LeadingAge NY Provides Interim Comparison of Federal COVID-19 Guidance Changes with Old DOH Guidance
New COVID-19 infection prevention guidance issued by the Centers for Medicare and Medicaid Services (CMS) and the Centers for Disease Control and Prevention (CDC) on Sept. 23rd has raised a host of questions regarding the continued validity of previously issued Department of Health (DOH) guidance. Various DOH requirements are now inconsistent with federal guidance, even though they were intended to follow federal guidance in effect at the time they were imposed. LeadingAge NY has asked DOH for its position on the new federal guidance but has not received any updates as of the publication of this article. We recommend that members continue to follow the DOH guidance pending instructions from DOH, unless the CDC or CMS guidance offers stronger infection prevention measures than State guidance or covers issues that have not been addressed by DOH.
To assist members in analyzing the new guidance and in identifying inconsistencies with DOH guidance, LeadingAge NY has developed a comparison chart that provides an overview of the key changes in protocols set forth in the federal guidance documents. Areas that are consistent or not irreconcilably inconsistent between the federal and State regulatory authorities include:
- Work restrictions for health care personnel with COVID-19 infection: DOH and CDC guidance are consistent, except that the CDC now requires two tests, at least 48 hours apart, if an antigen test is used to enable a staff member to return to work at seven days, instead of 10 days.
- Testing after exposure or in response to outbreak: The CDC and CMS recommend initiation of testing at least 24 hours after exposure or outbreak and three tests, at least 48 hours apart, if each result is negative. DOH has not addressed the testing intervals for outbreaks or exposures.
- Testing of recently recovered individuals: The CDC recommends against testing asymptomatic individuals within 30 days after recovery from COVID-19; DOH guidance references a 90-day waiting period. The CDC guidance is more protective and can be followed.
- Quarantine of new admissions and exposed residents: The CDC no longer categorically recommends quarantine or empiric use of transmission-based precautions for newly admitted/readmitted residents or residents who are exposed to COVID-19. Instead, they recommend COVID-19 testing in areas of high community transmission and source control. We have not identified specific recommendations on this issue from DOH to date.
In other respects, as indicated in the comparison chart, the CDC and CMS guidance documents are inconsistent with DOH guidance.
Adult care facility (ACF) members should be aware that, in recent guidance, DOH has directed ACFs with a positive case and all assisted living residences and assisted living programs to follow CDC guidance. While we anticipate that DOH will continue to align ACF guidance with CDC recommendations, we have yet to see any clarification or updated guidance for ACF or assisted living providers in response to the recent federal updates.
The federal updates were previously reported by LeadingAge NY here. Members are encouraged to read the guidance documents in their entirety and review the chart. We will notify members as soon as we receive any relevant updates from DOH.
Contact: Karen Lipson, klipson@leadingageny.org