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";s:4:"text";s:30867:"To give nursing homes a more robust strategy to protect residents and staff, CDC has updated its infection prevention guidance for long-term care settings to include tiered recommendations to address nursing homes in different phases of COVID-19 response, as well as new recommendations to designate at least one individual to manage the nursing The state has a long-term care ombudsman program, but its advocates have no authority to force facilities to fix problems. The deadly coronavirus outbreak has claimed the lives of 7,882 long-term care residents and 144 staff members, according to the state Health Department COVID data dashboard. "People think of seniors as a throwaway society," she said. In Kentucky, an employee exodus has left surveying teams understaffed and inexperienced. The panel has not released its findings, but Newsweek obtained responses from a sample of states with the largest and smallest inspection backlogs. Unable to replenish their thinning ranks, some states are entering contracts with private companies that conduct inspections and investigate complaints. The health care industry, which lobbied aggressively for the law, argues that it is not trying to avoid accountability butthe regulatory changes are still needed. Is it a cold, allergies or delta variant symptoms? State officials did not provide how much more they were paying for the salaries each year, but they said CMS funding helped shoulder the cost. A spokesperson for Exceptional Living Centers said the company employs several measures, including self-inspections, to ensure residents receive proper care at its more than two dozen long-term care communities spanning Kentucky, Tennessee and the Rust Belt. However, they added the state never stopped investigating complaints. But boosters arent the issue for the 25.8% of long-term care staff in New Jersey who havent been fully vaccinated yet. "This law was designed to provide health care professionals with support to make on-the-spot, unfettered medical decisions for the benefit of their patients," the association's president and CEO, Cathy Bennett, said in a statement. Like her colleagues, Terry Harrison said she believed deeply in protecting nursing home residents, but short-staffing intensified her long-held frustrations with the job. In New York, former Gov. In New Jersey, its anticipated that nursing homes and assisted living residences will work with their usual pharmacies to get the booster shots, Aronson said. One registered nurse, who left shortly before the blanket wage increase, said she received a single raise during her eight years as a surveyor. Centers for Medicare & Medicaid Services: Overdue Recertification Surveys Report, Feb. 19, 2023, Centers for Medicare & Medicaid Services: Memo to state survey agency directors, August 2020, Centers for Medicare & Medicaid Services: Memo to state survey agency directors, November 2021, Department of Health and Human Services: Nursing home inspection inquiry, January 2022, Kentucky Cabinet for Health and Family Services: Letter to Senate Special Committee on Aging, October 2022, Join half a million readers enjoying Newsweek's free newsletters. If no one does, nursing home residents could continue to pay the price. In response to New Jerseys high death rate, lawmakers adopted a raft of laws that increased minimum staffing levels at long-term care facilities and addressed infection control. Senate President Stephen Sweeney's office declined to comment and Assembly Speaker Craig Coughlin's did not respond. CMS imposed few formal sanctions, reduced financial penalties and did not track the effectiveness of corrective action plans, the inspector general for the Department of Health and Human Services determined early in 2022. Sick and healthy residents were allowed to congregate. If Harrison had stayed another year before retiring, she said the state would have paid her entire health insurance premium for life. They didn't have the staffing that they needed to take care of my son," said Whitfield, whose lawsuit also says Hillcreek left Maxwell in old bandages and dirty underwear for long periods. Most of the positions in her regional office were empty, and more coworkers were planning their exits. How do I report an outbreak or misconduct at a long term care facility or nursing home? Massachusetts and North Carolina both direct nursing homes to devote a certain share of the rate increase to direct care staff wages (75% and 80%, respectively). COVID-19 status. Prior to the pandemic, the agency made limited efforts to hold states accountable for missing deadlines, according to one federal oversight office. If you visit, work or live in a nursing home, the president said, you should not be at high risk of contracting COVID from unvaccinated employees.. If you purchase a product or register for an account through one of the links on our site, we may receive compensation. Experts say while that is vital, it can divert attention from comprehensive annual inspections, which also serve residents too infirm to file grievances. 