As coronavirus outbreaks continue to expand across nursing facilities in North Carolina,  Governor Roy Cooper issued Executive Order No. 131 on April 9, 2020. Among other directives, the Executive Order imposes mandatory mitigation requirements on skilled nursing facilities (“SNFs”) in the state and “strongly encourages” the same measures, to the extent personal protective equipment (“PPE”) is available, be taken by other long term care facilities, including adult care homes, family care homes, mental health group homes, and intermediate care facilities for individuals with intellectual disabilities. The Executive Order becomes effective on April 10 at 5:00 p.m. and will remain in place until it is rescinded or replaced with a subsequent Executive Order, or until the March 10 Declaration of a State of Emergency is rescinded.  

The mitigation measures require SNFs to:

• Remind staff to stay home when they are ill and prevent staff who are ill from reporting to work;
• Screen all staff at the start of each shift for fever and respiratory symptoms and, if a staff member is ill, have the person put on a face mask and leave the facility;
• Cancel communal dining and all internal and external group activities;
• If supplies are available, implement use of face masks for all staff while they are in the facility;
• Monitor residents upon admission and at least daily for fever and respiratory symptoms; and
• Notify the local health department immediately of (1) a resident with new, confirmed, or suspected COVID-19; and (2) any “cluster” (defined three or more people with new-onset symptoms within a 72-hour period) of residents or staff with symptoms of respiratory illness.  

Although these mitigation measures are mandatory only for skilled nursing facilities, the other types of long term care facilities mentioned above should be aware of and consider implementing these measures, given the possibility that these measures may become mandatory for all such facilities through a future Executive Order.