 residents and 45 staff
  • Regency Healthcare and Rehabilitation Center in Wilmington; 74 residents and 48 staff
  • Seaford Center Nursing Home in Seaford; 26 residents and 22 staff
  • The Moorings at Lewes in Lewes; 17 residents and 40 staff
  • Westminster Village in Dover; 47 residents and 30 staff
  • WillowBrooke Court Skilled Center at Manor House in Seaford; 44 residents and 36 staff
  • WillowBrooke Court at Cokesbury Village in Hockessin; 13 residents and 15 staff

*Staff members may include health care and non-health care personnel, such as facility vendors or other individuals working in the long-term care facility who may not be full-time facility employees. Facilities listed represent those that have had a cumulative total of more than 10 cases among residents and more than 10 cases among staff to date since the beginning of the outbreak monitoring period, Sept. 25, 2020. As facility outbreak investigations close, they will be removed from this list.

Long-term Care Statistics:

As of 6 p.m. Thursday, January 14, there have been a total of 1,996 positive COVID-19 cases cumulatively involving long-term care residents, and 531 residents of Delaware long-term care facilities have died from complications related to COVID-19.

The locations and number of deaths involving residents of long-term care facilities are:

  • Atlantic Shores Rehabilitation and Health Center, Millsboro (18)
  • Brackenville Center, Genesis Healthcare, Hockessin (18)
  • Brandywine Nursing and Rehabilitation Center, Wilmington (34)
  • Brandywine Living at Seaside Pointe, Rehoboth Beach (5)
  • Brookdale Dover, Dover (9)
  • Cadia Healthcare Broadmeadow, Middletown (13)
  • Cadia Healthcare Capitol, Dover (19)
  • Cadia Healthcare Renaissance, Millsboro (11)
  • Cadia Healthcare North Wilmington/Silverside, Wilmington (27)
  • Churchman Village, Newark (7)
  • Country Rest Home, Greenwood (11)
  • Delaware Hospital for the Chronically Ill, Smyrna (13)
  • Delmar Nursing and Rehabilitation Center in Delmar (2)
  • Dover Place, Dover (4)
  • Foulk Manor South, Wilmington (7)
  • Forwood Manor, Wilmington (2)
  • Governor Bacon Health Center, Delaware City (1)
  • HarborChase of Wilmington, Wilmington (4)
  • Harbor Healthcare and Rehabilitation, Lewes (24)
  • Harrison House Senior Living, Georgetown (43)
  • Hillside Center, Wilmington (4)
  • Ingleside Assisted Living, Wilmington (2)
  • Kentmere Rehabilitation and Healthcare Center, Wilmington (8)
  • Kutz Senior Living, Wilmington (3)
  • Little Sisters of the Poor, Newark (11)
  • Lofland Park Center, Genesis Healthcare, Seaford (6)
  • ManorCare Health Services, Wilmington (14)
  • ManorCare Health Services, Pike Creek (24)
  • Methodist Country House, Wilmington (4)
  • Millcroft, Newark (2)
  • Milford Center, Genesis Healthcare, Milford (40)
  • New Castle Health and Rehabilitation Center, New Castle (12)
  • Newark Manor Nursing Home, Newark (11)
  • Parkview Nursing and Rehabilitation, Wilmington (26)
  • Pinnacle Rehabilitation and Health Center, Smyrna (24)
  • Regal Heights Healthcare and Rehabilitation Center, Hockessin (12)
  • Regency Healthcare and Rehabilitation Center, Wilmington (8)
  • Somerford House and Place, Newark (2)
  • Summit Assisted Living, Hockessin (3)
  • Sunrise Assisted Living, Wilmington (2)
  • The Center at Eden Hill, Dover (2)
  • The Moorings at Lewes, Lewes (4)
  • Westminster Village, Dover (20)
  • WillowBrooke Court Skilled Center at Manor House, Seaford (7)
  • WillowBrooke Court at Cokesbury Village, Hockessin (2)
  • Four other New Castle County long-term care facilities (1 death at each facility)
  • Two other Kent County long-term care facility (1 death at this facility)

If you are sick with any of the following symptoms, stay home: fever, cough, shortness of breath, sore throat, muscle aches, fatigue, chills, shaking with chills, loss of smell or taste, nausea or vomiting, diarrhea, or headache or congestion or runny nose without a known cause such as allergies. Other symptoms such as abdominal pain or lack of appetite have been identified as potential symptoms related to COVID-19 and may prompt further screening, action or investigation by a primary care provider. If you are sick and need essential supplies, ask someone else to go to the grocery store or the pharmacy to get what you need.

