New York COVID and Nursing Homes

COVID-19 has impacted older people, those with underlying medical conditions, and those with compromised immune systems to a significantly greater degree than other people. According to the Centers for Disease Control (CDC), 8 of 10 COVID-related deaths in the United States have been people aged 65 and older. Furthermore, because of the volume of COVID patients in New York hospitals, the governor has required nursing homes to admit recovering patients who are stable. As result, nursing home residents and staff are at a higher risk of infection.

The CDC has issued guidance to nursing homes and long-term care facilities to improve their preparedness for caring for COVID patients, including establishing a strong infection prevention and control (IPC) program.

1. Management of the IPC Program. Facilities should assign at least one person trained in infection control to provide on-site management of the program. If the facility has over 100 residents, the person should be full-time.
2. Report COVID-19 cases. On a weekly basis facilities should report COVID019 cases, facility staffing, and supply information to the National Healthcare Safety Network (NHSN) Long-term Care Facility (LTCF) COVID-19 Module.
3. Educate resident, staff, and visitors. Facilities should educate residents, healthcare personnel, and visitors about precautions the facility is taking and what they should do to protect themselves.
4. Implement source control measures. Healthcare personnel should wear masks at all times. Generally, facemasks are preferred over cloth face coverings, and cloth face coverings should never be worn instead of a respirator or facemask if PPE is required.
5. Visitor restrictions. Visitors should not enter the facility when ill or if they have a known exposure to someone with COVID-19. Facilities should send letters or emails to families reminding them of this and facilitate alternate ways of visiting with residents such as via videoconferencing. At check-in, visitors should also assess visitors for symptoms.
6. Test residents and healthcare personnel for SARS-CoV-2. Create a plan for testing for SARS-CoV-2, the virus that causes COVID-19.
7. Manage healthcare personnel. Screen all healthcare personnel at the beginning of their shift for fever and symptoms of COVID-19. Implement sick leave policies that are non-punitive, flexible, and consistent with public health policies that encourage healthcare personnel to stay home when sick.
8. Provide adequate infection prevention and control supplies. Facilities should make sure there are adequate supplies that are easily accessible including hand hygiene supplies, tissues and garbage cans, gowns, personal protection equipment (PPE), and other appropriate equipment.
9. Dedicated space for COVID-19 residents. Identify dedicated space in the facility that to monitor and care for residents with COVID-19. Have a plan for how roommates, other residents, and healthcare personnel who may have been exposed to an individual with COVID-19 will be handled.
10. Create a plan for managing admissions whose COVID-19 status is unknown. Facilities should evaluate whether placing the resident in single-person room in a separate 14-day observation area so the resident can be monitored for evidence of COVID-19.
11. Evaluate and manage residents with symptoms of COVID-19. Ask residents to report if they feel feverish or have symptoms consistent with COVID
12. Suspected COVID-19. If a patient is suspected to have COVID-19, immediately follow the CDC’s guidance for patients with suspected or confirmed COVID-19 in healthcare settings

On April 6, 2020, New York State passed the Emergency Disaster Treatment Protection Act (EDTPA), which provides immunity to nursing homes as well as other healthcare facilities and healthcare workers from potential liability related to the care of individuals with COVID-19 as long as the care provided was not willful, criminal, reckless, intentional, or grossly negligent. The full text of the EDTPA is here.

Note that the special COVID-related guidance and regulations related to nursing homes are subject to change at any time. Check back to this page for updates.