DOH Responds to Questions on Oct. 13th Nursing Home COVID-19 Guidance

On Oct. 20, 2022, the Department of Health (DOH) responded via email to questions posed by LeadingAge NY regarding the Oct. 13, 2022 nursing home guidance on COVID-19 testing, visitation, and cohorting. Most notably, the Department clarified that, although its guidance states that facilities must "review and report" COVID-19 test results of visitors, "[r]esults of visitor self-testing do not need to be reported by the facility on [the Electronic Clinical Laboratory Reporting System (ECLRS)] or [the Health Emergency Response Data System (HERDS)]." The following are the responses from DOH to LeadingAge NY's questions:

1. Relaxation of Work Restrictions of Exposed Personnel:

Q: The Centers for Disease Control and Prevention (CDC) eliminated work restrictions for health care personnel in all settings who have a higher-risk exposure, and instead recommended that they have a series of three COVID-19 tests. What is the DOH position on exposed personnel?

A: This is under review, and a response will be forthcoming.

 

2. Exposed Visitors:

Q: Centers for Medicare and Medicaid Services (CMS) guidance acknowledges that it is safest to defer non-urgent, in-person visitation until 10 days after a COVID-19 exposure, but no longer categorically excludes visitors who have been exposed to COVID-19, provided that they can wear source control. DOH was silent on this, although it stressed the resident’s right to receive visitors. May we assume that you are following CMS on this question?

A: As noted in the Oct. 13, 2022 guidance, [c]onsistent with 42 CFR § 483.10(f)(4)(v), facilities shall not restrict visitation without a reasonable clinical or safety cause.

 

3. Review and Report Visitor Test Results: 

Q: The DOH guidance indicates that nursing homes must “review and report” the results of visitors' on-site COVID-19 tests. However, in its Jan. 4, 2022 Dear Administrator Letter (DAL) on this issue, DOH said: “In the case of visitor testing, a nursing home is allowed to provide a visitor with an iHealth OTC COVID-19 Antigen Rapid Test and the visitor may test themselves. The results of self-testing for visitors will not need to be reported to either ECLRS or to HERDS." Can we assume that this directive remains in place, or are nursing homes now required to report visitor testing on ECLRS or HERDS?

A: The results of self-testing for visitors will not need to be reported to either ECLRS or to HERDS.

 

4. Cohorting: 

Q: Please consider an exception to the requirement to separate disparate-testing roommates, if both roommates request to remain together and they or their representatives are informed of the risks. 

A: The following answers your question: Although DOH is aligning with the CDC guidance on cohorting, nursing homes must exhaust all efforts to separate disparate-testing roommates, meaning in rare circumstance when no other options are available, the exposed roommate can be left in place until such time that alternate accommodations are available. Nursing homes must fully inform residents and families of the circumstances and offer transfer out of the facility if unwilling to cohort. As such, facilities must continue to work closely with the DOH public health team regarding cohorting. Documentation and communication are critical.

 

We will continue to keep members informed as we receive further guidance from DOH.

Contact: Karen Lipson, klipson@leadingageny.org