NYS nursing homes push for less stringent testing, visiting regs

ALBANY COUNTY — The association representing over 425 long-term care facilities across New York State that in August successfully pushed for less stringent requirements for visitors is pushing again.

Stephen Hanse, president and chief executive officer of the New York State Health Facilities Association and the New York State Center for Assisted Living, issued a statement on Tuesday, saying, “It has been since early March of this year that many nursing home residents throughout New York have been unable to receive visitors in person because of the COVID-19 pandemic. During this time, nursing home residents have been isolated from their loved ones and have suffered dearly as a result of being unable to see the people who mean the most to them.”

A survey by the organization this summer showed that 77 percent of providers statewide were unable to open for in-person visits under the state’s 28-day restriction.

The state subsequently changed the 28-day waiting period after a positive COVID-19 test for nursing home staff or residents to 14 days before visitors are allowed. This followed federal guidelines from the Centers for Medicare & Medicaid Services, known as CMS.

This month, Hanse wrote a letter to the state’s health commissioner and governor calling for less stringent testing for visitors to nursing homes and for less frequent testing of nursing-home staff, again following federal guidelines.

CMS is requiring testing once a month for facilities in counties with less than a 5-percent infection rate; once a week for facilities in counties with a positivity rate between 5 percent and 10 percent; and twice a week for facilities in counties with a positivity rate of over 10 percent.

The vast majority of counties in New York State have a positivity rate below 3 percent.

New York was ahead of the federal government in setting requirements for nursing-home visits and for testing of staff and residents. After nursing homes across the state suffered many deaths of residents, Governor Andrew Cuomo required nursing-home workers to be tested twice weekly for COVID-19. That was later reduced to once a week.

The majority of COVID-19 deaths in Albany County have been of nursing-home residents.

A July 6 report issued by the state’s Department of Health concluded that the primary cause of the spike of COVID-19 cases in nursing homes was due to workers being infected. The report says that one in four nursing-home workers were infected and also that visitors to the nursing homes, before a March 13 executive order forbade visitors, could also have unwittingly spread the disease.

Critics of the report have maintained the cause of many deaths was Cuomo’s initial policy that nursing homes accept COVID-19 patients, an order he reversed on May 10. Cuomo said at the time that he was following directives from the Centers for Disease Control and Prevention.

At the height of the pandemic in New York, there were concerns there wouldn’t be enough hospital beds for patients with severe cases of COVID-19.

Nationwide, over 40 percent of COVID-19 deaths have been of nursing-home residents who make up about 1-percent of the United States population.

Hanse writes in his Oct. 7 letter, released on Tuesday, about the need to balance measures to protect nursing-home residents from COVID-19 with “the federally guaranteed right of residents to receive visitors, given the well-documented studies which conclude that prolonged and enforced isolation from families and loved ones can have severe psychological, mental and physical effects on residents, including death.”

He also writes, “The CMS guidance does not require facilities to test visitors, but does ‘encourage’ it in counties where the positivity rate exceeds 5%. Notably, however, in New York State, most counties are well below the 5% threshold. Nevertheless, New York requires that all visitors be tested (regardless of whether they are asymptomatic) within 7 days of any visitation.”

Hanse cites a $100 cost per test, which he writes most insurers won’t cover, as “an extremely difficult burden.” 

In Albany County, free diagnostic COVID-19 testing is offered by the state at the uptown University at Albany campus, and through the county in at-risk neighborhoods, as well as at several pharmacies.

Hanse also objects to New York State’s required weekly testing of nursing-home workers, noting CMS requires monthly testing in counties where positivity rates are below 5 percent.

He says that facilities have to bear the cost “without any source of reimbursement at a time when facilities’ financial resources are already stretched to the limit as a result of other COVID-19 mandates and the precipitous decline in census brought on by the pandemic.”


State report

On Tuesday, Cuomo announced that three states — Ohio, Michigan, and Virginia — have been added to New York State’s COVID-19 travel advisory. No areas have been removed. The advisory requires individuals who have traveled to New York from areas with significant community spread to quarantine for 14 days.

Cuomo said in a statement, as he released the test results from Monday, “Our numbers overall continue to remain steady, despite the micro-clusters that have popped up in certain pockets of the state. Our strategy is to continue to identify these clusters if and when they pop up, get even more refined in our targeting and attack them as needed.”

The positivity rate for “red zone” areas — largely in  Queens and Brooklyn in New York City and in Orange and Rockland counties — was 4.13 percent. The red zone areas are home to 2.8 percent of the state’s population, Cuomo again noted, yet had 12.3 percent of all of the state’s positive cases reported on Tuesday.

The Capital Region, of which Albany County is a part, had one of its highest rates in weeks, at 1.7 percent.

Only two of the state’s 10 regions had rates below the target of 1 percent: The Mohawk Valley had a rate of 0.7 percent and the North country, as usual, was the lowest, at 0.5 percent.


Newest numbers

Albany County, as of Tuesday morning, had 3,208 confirmed cases of COVID-19, according to a release from Albany County Executive Daniel McCoy’s Office, asn increase of 18 cases.

Of the new cases, 10 had close contact with someone infected with the disease, three reported they had traveled, and five did not have a clear source of transmission detected at this time. Separately, two of the new cases are associated with the University at Albany.

The county now has 885 residents under quarantine, down from 927 on Monday, and 1,000 earlier in the week. The five-day average for new daily positives decreased to 16.8 from 17.2. There are now 99 active cases in the county, down from 111 yesterday.

So far, 13,887 people have completed quarantine. Of those, 3,109 tested positive and recovered.

No new COVID-19 patients were hospitalized overnight so five residents remain in the hospital with one patient in an intensive-care unit. The county’s hospitalization rate remains at 0.15 percent.

Albany County’s COVID-19 death toll remains at 136.

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