DPH reminds Delawareans that if you believe you have been exposed to someone with COVID-19, or have symptoms of illness, make sure to distance yourself from others, particularly vulnerable populations. Older adults and people of any age with serious underlying medical conditions – including serious heart conditions, chronic lung conditions, including moderate to severe asthma, severe obesity and those who are immunocompromised, including through cancer treatment – may have a higher risk for severe illness from COVID-19.

Information about testing events, including community testing sites, permanent fixed testing sites, and free-standing sites operated by the health care systems and hospitals, will be listed on the testing section of the Delaware coronavirus website at de.gov/gettested.

Delawareans over the age of 18 are encouraged to download COVID Alert DE, Delaware’s free exposure notification app to help protect your neighbors while ensuring your privacy. Download on the App Store or Google Play.

Individuals with general questions about COVID-19 should call Delaware 2-1-1, individuals who are deaf or hard of hearing can text their ZIP code to 898-211, or email delaware211@uwde.org. Hours of operation are 8:00 a.m. to 9:00 p.m. Monday through Friday; 9:00 a.m. to 5:00 p.m. Saturday and Sunday. Medically related questions regarding testing, symptoms, and health-related guidance can be submitted by email at DPHCall@delaware.gov.

Individuals who have complaints about individuals violating public gathering restrictions should contact state or local law enforcement. Concerns that a business may be violating operating restrictions should be directed to: HSPContact@delaware.gov. Questions related to business re-openings or operations as businesses re-open should go to COVID19FAQ@delaware.gov. Questions regarding unemployment claims should be emailed to: UIClaims@delaware.gov.

DPH will continue to update the public as more information becomes available. For the latest on Delaware’s response, go to de.gov/coronavirus


DHSS Recommends Nursing Homes and Other Long-Term Care Facilities Temporarily Ban Visitors to Reduce Coronavirus Risk

NEW CASTLE (March 12, 2020) – The Department of Health and Social Services (DHSS) is recommending that all Delaware nursing homes, long-term care facilities and adult day-care centers temporarily end visitation as a way to reduce the risk of residents and clients contracting coronavirus disease (COVID-19).

The recommendation follows the Centers for Disease Control and Prevention (CDC) guidance that urges long-term care facilities to be vigilant in preventing the introduction and spread of COVID-19. DHSS’ Division of Public Health and DEMA are working with DHSS’ Division of Health Care Quality (DHCQ), Division of Services for Aging and Adults with Physical Disabilities (DSAAPD) and other community partners to implement strategies and restrictions to keep residents safe and healthy. In addition to restricting visitors, DHSS is urging Delaware’s long-term care facilities to:

  • Make online methods of face-to face communication and phone calls available.
  • Staff should be monitored if they are showing any signs of respiratory infection such as fever, cough or sore throat.
  • Any staff member who has these signs or symptoms should not go to work. Any staff that develop these signs or symptoms on the job should immediately stop working, put on a face mask, and self-isolate at home.
  • Nursing homes should increase availability of alcohol-based hand sanitizers, tissues, no-touch receptacles for disposal, and face masks at entrances, waiting rooms, and resident check-ins
  • Signage should be increased for vigilant infection prevention.
  • Properly clean, disinfect, and limit sharing of medical equipment between residents and areas of the facility.

The CDC has found that early data suggests older people are twice as likely to suffer a serious illness from coronavirus disease, also known as COVID-19. Earlier this week, DHSS urged older Delawareans and people with severe chronic health conditions to follow CDC guidance that they “avoid crowds as much as possible” as a way to reduce their risk. Delaware announced its first presumed positive cases this week and the Division of Public Health (DPH) and other state partners are planning for the likelihood of community transmission.