252, 253, and 264, Directive for the Resumption of Services in all Long-Term Care Facilities licensed pursuant to N.J.A.C 8:43, N.J.A.C 8:36, N.J.A.C 8:39, and N.J.A.C 8:37, COVID-19 Related Health and Safety Requirements For the Reopening of New Jersey Pediatric Medical Day Care Facilities, Rescinding ED No. He saidproponents of repealing immunity have a "fair position," but policymakers must resist the urge to "legislate with hubris," because there are still unanswered questions about the virus, such as how long vaccines will be effective against them and whether various strains will cause another surge. Now, in a sober acknowledgment of failings, New Jersey has agreed to pay $53 million to . But similar lawsuits are pending across the country against private and public nursing homes. The company's nursing homes average close to a three-star rating for patient care and outcomes, one factor in the overall quality rating, the spokesperson said. May 12, 2021 / 9:43 PM 8:36 . The New Jersey nursing home settlement is believed to be the first of its kind nationwide. Workdays frequently stretched past 12 hours, with evenings spent conducting phone interviews and compiling notes back at their hotel. In the meantime, families are left with few options for seeking justice. Legislative leadership has shown no willingness to repeal the law, which was introduced on Good Friday last year and passed the Mondayafter Easter. ED 20-035 New Jersey Vaccine Education and Prioritization Plan Pursuant to N.J.S.A. Use of and/or registration on any portion of this site constitutes acceptance of our User Agreement, Privacy Policy and Cookie Statement, and Your Privacy Choices and Rights (each updated 1/26/2023). The octogenarian had checked into the facility for physical therapy following a COVID-19 hospitalization, she said. Some in the largely female workforce express concern that the vaccines will affect their fertility. The higher the rate of spread in the community, he said, the more likely it is that COVID will find its way into facilities.. The Legislature passed and the governor signed a law requiring outbreak response plans for long-term care facilities that are licensed to provide care to residents on ventilators, after a deadly adenovirus outbreak killed 11 children at the Wanaque Center for Nursing and Rehabilitation in Haskell. Instead, they must hire former government employees, or poach talent from state health departments. Nursing home owners are concerned that a requirement aimed solely at their employees will drive them to jobs in other health care settings, such as home care, where the shots are not required. Demand is so great that he limits how many inspections clients can purchase. Laryssa Whitfield, 45, removed her son Tony Maxwell, 28, from Hillcreek Rehabilitation and Care in summer 2021. 2023 CBS Broadcasting Inc. All Rights Reserved. As a step toward lowering the rates of transmission in the community, federal regulations to implement Bidens vaccine requirement for nursing homes are expected next month. Murphy signed it into law the next day. "It ensures that, during a crisis, health care providers can make hard decisions like allocating ventilators, intensive care unit beds and other resources that may be in limited supply due to that crisis," she said. ISOLATE AT HOME: Stay away from people and pets for at Free COVID-19 testing is available at many locations across the state. Some investigations start in a matter of days, while others take longer to begin. The company provides consulting services to nursing homes, a potential conflict of interest, Harvard Kennedy School professor of democracy and citizenship Archon Fung said. Mr. Habers mother, who is 89, was released from the hospital this week, he said, after being treated for the virus. TRENTON, N.J. (CBSNewYork) -- New Jersey is easing coronavirus restrictions at nursing homes. Five additional families are suing the nursing home for alleged negligence. It applies to the three state veterans homes. Three days after her father died, her mother tested positive for the virus. YouTubes privacy policy is available here and YouTubes terms of service is available here. "We can't expect residents to be the ones to carry the ball for themselves.". Like Hillcreek, more than half of all facilities' last documented inspection was prior to 2020. Abill to repeal immunity forlong-term care facilities but not for hospitals has not moved in the Legislature since it was introduced in October. There were 45 long-term facilities with active COVID outbreaks as of Thursday, with 101 residents and 81 infected, according to state data. The families had been preparing to file lawsuits that accused the state of gross negligence. Officials have blamed a cyberattack in late 2021 that, they said, halted their progress for five months. It is opposed by both the nursing home industry and the Arizona Public Health Association. "This is [the states'] primary tool for not only monitoring nursing homes but laying down an expectation that the nursing home deals with its problems.". "During visitation, if both the visitor and