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LeadingAge NY Meets with DOH Nursing Home Regulators

After an over two-year pause, the nursing home association/Department of Health (DOH) meetings resumed on June 16th with a number of topics discussed. Sheila McGarvey, director of the Division of Nursing Home Surveillance, provided an update on the most frequently cited survey deficiencies and the number of recent Immediate Jeopardy citations issued. The highlights are as follows:

  • Visitor Testing: Facilities should be strongly encouraging visitor testing, but if the visitors refuse, they can be allowed in the facility with N95 masks and gowns. LeadingAge NY is seeking additional clarification on this, as it does not align with the guidance that some members have received from their regional office.
  • HERDS: Further reduction in the frequency of Health Emergency Response Data System (HERDS) surveys is not under consideration, but DOH will consider updating the instructions.
  • Surveys: Surveys are lagging due to staffing issues, and DOH is experiencing recruitment problems. New surveyors are being hired, but the training is lengthy and surveyors have to pass a federal test, so it will take time before the new hires can be a fully contributing part of the survey teams. The current strategy to address the considerable gap between surveys is to focus on facilities with a history of poor performance or substantial complaints.
  • Complaints: There is a rising number of reports of abuse, including sexual abuse. Facilities must report to DOH any allegation of abuse within two hours of being made aware of the allegation. This is the more stringent federal requirement. The current DOH Incident Reporting Manual is not up to date and does not reflect this requirement. The manual may be removed from the website until it can be revised.
  • Advance Directives: Medical Orders for Life-Sustaining Treatment (MOLST) and advance directive procedures are not being implemented properly – dots indicating advance directives are falling off wristbands or residents are moving rooms, but dots on headboards are not being updated following the move. Staff is unable to identify the advance directives of the resident.
  • Prometric/Certification: Prometric is having trouble recruiting proctors for certified nursing assistant (CNA) exams, but is working on it. Facilities should volunteer to be testing sites. In the past, DOH has asked that any facility experiencing certification issues reach out to them. A call between the associations and Prometric was proposed.
  • Paid Feeding Assistants: DOH will consider an abbreviated Paid Feeding Assistant training for those who were trained under the waiver. In addition, they will consider allowing licensed practical nurse (LPN) students to sit for the CNA exam.

The PowerPoint presentation with information on the citations and Immediate Jeopardy is here.

Contact: Elliott Frost, efrost@leadingageny.org, 518-441-8761