Long-Term Care Facility COVID-19 Procedures
216-RICR-40-10-27 INACTIVE RULE EMERGENCY RULE
27.1Authority
27.2Definitions
27.3COVID-19 Practices and Procedures
27.4COVID-19 Vaccination Monitoring and Reporting
27.5Proof of Vaccination or Testing for Visitors
| Title | 216 | Department of Health |
| Chapter | 40 | Professional Licensing and Facility Regulation |
| Subchapter | 10 | Facilities Regulation |
| Part | 27 | Long-Term Care Facility COVID-19 Procedures |
| Type of Filing | Adoption |
| Regulation Status | Inactive |
| Effective | 01/10/2022 to 05/10/2022 |
Regulation Authority:
R.I. Gen. Laws § 23-1-1
R.I. Gen. Laws § 23-17-10
R.I. Gen. Laws § 23-17.4-10
Purpose and Reason:
To provide COVID-19 procedures for long-term care facilities regarding testing of residents and personnel; collecting vaccination status of personnel; and provide requirements for visitors and essential caregivers to enter the facility.
Brief statement of Reason for Finding Imminent Peril:
The Rhode Island Department of Health (RIDOH) is filing a new emergency
regulation, effective upon filing with the Rhode Island Secretary of State,
entitled “Long-Term Care Facility COVID-19 Procedures” (216-RICR-40-10-27),
that requires long-term
care facilities, specifically nursing facilities and assisted living
residences, to deny entrance to any visitors, including essential caregivers,
who do not provide proof of vaccination against COVID-19. For those who are not vaccinated against
COVID-19, proof of a negative polymerase chain
reaction (PCR)
COVID-19 test completed within the previous 72 hours or proof of a negative
test result from a point-of-care rapid antigen test (e.g., Binax NOW) completed
within the previous 48 hours must be provided to long-term care facility staff
prior to entry.
Additionally,
a visitor must keep a mask on throughout the duration of a visit with a
resident.
RIDOH anticipates that these mandatory
requirements will be time-limited. Rhode
Island is experiencing a sharp increase in COVID-19 cases. The uptick in cases may be driven by the
speed at which the new Omicron variant is spreading. Omicron arrived in the United States around
Thanksgiving and during the week of December 12 – December 18, 2021, Omicron accounted for 73 percent of all new
infections, according to the Centers for Disease Control and Prevention.[1]
Rhode Island is in a period of high COVID-19
transmission. As of December 23, 2021, there were 728.5 new cases per 100,000
persons in the last seven days in Rhode Island, with a test positivity rate of
6.1 percent. Of approximately 1.1
million residents, 794,940 (72%) are fully vaccinated against COVID-19. [2]
According to a report from the United Kingdom (UK), which
may be predictive for the United States, Omicron cases were multiplying at a
pace of 35 percent per day.[3] “There are legitimate concerns about
the trajectory of the newest variant, Omicron, and public health experts are
paying close attention to the exponentially mounting cases, particularly in the
United Kingdom, which in the past has functioned a canary in the Covid-19 coal
mine for the U.S.”[4]
The relationship between case fatality rates and the Omicron
variant is still emerging: “With
Omicron, however, we not only don’t see the rise in death rates that were
associated with the first waves, but we actually see a continuing decline in
death rates, despite a radical increase in cases. Whether or not this breakdown
of the relationship between Omicron cases and deaths will play out in other
countries, like the U.S., is hard to say,” according to STAT NEWS
reporter Duane Schulthess. [5]
It is important
to point out that earlier in the pandemic (2020), Kaiser Family Foundation reported
that Rhode Island was one of two states
that had the highest percentage (78%) of long-term care deaths as a share of
total state deaths.[6] COVID-19’s impact on the vulnerable long-term
care population has been dramatic and disproportionate to the general
population. RIDOH’s goal is to mitigate
COVID’s effects on this population by requiring long-term care facilities to
screen visitors for proof of COVID-19 vaccination and to have visitors mask up
while in the facility.
The
COVID-19 pandemic continues to have a profoundly disruptive effect on the lives
of Rhode Island’s nursing home and assisted living residents and their
families, particularly as the second year of the pandemic draws to a close.
These
emergency regulations are intended to protect nursing home and assisted living
residents’ lives; maintain safety in Rhode Island long-term care facilities;
and avoid imminent peril during this challenging time by requiring proof of
vaccination against COVID-19 and mask-wearing throughout the duration of a
visit with a long-term care resident.
[1] See: Centers
for Disease Control & Prevention, COVID Data Tracker, “United States at a
Glance - NOWCAST”, Available online at: CDC COVID Data Tracker Accessed December 23, 2021.
[2] See: Rhode
Island Department of Health, COVID-19 Data Tracker, Available here: RI Department of Health COVID-19 Response Data Hub
(arcgis.com) Accessed December 23, 2021.
[3] See: UK Health Security Agency, SARS-CoV-2 variants of concern and variants under
investigation (publishing.service.gov.uk), Technical Briefing #31, December 10, 2021.
[4] See: Schulthess, Duane, “An Omicron oddity: The number of cases doesn’t predict the
number of deaths.” STAT NEWS, December
22, 2021 and available here: An Omicron oddity: unlinking case rates and death rates
- STAT (statnews.com) Accessed
December 23, 2021.
[5] Ibid at page 3.
[6] See: Kaiser
Family Foundation, State Data and Policy Actions to Address Coronavirus,
November 2020. Available online at: https://www.kff.org/health-costs/issue-brief/state-data-and-policy-actions-to-address-coronavirus/