DOH Issues Updated ACF COVID-19 Guidance

On Dec. 23, 2022, the Department of Health (DOH) issued updated COVID-19 guidance for adult care facilities (ACFs). The guidance is directed to all ACFs, including all categories of ACF and assisted living licensure. Members are encouraged to review the guidance carefully; however, below is a summary. The most notable change is the long-awaited update to guidance regarding isolation and exposure for staff and residents to reflect Centers for Disease Control and Prevention (CDC) recommendations.

Residents, staff, and visitors should adhere to CDC Isolation and Precautions for People with COVID-19 regarding isolation for people with COVID-19, including when to isolate, for how long to isolate, and how to end isolation. See What to Do If You Were Exposed to COVID-19 for precautions to be taken after exposure to COVID-19, which include masking and testing recommendations.
ACF staff on isolation for a COVID-19 infection may return to work according to CDC Isolation and Precautions for People with COVID-19 (e.g., ACF staff with COVID-19 should be excluded for at least five days; return to work considerations should include whether symptoms are resolved or improving, severity of symptoms, and ability of the staff member to adhere to all recommended CDC precautions).
- If an ACF determines it is unable to provide essential services and therefore plans to have staff return to work before all recommended CDC criteria to end isolation are met, the ACF should contact the DOH Surge and Flex Operations Center at 917-909-2676.
- Work restrictions are generally not necessary for asymptomatic ACF staff with a close contact exposure to a person with COVID-19 if the staff member is able to adhere to all recommended CDC precautions (e.g., staff member is able to wear a well-fitting facemask, obtain the recommended testing for COVID-19, and follow other precautions).
- ACFs should also follow work exclusion recommendations provided by the local health department (LHD).

ACFs are reminded that they should work with their LHD in the event of a communicable disease outbreak, including, but not limited to, COVID-19 and influenza.
The guidance provides information regarding the parameters for determining a close contact when conducting an outbreak investigation.
Asymptomatic residents exposed due to close contact with a person with COVID-19 can still receive visitors. The resident should adhere to all recommended CDC precautions, and visitors should be made aware of the potential risk and recommended precautions.

The remaining items are largely reminders, with some nuances.

The guidance reminds ACFs of the requirement to facilitate access to the COVID-19 vaccine, including the bivalent booster, and document efforts. The guidance recommends coordinating with the flu vaccine, which can be offered at the same time.
The guidance reiterates masking requirements and recommendations. Specifically, staff and visitors over age 2 are required to wear masks. Current CDC guidance recommends masking, including in schools and public indoor places, when there is a high level of community COVID-19 burden.
Residents and their visitors, when alone in the resident’s room or in a designated visitation area, may choose to have close contact (including touch), but both parties should be informed of risk prior to visit.
Education and signage on symptoms and infection prevention and control strategies is stressed, and various resources for education, as well as ways to assess and mitigate risk, are provided.
ACFs should continue to promote and ensure adherence to appropriate hand hygiene practices and frequent, effective, and appropriate cleaning and disinfection of high-touch environmental surfaces, including in designated visitation areas after each visit. Staff should be instructed in and monitored for appropriate use of personal protective equipment (PPE).
There is not a limit to the number of visitors at any given time, though visits should be conducted according to the ACF’s COVID-19 infection prevention and control procedures, so visits do not increase risk to other residents, visitors, or staff.

Again, members are encouraged to review the guidance in its entirety. The above is simply a summary and does not include all details. Please let us know if you have any questions.

Contact: Diane Darbyshire, ddarbyshire@leadingageny.org, 518-867-8828