Any resident of New Jersey's long-term care facilities who leaves to spend Thanksgiving with family will be required to quarantine for 14 days once returning, state health officials said Monday.

And if that's not possible, they won't be let back in at all, state Health Commissioner Judi Persichilli said as she and other officials gathered for the latest of Gov. Phil Murphy's routine novel coronavirus briefings.

"We are still very concerned about the outbreaks we are seeing in long term care," Persichilli said.

In fact, the state health department is recommending against removing residents from long-term care facilities at all — instead urging outdoor visitation at the facilities, or indoor visitation in limited cases where safety protocols make it possible.

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The state's instructions to long-term care facilities — which include nursing homes and assisted living facilities — come as New Jersey is reporting 241 active outbreaks in the LTCs, out of 911 since the novel coronavirus pandemic first hit the state in March. According to the state, 7,252 lab-confirmed coronavirus deaths have taken place among LTC staff or residents — out of 14,779 lab-confirmed and 1,801 New Jersey deaths overall.

Federal investigators have been reviewing the state's handling of the virus in nursing homes and veterans homes — criticized by Republican lawmakers after Murphy ordered the homes to accept readmittance of patience who'd tested positive for the virus. Administration officials, who put an early emphasis on keeping hospital beds free, have said nursing homes are capable of isolating contagious patients.

Monday, Persichilli said noted residents of long-term facilities are particularly susceptible to the coronavirus — which is broadly understood to be more dangerous for the elderly and for people with pre-existing health conditions: "Bringing your loved ones home could put them at risk."

She said any resident who leaves a facility will be quarantined for two weeks. Those who have roommates will be moved to observation rooms.

Persichilli said nursing homes will be required to set up reservation systems for checking residents out — to make sure there are enough isolated rooms available. Those systems should include wait lists, when the amount of requests exceeds the capacity to isolate returning residents. Reservations and any changes to plans should be confirmed 36 hours in advance, she said.

And if a resident on a wait list or without a reservation at all leaves anyway, he or she won't be returned until a bed in an isolated room is available, Persichilli said.

Residents and their families will have to be informed of the risks of leaving the long-term care facilities, she said. They'll need to agree to inform the facilities if anyone at a gathering tests positive for the novel coronavirus or shows COVID-19 symptoms within 14 days.

The rules come as New Jersey remains in what Murphy on Monday called a "phase of high concern" — with 5 percent of the state's positive tests, ever, happening since Friday. Murphy acknowledged Monday that's a difficult statistic to use to reflect trends — testing capacity has increased dramatically since the state was hard-hit in March and April, and its not known how many cases might have registered then if more people were tested — but hospitalizations are quickly rising, and at their highest level since early June.

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