resident are fully vaccinated, residents and their visitors may choose to have close contact, including touching or hugging and removing their face masks if they are alone in the resident's room," said New Jersey Health Commissioner Judy Persichilli. Pay is one of the biggest draws. The shots will be available, once authorized, to people eight months after they received their second dose. So were more than half of facilities in Alabama, Delaware, Missouri, New Jersey and Tennessee. "I'm present at home, and I think that makes a huge difference," she said. Its past time for New Jersey to take action, and we need to hold facilities accountabletothe care theyre supposed to provide." New Jersey Board of Nursing (Homemaker-Home Health Aide) Chapter 45A Subchapter 27. The remaining 40 percent of the award will be apportioned on a case-by-case basis in a private arbitration process and is expected to be paid by July. Five of 17 surveyor positions were filled as of mid-February, and four more workers were in the onboarding process, they added. Some nursing home residents already are eligible for boosters because they are immune-compromised, said Persichilli. Although Connecticut and New York lifted immunity, the decision is a difficult one to make, saidJonathan Berkowitz, a partner at theGoldberg Segalla law firm who represents long-term care facilities. CareOne, with 20 nursing homes, 12 assisted-livingfacilities and three long-term acute-care hospitals in the state; Hackensack Meridian Health, with 12 nursing homes and three assisted-living facilities, New Jerseys current mandate for health care workers in congregate settings, Your California Privacy Rights / Privacy Policy. Each worker was assigned a hallway, where they interviewed every resident and their caretakers, jotting detailed notes in blue ink. New Jersey began requiring nursing home employees to wear masks three days later, and state officials have said that no one was disciplined for wearing a mask before then. Below, you can find a list of free public testing locations in New Jersey by county, including short-term pop-up testing sites Docket App If companies like CertiSurv continue to grow, it could cost states more than money. Going forward, this law will ensure our states long-term care facilities are fully equipped, staffed and prepared to respond to future outbreaks, Sen. Joseph Vitale, D-Middlesex, a prime sponsor of the bill with Assemblyman Herb Conaway, D-Burlington. "If you conduct a tough inspection on somebody, does it become harder for you to get that nursing home as a client for your consulting services later on?" 2021 CBS Broadcasting Inc. All Rights Reserved. ", "New Jersey should not prolong the suffering of the families of loved ones who were neglected or who died because nursing home operators continue to bar families from seeking justice and holding wrongdoers accountable. Her complaint is one of six wrongful death lawsuits filed against Hillcreek by families of former residents since early 2021, court records show. Ask CBS2's Dr. Max Your Vaccine Questions, Find A New York City Testing Site Near You, Resources: Help With Unemployment, Hunger, Mental Health & More, Remote Learning Tools For Students And Parents At Home. It was among the countrys deadliest coronavirus outbreaks: One in every three residents of a New Jersey nursing home for frail military veterans died as the virus raced unchecked through the state-run facility. I dont know if thats the case," Berkowitz said. Susan K. Livio may be reached at slivio@njadvancemedia.com. Lawyers involved in the New Jersey agreement said they were not aware of any other multicase settlement involving deaths at a long-term care center in the United States. This community is comprised of some of our states most vulnerable residents. "Were still in the pandemic, and a lot of these things that are put into place through this law and through the immunity provisionare still going on," he said. Hutchins is not the only family member suing Hillcreek. States' diminished oversight of nursing homes comes at a time when the industry's workforce remains at its lowest level in nearly three decades, according to the American Health Care Association. Residents or loved ones experiencing challenges in navigating the options for visitation at long-term care facilities can call the Office of the Long-Term Care Ombudsman at 1-877-582-6992, or visit nj.gov/ooie to send an email or to file a complaint. Yet states across the country have continued to fall short. Whitfield said she called the nurse's station to no avail. In July 2022, Kentucky gave all state employees an 8 percent raise, and its surveyors who are registered nurses make between $54,000 and $58,000 per year, records show. "Basically the people that are the most vulnerable, the state has decided to make it more difficult for them to ever assert any rights to protect themselves," said Francisco Rodriguez, a personal injury attorney at the law firmJaverbaum Wurgaft Hicks Kahn Wikstrom & Sinins. His bill, which was introduced in late January, would also require biannual inspections. However, clinical