Galveston Issues Order for Long Term Care Facilities

The Galveston County Health Authority issues an order covering long-term care facilities.

More than 80 residents and employees at The Resort in Texas City have tested positive. It’s a 135 bed long term facility.

This is the county’s order.


Protecting and Promoting the Optimal Health and Well-Being of Galveston County

Ben G. Raimer, MD Kathy Barroso, CPA

Chair, United Board of Health Chief Executive Officer

Philip Keiser, MD

Local Health Authority


WHEREAS, the World Health Organization has declared the coronavirus, now designated COVID19, as a global pandemic on March 11, 2020; and

WHEREAS, the Office of the Texas Governor has declared COVID-19 a statewide public health disaster on March 13, 2020; and

WHEREAS, the Commissioner of the Texas Department of State Health Services declared a Public Health Disaster for the State of Texas on Thursday, March 19, 2020; and

WHEREAS, the Commissioners Court of Galveston County voted unanimously to continue the State of Local Disaster declaration related to COVID-19 until April 22, 2020 with the possibility of forthcoming extensions; and

WHEREAS, symptoms of COVID-19 can range from mild to severe illness and cause additional health complications, including death; and

WHEREAS, COVID-19 mainly spreads between people who are in close contact with one another through respiratory droplets when an infected person coughs or sneezes; and

WHERE AS, the implementation of mitigation strategies can slow the transmission of the disease.

THEREFORE, the County of Galveston’s Local Health Authority, Philip Keiser, MD, is issuing this Application of Control Measures to Property Order (“the Order”) to as prescribed herein.


1. This Order shall be in effect beginning at 12:01 a.m. on April 4, 2020 and continuing until 11:59 p.m. on April 18, 2020, or until it is either rescinded, superseded, or amended pursuant to applicable law.

2. This Order applies to all Long-Term Care Facilities (“LTCFs”) in Galveston County, Texas. A Long-Term Care Facility is a nursing institution, an assisted living facility, or an ICF-IID licensed under Chapter 242, 247, or 252, or certified under Chapter 32 of the Texas Human Resources Code.

3. If a resident of an LTCF is identified with a COVID-19 diagnosis, the LTCF shall do the following:

a. Immediately notify all staff (from all levels of care or any job description within the LTCF) that a resident has been diagnosed with COVID-19. This notification shall be done in staff meetings, by phone, text message or email.

b. Immediately notify all residents (in all levels of care within the LTCF) who are mentally competent that a resident has been diagnosed with COVID-19. If the LTCF learns of the diagnosis while the resident is asleep, the resident shall be notified immediately after they wake. The LTCF shall insure that the notification is documented and maintained in its records, including noting the time and method of delivery of the notification.

c. As expeditiously as possible, notify family members and/or responsible parties of all residents (in all levels of care within a facility with the exception of independent living) by phone, text message or email that an individual within the facility has tested positive for COVID-19.

d. Tender a notification statement on or affixed to the main entryway of the physical premise that a resident of the facility has tested positive for COVID-19 within two (2) hours of identification of a case. Said notification must remain in-place until all residents of the facility have been deemed recovered from COVID-19 in accordance with CDC and local health regulatory guidelines.

4. If an LTCF has any resident with a diagnosis of COVID-19, the LTCF shall institute the following measures within the same level of care:

a. All health care personnel must wear facemasks while in the LTCF and consider having all health care personnel wear all recommended personal protective equipment (“PPE”) (gown, gloves, eye protection, N95 respirator or, if not available, a facemask) for the care of all residents, regardless of presence of symptoms. The LTCF should also implement protocols for extended use of eye protection and facemasks. The LTCF shall insure that all health care personnel must have temperature and symptom checks prior to each shift.

b. The facility will be closed to new admissions and will also cease any and all outpatient services.

c. Any and all of the staff at the LTCF shall not work at any LTCFs other than the impacted LTCF, and the administrator any LTCF shall keep a list of all employees who have worked at any other LTCFs, including the name and contact information for the administrator at the other LTCF.

5. Any standards prohibiting improper transfer of patients will be strictly enforced.

6. If an LTCF has any resident with a diagnosis of COVID-19, the LTCF may allow transfer of a resident to home care, but only after a patient has been tested as negative for COVID-19. In the case of such a transfer, the LTCF must provide a copy of this Order to those in the household to which the resident is being transferred.

7. If an LTCF has any resident with a diagnosis of COVID-19, the LTCF may allow transfer of a resident to a hospital or dialysis treatment center, but only after the LTCF has provided notice to the receiving facility that the patient is being transported from an LTCF with COVID-19 positive residents. If the patient is transferred by ambulance, the LTCF must also provide notice to the ambulance providers that the patient is coming from a LTCF with identified COVID-19

8. Nursing facilities and LTCFs may accept patients previously diagnosed with COVID-19 if the patient is no longer deemed infectious as per CDC and local health authority guidelines.

9. The LTCF shall inform the Galveston County Health District of any new positive COVID-19 case within three (3) hours of case identification.

10. The Galveston County Health District, under the direction of the Local Health Authority, must promptly provide copies of this Order via email to all LTCFs located within Galveston County. Additionally, the Order will be prominently posted on the Galveston County Health District website. In addition, the owner, manager, or operator of any facility that is likely to be impacted by this Order is required to post a copy of this Order onsite and to provide a copy to any member of the public asking for a copy.

11. If any subsection, sentence, clause, phrase, or word of this Order or any application of it to any person, structure, gathering, or circumstance is held to be invalid or unconstitutional by a decision of a court of competent jurisdiction, then such decision will not affect the validity of the remaining portions or applications of this Order.

ORDERED this 3rd day of April 2020.

Coronavirus Concerns at Nursing Homes

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