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DOH Issues Revised ACF and Nursing Home Staff Testing Guidance

On June 10th, the Department of Health (DOH) issued revised staff testing guidance for adult care facility (ACF) and nursing home providers. After over a year of mandated weekly staff testing, this has been a critical advocacy issue. Most recently, LeadingAge NY had been pushing the State to adopt the federal guidance which recommended ceasing the serial testing of fully vaccinated staff. We are so pleased that our collective advocacy has been successful, and we appreciate your efforts.

Essentially, the new guidance allows both ACFs and nursing homes to stop weekly COVID-19 testing of fully vaccinated staff, including employees, contract staff, medical staff, operators, and administrators. Adult day health care programs should also follow the new nursing home testing guidance for their personnel. Note that this change would impact home care and hospice staff coming into ACFs and nursing homes as well. If, however, those individuals exhibit symptoms, they must be tested immediately. Unvaccinated staff will continue to be tested – once weekly for ACFs, and twice weekly for nursing homes. We read the guidance to mean that unvaccinated employees, contract staff, medical staff, operators, and administrators must continue to be tested at the frequency applicable to the facility. The Department has clarified that the testing frequency for unvaccinated part-time staff remains the same. We are seeking clarity regarding the implications for outside beauticians coming in to provide services to residents.

DOH will continue to provide nursing homes with Abbott BinaxNOW COVID-19 antigen tests. According to the guidance, these tests are to be used to perform a second weekly test of all unvaccinated staff. The directive also provides recently updated Frequently Asked Questions for health care providers about antigen testing, which contain comprehensive information that may be of interest to nursing homes and ACFs, including the processes surrounding testing such as obtaining a proper license and reporting.

The directives state that ACFs and nursing homes must continue to screen all staff (each shift), each resident (daily), and all persons entering the facility, such as vendors, volunteers, and visitors, for signs and symptoms of COVID-19. This screening must occur regardless of vaccination status. If residents or staff show symptoms, they should be tested immediately. Nursing homes are directed to conduct testing for COVID-19 as well as any other medically appropriate testing (e.g., viral respiratory pathogens). In both settings, the staff are expected to be restricted from the facility pending the results of COVID-19 testing.

Residents who have signs or symptoms of COVID-19, irrespective of vaccination status, must be tested immediately in both nursing homes and ACFs. During the time in which test results are pending, the local health department (LHD) must be contacted, and such residents should be placed on transmission-based precautions. ACFs are directed to contact their LHD if there is any staff or resident positive and follow their infection control recommendations, whereas nursing homes have more specific responsibilities outlined below.

Nursing Home-Specific Requirements

The nursing home directive points to the Centers for Disease Control and Prevention's (CDC) Updated Healthcare Infection Prevention and Control Recommendations in Response to COVID-19 Vaccination regarding what steps to take after an exposure, based on the vaccination status of the individual as well as the nature and duration of the exposure. Nursing home members are encouraged to review the CDC guidance. Nursing homes must also conduct testing in response to an outbreak, which is defined as a new COVID-19 infection in any health care personnel (HCP) or any nursing home-onset COVID-19 infection in a resident. Upon identification of a single new case of COVID-19 infection in any HCP or resident, all HCP and residents, regardless of vaccination status, should be tested immediately, and all HCP and residents who test negative should be retested every three to seven days until testing identifies no new cases of COVID-19 infection among HCP or residents for a period of at least 14 days since the most recent positive result.

Conclusion

Both ACF and nursing home members are encouraged to review the respective directives carefully to ensure compliance. Again, LeadingAge NY is pleased at this development. We trust that the approach will continue to ensure safety for your residents, while also relieving your vaccinated workforce of having to endure repeated testing. We know this will free up much-needed resources. LeadingAge NY will provide any further clarifications we receive from the Department to members as we learn them.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828 or Karen Lipson, klipson@leadingageny.org, 518-867-8383