trials for safety and efficacy were designed to include diverse populations. Box 1: 2016 Nursing Facility Regulations Relevant to COVID-19 Pandemic: The 2016 regulations require facilities to establish an infection prevention and control program to provide a safe, sanitary . In Arizona, one state lawmaker has a bill to outsource all surveyor work to the private sector starting in July 2024. Lt. Cookie Settings/Do Not Sell My Personal Information. That includes a Prestige Care and Rehabilitation location in Idaho's panhandle, where a complaint-driven investigation in the summer of 2022 found staff did not prevent a man living at the facility from groping a female resident and watching another undress. Uncertainty still looms in other parts of the country, even as a "silver tsunami" of aging baby boomers is expected to dramatically increase the nation's elderly population in coming years. has had one of the highest death tolls in the nation. By the time Joe Naegele left Hillcreek Rehabilitation and Care, he appeared a shell of the man who entered. What's at stake. Fully vaccinated residents can also have unvaccinated visitors, but both must wear a face mask. Find your state health department's phone number and where to file a complaint on their websites: https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/contactinformation. The average payout is expected to be roughly $445,000 as part of an out-of-court settlement that is believed to be the first of its kind nationwide. Three metrics make up overall ratings. The 101 residents who died in the first eight months of the pandemic included both of Regina Costantino Discenzas parents, who had been living at the complex, Menlo Park Veterans Memorial Home in Edison, N.J., for about two years when the virus began ravaging long-term care centers throughout the Northeast. Downey said there have to be standards for health care facilities and restoring liability is one way of upholding them. More:NY lawmakers pass bill to repeal COVID-19 liability protections for nursing homes, hospitals, More:NJ Republicans to probe Murphy's COVID response without Democrats on board. Some surveyors took lucrative opportunities with travel nursing agencies, while others opted to retire early or find work with less risk of COVID-19 exposure. All rights reserved (About Us). A federal partnership with CVS and Walgreens to provide vaccines will also be reactivated, but at a smaller scale, Persichilli said. First published on May 12, 2021 / 9:43 PM. President Joe Biden is extending the federal government's 100% reimbursement of COVID-19 emergency response costs to states, tribes and territories through July 1, the White House announced Tuesday. Deaths at long-term care centers across the state account for 30 percent of the more than 29,000 virus-related fatalities in New Jersey since the start of the pandemic. As a result, countless families have virtually no legal recourse to hold health care facilities accountable for deaths or injuries related to COVID-19 as long as Murphy keeps hishealth emergency order in place. The federal regulation for staff to be vaccinated will apply to nursing homes that receive Medicare and Medicaid funds, and not to assisted living facilities. Inspection results also are the cornerstone of the federal Five-Star Quality Rating System, public rankings that help consumers compare and choose facilities. As of July, at least 184,000 coronavirus deaths had been reported among residents and employees of long-term care facilities for older adults in the United States, according to a New York Times database. But its making a point: These veterans were not properly cared for.. Phil Murphy vowed changes . In a statement, Prestige Care said it immediately acted to correct the problems and is now in "full compliance with all regulations.". Bayada has extensive COVID-19 safety protocols and all PPE is provided for cases Work in your neighborhood and give back to your community. Many health departments say they can't retain or recruit enough surveyors to catch up, blaming a mixture of retirements, employee burnout, lingering fears of COVID-19 and uncompetitive wages caused by stagnant federal funding. The 87-year-old's face was gaunt and his hair disheveled. Aquarter of the staff in New Jersey remain unvaccinated, 113facilities had outbreaks that infected 279staff and 304residents, Biden wants to use the immense leverage of federal payments, State workers, NJ teachers must get the COVID shot, says Murphy. Her father, Charles Costantino, was 86 and had spent his career working as a proof press operator for The Times. Get browser notifications for breaking news, live events, and exclusive reporting. Why that number is crucial, More:Serious COVID risk remains for NJ nursing home residents as employees lag in vaccinations. Underperforming facilities can face hefty fines and lose funding from Medicaid and Medicare, public health insurance programs that pay out tens of billions to the industry each year. Governor Sheila Oliver, Improving Health Through Leadership and Innovation, supersedes March 2016 visitation guidance