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March 16th COVID-19 Update

New updates pertaining to the COVID-19 emergency continue to be announced by both the state and federal government on a regular basis. The latest developments for providers of long-term/post-acute care (LTPAC) and senior services are outlined below.

As a reminder, LeadingAge NY continues to convene weekly webinars on Mondays at 11 a.m. to address emerging questions on COVID-19. A recording of our most recent webinar, held on March 15th, is available here. If you have questions for next week’s update, please send them to Ami Schnauber, and be sure to check your email for the access information, or contact Jeff Diamond.

Cross-Sector Updates

Vaccination Update

The latest vaccination updates – including information on increased Medicare reimbursement for vaccine administration, populations newly eligible for the vaccine, New York City Department of Health and Mental Hygiene (NYC DOHMH) vaccination efforts, and Vaccine Tracker reporting changes – are summarized here.

New DOH Return to Work Guidance for Exposed Staff Offers Some Flexibility

The Department of Health (DOH) has issued new guidance on Return to Work (RTW) for Health Care Personnel who are exposed to COVID-19 or who travel to non-contiguous states or foreign countries. Notably, the new RTW guidance loosens work exclusion requirements in a limited way for exposed staff who are fully vaccinated and clears up some of the confusing language in the prior guidance documents. Click here for more information.

New Interim Travel Guidance for General Public

Last week, DOH issued new quarantine restrictions for travelers arriving in New York following out-of-state travel. This guidance is for the general public and will pertain to residents and family members. Click here for more information.

Quarantine for Community Persons Exposed to COVID-19

DOH recently issued new quarantine guidance which takes into consideration vaccination and COVID-19 recovery status. Click here for more information.

Nursing Home and Adult Care Facility (ACF)/Assisted Living Updates

DOH and CMS Nursing Home Visitation Guidance Conflict: What Should Nursing Homes Do?

The Centers for Medicare and Medicaid Services (CMS) issued revised nursing home visitation guidance last week that is inconsistent with DOH guidance. Click here to review LeadingAge NY’s comparison of the two documents and here for an overview of the major inconsistencies.

Information for Members Considering Tent Structures for Visitation

A number of members are considering the use of tents to facilitate outdoor visitation at the nursing home. In response to member questions regarding the regulations governing the use of tents, LeadingAge NY reached out to The Chazen Companies, a consulting firm that works closely with LeadingAge NY ProCare on Life Safety Code issues. Their comprehensive review of the relevant regulations is available here.

Additional Details Regarding ACF Visitation Guidance and Q&A Document

On March 11th, DOH issued Questions and Answers regarding the updated ACF visitation guidance that was issued on March 2nd. Click here for highlights and notable updates, including DOH’s clarifications that ACFs should cease communal dining and activities if either a resident or a staff person tests positive.

Local Positivity Rates

A document showing the most recent 14-day test positivity rates for each county in New York State based on both federal and state figures is available here. Based on that data, no counties in the state have a positivity rate exceeding 10 percent. While we continue to advocate for policies that take into consideration the fact that most nursing home residents and staff are now vaccinated, nursing homes across the state are still required to test staff twice per week. Updated visitation guidance dated Feb. 23rd requires nursing homes to consult the federal positivity rates to guide their approach to requiring visitors to be tested. Note that the ACF visitation guidance issued March 2nd, while different from the nursing home guidance, also refers ACF providers to the CMS county positivity rates.

The county positivity data posted by CMS are lagged by a week and are updated each Monday or Tuesday (e.g., data for the two-week period ending March 9th are posted on March 16th). They are available for download in raw format here. LeadingAge NY extracts the CMS-calculated rates for New York State counties and posts them here, along with positivity rates calculated on state data covering the same two-week period. Members should note that although state data is more current and comprehensive (e.g., it includes both PCR and antigen tests, where CMS positivity rates are calculated exclusively on PCR tests), the visitation guidance specifies that providers use CMS positivity rates to guide their approach to visitation.

Current daily county-level data for New York State are here, 7- and 14-day regional data are here, and ZIP code-level data for NYC showing infection rates during the most recent four weeks are available here. Metrics related to the State’s micro-cluster initiative are available here, and links to updated cluster maps and the address look-up tool are here.