DOH Regional Offices Shifting Directions on Outdoor Visitation and Other Activities During Nursing Home Outbreaks – UPDATED
LeadingAge NY reported on our COVID-19 update webinar on Mon., April 19th that some Department of Health (DOH) regional offices appeared to be loosening some restrictions on outdoor visitation and socialization during outbreaks. Unfortunately, we have subsequently learned that they may be retracting that guidance and prohibiting residents of any unit on transmission-based precautions (TBP) from participating in outdoor visitation. We have sought, but have not received, confirmation from the central office of the State's policies related to outdoor visitation and social interaction.
We have also heard from members in several regions that they have been instructed that if a staff member tests positive but has not worked in the facility for seven days prior to the date of specimen collection, there is no need to initiate outbreak testing and no need to suspend visitation. It is unclear whether these staff members must be reported on Health Emergency Response Data System (HERDS) surveys.
Members are cautioned that these instructions concerning outdoor visitation and outbreak testing are not explicitly included in any official document, although they are not inconsistent with official guidance documents.
Notably, the DOH visitation guidance, like the Centers for Medicare and Medicaid Services (CMS) visitation guidance, includes the provisions governing visitation during an outbreak only in the section entitled "Indoor Visitation During an Outbreak" and directs nursing homes to "suspend all visitation" during the first round of outbreak testing. In another section, it provides that only virtual and window visits are allowed for residents on TBP. The CMS guidance thereby creates ambiguity concerning the permissibility of outdoor visitation during the first round of outbreak testing and for residents who are on TBP due to a case in their unit, rather than a positive diagnosis or actual exposure.
We recommend that members consult with their regional offices on these issues and seek written instructions. If instructions are provided orally, we recommend sending a confirmatory email.
Contact: Karen Lipson, klipson@leadingageny.org