memorandum, ED 20-021Child Care and Youth Summer Camp Standards, ED 20-022 Standards for Pools and Aquatic Receation Facilities, Visitation Protocols Supplementing Executive Directive No. Hutchins pulled her uncle from the Louisville, Kentucky, nursing home less than a month after he was admitted in December 2020. Chapter 45J. Neither option seems likely in the near future. As a member of our home care team, you will be valued, respected, and heard. The last staff member death was reported in May. But the long-term care industry successfully lobbied to reduce this requirement to hiring a consultant by Feb. 1, 2022. Community Rules apply to all content you upload or otherwise submit to this site. The 87-year-old's face was gaunt and his hair disheveled. "There'sno justifiable reason that theyshould deny families access to courts. She is suing the nursing home for alleged negligence. Aquarter of the staff in New Jersey remain unvaccinated, as outbreaks of COVID have increased at the states approximately 570long-term care facilities over the last month. If you test positive for COVID-19, you should ask your healthcare provider about whether a treatment is right for you. The reasons for vaccine hesitancy among nursing home workers are the same as in the community at large, Aronson said. Barred from visiting him because of the pandemic, the 58-year-old accountant said she did not receive regular updates on her uncle's eating habits. 10:161B-1.3, 6.3, 9.1, 10.1, 11.6, 11.9, 11.12, 11.13, 12.4, 15.1, Appendix B and Appendix C, Notice of Revocation of Revised Temporary Rule Waiver/Modification/Suspension Pursuant to Executive Order Nos. But for the 119 families, the settlement offered some solace, and finality. CMS launched a multi-faceted approach aimed at determining the minimum level and type of staffing needed to enable safe and quality care in nursing homes, which includes conducting a mixed methods study with qualitative and quantitative elements to inform the minimum staffing proposal. Philip D. Murphy noted that the settlement, reached two days before Christmas, will allow families to move forward without years of protracted and uncertain litigation.. Essex County COVID-19 Media Videos. They were also barred from taking masks from the facilitys rationed supplies. Source: Department of Health's Executive Directive for the Resumption of Services in all Long-Term Care Facilities. It will be years before Idaho conducts inspections in a timely manner, thanks to a slew of recent retirements, state health officials said. Inspection teams can contain an array of healthcare professionals, but each is required to have at least one registered nurse, many of whom can earn far more in other roles. The state's Department of Health will soon allow more visitations and group activities for vaccinated residents. A state-run veterans home in Paramus, about 40 miles north, had an equally devastating death toll: 89. "While things may be more normal now, are things normal period? The new law requires facilities to submit an outbreak response plan within six months, including a strategy to secure more staff in the event of an outbreak or other emergency, according to the legislation (S2798). In an effort to support the psychological well-being of the residents in long-term care facilities, . COVID-19 Therapeutics Overview The state rarely met this requirement in 2022, and health officials have suggested CMS allow them to discard complaints over a year old because they are "nearly impossible to investigate," records show. As of October 2022, most remaining workers had less than three years of experience, which the state admits "affects the quantity and quality of our work product," according to a letter written to federal officials and obtained by Newsweek. "Patients die every day. The 87-year-old was a resident of the Hillcreek Rehabilitation and Care nursing home from December 2020 to January 2021. Residents, their loved ones and caretakers can file complaints against nursing homes with their state's health department. Thelaw which is in effect as long as Murphy's emergency orders are in placegivesbroad immunity to health care facilities and workers except in cases of crime, misconduct and gross negligence, which lawyers said is difficult to prove. The new law will require long-term care facilities to provide an outbreak response plan. She said she and her daughter watched Tony Maxwell slide out of his bed and crash face down onto the floor, where he spent the next 10 minutes. 