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DOH Issues Updated Nursing Home Visitor Testing and Screening Guidance

On March 17, 2023, the Department of Health (DOH) issued updated screening and visitation guidance for nursing homes. The guidance does NOT apply to adult care facility (ACF)/assisted living (AL) settings.

In the advisory, DOH states that it is fully aligning with Centers for Medicare and Medicaid Services (CMS) QSO-20-39-NH regarding nursing home COVID-19 screening and visitor testing. All previous DOH requirements related to nursing home screening and visitor testing have been superseded, including, but not limited to, requirements outlined in Dear Administrator Letter (DAL) NH 21-30, issued on Jan. 4, 2022, and Nursing Home Testing, Cohorting, and Visitation Guidance, issued on Oct. 13, 2022.

The key takeaways of the new advisory include the following:

  • Nursing homes are no longer required to verify that visitors have a negative COVID-19 test before entry or conduct active COVID-19 screening.
  • Passive screening is “recommended,” aligning with the Centers for Disease Control and Prevention's (CDC) national standard found here.
    • Passive screening would include instructional signage to incorporate:
      • What to do if you have a positive test or close contact with someone with COVID-19
      • Visitor education on COVID-19 signs and symptoms
      • Infection control and prevention precautions
      • Appropriate hand hygiene education
      • Other facility practices such as
        • Use of face covering or mask
        • Specified entries, exits, and routes to designated areas (e.g., visitation areas)

Facilities are reminded that according to QSO-20-39-NH, while not required, facilities in counties with high levels of community transmission are encouraged to offer testing to visitors, if feasible. If facilities do not offer testing, it is recommended that they encourage visitors to be tested on their own before coming to the facility (e.g., within two to three days).

Nursing homes are also reminded to adhere to core principles of COVID-19 infection prevention, which include the following:

  • For a visitor who is aware that they are positive or had a recent exposure, deferring non-urgent visits until the end of the isolation period;
  • Hand hygiene practices and education;
  • Using masks and personal protective equipment (PPE) in accordance with CDC recommendations;
  • Frequent cleaning and disinfection of high-touch surfaces and designated visitation areas;
  • Using effective cohorting procedures; and
  • Performing resident and staff testing according to CMS QSO-20-38-NH.

Facilities may choose to continue visitor testing and/or active screening at their discretion. Active screening refers to requiring anyone entering the facility to complete a symptom screening questionnaire or an in-person interview and/or have their temperature taken before being allowed entry into the facility.

Test kits will be supplied based on monthly Health Emergency Response Data System (HERDS) survey responses, while supplies last. If a facility has an ongoing need for these assets beyond resources available from the State, they should explore regular procurement options for test kits. Requests for emergency test kits can be made through county offices of emergency management (OEMs). Free test kits from LeadingAge National can be accessed here.

Although the new guidance supersedes prior guidance regarding screening and visitor testing, it is unclear whether other provisions of that guidance are still in effect (e.g., provisions governing cohorting, active screening of staff).

Questions about this advisory can be sent to covidnursinghomeinfo@health.ny.gov or icp@health.ny.gov.

Contact: Carrie Mosley, cmosley@leadingageny.org, 518-867-8383 ext. 147