The Department of Health and Social Services advises that community preparedness planning – recommended by CDC – should include older adults and people with disabilities, and the organizations that support them in their communities, to ensure their needs are taken into consideration. Many of these individuals live in the community, and many depend on services and supports provided in their homes or in the community to maintain their independence and their health. For family members and caregivers providing support, the CDC recommends these steps:

  • Know what medications your loved one is taking and see if you can help them have extra on hand.
  • Monitor food and other medical supplies (oxygen, incontinence, dialysis, wound care) needed and create a back-up plan.
  • Stock up on non-perishable food items to have on hand in your home to minimize trips to stores.
  • If you care for a loved one living in a care facility, monitor the situation, ask about the health of the other residents frequently and know the protocol if there is an outbreak.

DPH continues to monitor travelers arriving in the U.S. from countries with a Level 2 or higher Travel Alert. The CDC recommended that such travelers be monitored for 14 days after their return. During the 14-day period, these persons are asked to remain at home while self-monitoring for symptoms. If any of these persons shows symptoms of fever, cough and/or shortness of breath, the person should call DPH at 1-866-408-1899 immediately to determine next steps, which may include transport to a local hospital for evaluation and testing.

For more information and updates related to COVID-19, visit the DPH website at de.gov/coronavirus, where materials can be found in English, Simplified Chinese/Mandarin, Spanish, and Haitian-Creole. Members of the public with questions can call the Division of Public Health’s Coronavirus Call Center at 1-866-408-1899 or TTY at 1-800-232-5460 from 8:30 a.m. to 4:30 p.m. Monday through Friday, or email DPHCall@delaware.gov.


Secretary Walker Announces Appointment of New Director to Lead DHSS’ Division of Health Care Quality

NEW CASTLE (Sept. 3, 2019) – Department of Health and Social Services (DHSS) Secretary Dr. Kara Walker announced the appointment of Yrene Waldron, former Executive Director of the Delaware Health Care Facilities Association, to lead the Division of Health Care Quality. She will begin her duties Sept. 16.

“I am thrilled that Yrene is joining our Department as director of the Division of Health Care Quality,” Secretary Walker said. “As the former director of the Delaware Health Care Facilities Association, she brings extensive experience working with health care system and their staffs to her new role. She understands how the health care system works, the important role it plays in caring for and keeping Delawareans safe, and the role our Division of Health Care Quality which promotes quality care and the enforcement of state and federal laws and regulations.”

The Division of Health Care Quality, one of 11 divisions in the Department of Health and Social Services, has 72 full-time equivalent employees and an annual budget of $6.2 million for Fiscal Year 2020. The division’s mission is to protect patients and residents in health care agencies and facilities across the state. DHCQ staff licenses and certifies a broad range of facilities, homes and agencies, including nursing homes, hospitals, free-standing emergency departments, skilled home health agencies, office-based surgery facilities and group homes for individuals with mental illness.

The division also maintains an Adult Abuse Registry, a Criminal Background Check System for people who work in health care facilities and for agencies, a Certified Nursing Assistant (CNA) Registry, a Complaint and Incident Reporting System, and other enforcement systems.

“I am sincerely grateful and humbled by the opportunity to serve as the Director of Health Care Quality Division and look forward to working with stakeholders across the health care continuum on our mutual goals of improving health care quality outcomes,” said Yrene Waldron.

Waldron worked in the acute care setting prior to serving as the Executive Director of the Delaware Health Care Facilities Association from 1998 until this year, when she retired. She was responsible for monitoring, reviewing and analyzing federal and state statutes and regulations, and communicating changes to her members; coordinating educational seminars; and representing the organization on boards and commissions in Delaware and nationally. Among her achievements was establishing meaningful and trusting relationships with state and federal legislators, the governor’s administration, state agencies and other related stakeholders in order to reach consensus on outcomes affecting health care facilities.

Before being named to her position at the Delaware Health Care Facilities Association, Waldron held various positions with health care facilities and hospitals in Delaware, Florida and Pennsylvania.

Waldron succeeds Mary Peterson, who retired in April.