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How New COVID-19 Nursing Home Guidance Affects HCBS Providers

The Centers for Disease Control and Prevention (CDC) recently issued new COVID-19 recommendations for health care settings and providers regarding masking, screening of personnel and visitors, and return to work protocols. LeadingAge NY had been waiting for the Department of Health (DOH) to align State guidance with the CDC recommendations, and on Oct. 13th, DOH issued a Health Advisory to nursing homes recognizing some of the CDC provisions. However, much of the guidance continues many of the restrictive provisions adopted earlier. Some of the CDC provisions the State is not adopting relate to relaxed masking recommendations, more lenient return to work provisions for health care personnel (HCP) exposed to COVID-19, and more relaxed COVID-19 screenings of staff and patients.

The recent State guidance requires all HCP, including home care and other home and community-based services (HCBS) providers, to continue to mask in Article 28, 36, and 40 facilities and agencies. Further, the new guidance does not acknowledge any alignment with the CDC’s new return to work provisions, which allow HCP who are exposed to return to work if they are asymptomatic and regardless of whether they are “up to date” with their COVID-19 vaccinations. The new State guidance is silent on this issue, and LeadingAge NY is seeking clarification on the State’s position at this time. Current State guidance on return to work is here, and it references the old CDC recommendations.

The new State guidance also eliminates routine testing of asymptomatic personnel providing care in nursing homes if not “up to date” with all COVID-19 vaccinations and boosters. This routine testing is now at the discretion of facilities. While home care and hospice care in nursing homes is infrequent, personnel were subject to this requirement when providing care in this setting.

The Department's Dear Administrator Letter (DAL) DHCBS 22-13, issued Aug. 2, 2022, is still effective. It supersedes guidance dated March 22, 2020 (DHCBS DAL: 20-08 Updated) and modifies the twice-daily screening requirements for home care and hospice personnel upon arriving at work to screening only once a day. Agencies should continue to have policies in place, which are outlined in the DAL, regarding monitoring, reporting, and follow-up for anyone exhibiting symptoms. The document also reminds agencies that personnel are required to use appropriate personal protective equipment (PPE), including masks.

LeadingAge NY will be sure to provide members with any updates or clarifications that occur.

Contact: Meg Everett, meverett@leadingageny.org, 518-867-8871