26: 13-23, New Jersey Interim COVID-19 Vaccination Plan v.2, Authorization for Members of the Healthcare Provider Community to Conduct COVID-19 Vaccination Administration, Authorization for General Hospitals and Ambulatory Care Facilities Licensed for Primary Care to Conduct COVID-19 Vaccination Administration Outside of the Licensed Site, Rescinding Executive Directives and Lifting Certain COVID-19 Restrictions, Expansion of Attendance at Programs of All-Inclusive Care for the Elderly (PACE), COVID-19 Related Health and Safety Requirements for the Reopening of New Jersey Adult Day Health Services Facilities, Expanded Access to COVID-19 NJIIS Reports for LINCS Agencies and Local Health Departments, Secure Protection and Data Handling Agreement for Covid-19 Immunization Data by The New Jersey Local Information Network and Communications Systems (NJLINCS), Establishing COVID-19 Testing and Vaccination Sites Statewide, Protocols for COVID-19 Testing and Vaccination Reporting for Covered Settings Pursuant to Executive Order Nos. The state of New Jersey has seen a significant drop in outbreaks of SARS-CoV-2 infection in the past month. One solution appeared over and over: Increase surveyors' salaries. Feurer said he hopes federal officials will allow private companies to certify new surveyors. And staff members moved from room to room in the nursing homes without taking proper precautions to avoid transmitting the virus. The lawsuit says he suffered from malnutrition and dehydration. The new guidance from the Centers for Medicare and Medicaid Services instructs nursing homes to allow visits at all times for all residents. For unlimited access to hiswork covering New Jerseysgovernorand political power structure,please subscribe or activate your digital account today. Many people who fell ill at nursing homes died before being tested for the virus, leading to a potential undercount. Its not clear if that drop was due to waning immunity over time or the delta variants greater transmission rate, but that is a substantial decline in vaccine effectiveness against infection for those most vulnerable, said Rochelle Walensky, director of the federal Centers for Disease Control and Prevention. Hopefully it just wont happen again the way it happened.. After details of the New Jersey settlement were released publicly, lawyers suing in federal court on behalf of 40 former residents of the veterans home in Massachusetts contacted a lawyer involved with the New Jersey complaints, suggesting that the deal and the size of the award had the potential to be used as a framework in future cases. Facilities will no longer be able to limit the . Expansion of Third Dose to Immunocompromised Persons Aged 5 and Older, Modification of Johnson & Johnson (Janssen) Usage, Expansion of Pfizer Pediatric COVID-19 Vaccine to Ages 5 to 11, Expectations for 'Open' COVID-19 Vaccination Points of Dispensing, Importance of Demographic Data Collection and Reporting to Ensure Equitable Access to COVID-19 Vaccines, Certified Professional Midwives in Birthing Centers, Revised Inventory Expectations for 'Open' COVID-19 Vaccination Points of Dispensing, Revised Eligibility Expectations for Open COVID-19 Vaccination Points of Dispensing, Frequently Asked Questions: COVID-19 Vaccination Documentation, Expectations for Population Prioritization at Hospital-Based COVID-19 Vaccination Points of Dispensing, Authorization for Paramedics to Work in Hospital Setting, Authorization for Members of the Healthcare Provider Community to Conduct COVID-19 Testing Through Swabbing, Authorization for Long Term Care Facilities to Hire Temporary Nurse Aides and Out-of-State Certified Nurse Aides, Authorization for Assisted Living Facilities, Assisted Living Programs and Comprehensive Personal Care Homes to Hire Out-of-State Certified Nurse Aides, Authorization for New Jersey's Level I Trauma Centers to Coordinate Regional Efforts Related to COVID-19 Surge Planning & Expanding Hospital Bed Capacity, Authorization for Health Care Facilities to Add Ventilator Beds, Establishment of the Emergency Health Care Provider Registry, Issuance of Standing Order for COVID-19 Testing, LTC Staff Testing Requirements for COVID-19, COVID-19 Protocols for Food or Beverage Establishments Offering Service in Outdoor Areas, COVID-19 Protocols for Tanning Facilities and Body Art Establishments (June 13, 2020), COVID-19 Protocols for Ambulatory Surgery Centers Resuming Elective Surgery and Invasive Diagnostic Procedures, Standards and Protocols for Visitors and Facility Staff, COVID-19 Protocols for Hospitals Resuming Elective Surgery and Invasive Diagnostic Procedures, COVID-19 Protocols for Food or Beverage Establishments Offering Service in Outdoor and Indoor Areas, Health and Safety Standards for Indoor Dining, Support Persons in Labor and Delivery Settings, New Jersey 2021 COVID-19 Youth Summer Camp Standards, Standards for Outdoor Amusement and Water Parks, Protocols and Conditions for Visitation of Pediatric, Developmentally Disabled and Intellectually Disabled Residents of Long Term Care Facilities, Resumption of Services in all Long-Term Care Facilities, Memorandum: Respiratory Protection Program Attestation, Hospital Personal Protective Equipment Stockpiles, Guidelines for Health Clubs, Gyms and Fitness Centers, Health and Safety Standards for Outdoor and Indoor High-Touch Amusement and Recreation Activities, Health and Safety Standards for Outdoor Dining, Standards for Pools and Aquatic Receation Facilities, Point of Care Testing at Long Term Care Facilities, Standing Order for Testing at Long Term Care Facilities, New Jersey Vaccine Education and Prioritization Plan Pursuant to N.J.S.A. 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