DOH Addresses Questions on Micro-Cluster Visitation and Visits by External Health Care Professionals
In a weekly call with nursing home association representatives on Oct. 29th, staff from the Department of Health (DOH) and the Governor's Office addressed several questions related to visitation and offered infection prevention recommendations. The issues covered included:
- Micro-Cluster Visitation Guidance: The micro-cluster visitation guidance includes exemptions from visitation restrictions for "essential companions" of residents with developmental disabilities or dementia and for individuals accompanying a pediatric patient. LeadingAge NY pointed out that those exemptions do not apply in areas of the state that are not in micro-clusters and asked about the intent of these provisions. The Department responded that the guidance applies to a broad array of facilities, including hospitals and residences for individuals with developmental disabilities. These exemptions were developed with those settings in mind, and the Department is considering the possibility of clarifying the scope of the exemptions.
- Orange County Visitation Suspension: LeadingAge NY notified the Department of the Orange County order suspending visitation in facilities throughout the county, regardless of whether they are located in a micro-cluster. A member of the Governor's staff indicated that the State's Executive Orders and health directives supersede the Orange County order in its entirety. LeadingAge NY asked the State staff to clarify this with county officials.
- Visits for Provision of Routine Medical Care: LeadingAge NY asked whether health care professionals may be permitted to enter facilities to provide routine medical care, regardless of whether the facility is open for visitation, as required by Centers for Medicare and Medicaid Services (CMS) nursing home visitation guidance. DOH staff stated that facilities must follow New York State guidance. Such visits are permitted when a facility is open for visitation. If a facility is closed to visitation, the facility should consult with the resident's primary care provider and determine whether an external provider's visit is "medically necessary (i.e., visitor is essential to the care of the patient or is providing support in imminent end-of-life situations)." If the provider's visit meets these criteria, the visit is permitted. The staff were unable to reconcile this with the CMS guidance.
- Infection Control: The Department is concerned about outbreaks within facilities and is examining patterns and looking for strategies to curb them. They recommend increasing the frequency of medical team rounds in facilities with COVID-19 cases and strengthening communication among physicians and mid-levels working in the facility. They also recommend extra vigilance in relation to cleaning surfaces.
- HCS Communications: Facilities are reminded to ensure that updated contact information for facility staff is included in the Health Commerce System (HCS) communications directory.
- Staffing: If facilities are experiencing staffing shortages, the Department can provide a list of staffing agencies.
Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838