DOH Responds to Questions on Return to Work, Testing, and More

Department of Health (DOH) staff members have responded via email and in association meetings to some requests for clarification of guidance documents. As these clarifications have not been published in any written guidance, the following sets forth the responses from DOH to some common questions:

• Return to Work of Staff with Repeat Positive Test Results: Nursing home and adult care facility (ACF) staff must furlough (14 days for nursing homes and 10 days for ACFs) and present a negative COVID-19 test prior to returning to work after an initial positive test. If a staff member tests positive, completes their required furlough, tests negative, returns to work, and then tests positive again within 90 days, a full furlough is not required as long as the staff member is asymptomatic. They may return to work when they receive a negative test, even if the negative test result is obtained prior to the completion of the furlough period. If the new positive is beyond 90 days, the staff member will need to furlough for the entire required period. We are hearing from some LeadingAge NY members that DOH regional epidemiologists have expanded on this guidance to allow staff who complete their furlough after an initial positive test result and continue to test positive after the furlough to return to work as soon as they obtain a negative test result, without completing a subsequent 10- or 14-day furlough. We will seek confirmation that this logical extension of the DOH central office clarification has been approved at the central office level.
• Use of Abbott BinaxNOW Cards: The Department is providing nursing homes with Abbott BinaxNOW cards to support twice-weekly testing and rapid receipt of results. When asked whether use of the Abbott BinaxNOW cards is required for staff testing, DOH staff stated that some facilities are declining the cards, that these cards are intended to assist in meeting staff testing requirements, and that facilities may use whatever tests they need to meet the requirement. Facilities are expected to return test kits that they will not be using to test nursing home staff.
• Recording of Abbott BinaxNOW Results: DOH recognizes that the BinaxNOW cards do not automatically create a digital record of the results. Facilities are expected to create a system to log results and provide them to the test recipients.
• Reporting Point-of-Care Test Results: Facilities that conduct point-of-care COVID-19 tests, including the Abbott BinaxNOW tests, must have a limited service lab certificate and must report test results within 24 hours. As reported earlier, National Healthcare Safety Network (NHSN) reporting of point-of-care test results by nursing homes is now optional. However, nursing homes that report results via NHSN do not have to report through New York State's Electronic Clinical Laboratory Reporting System (ECLRS), provided that the facility confirms with ECLRS that NHSN is transmitting its results to ECLRS.
• End-of-Life Visits with COVID-Positive Residents: A COVID-positive resident may receive a visitor at the end of life, provided that the visitor is wearing full personal protective equipment (PPE), including mask and face shield, and the facility provides instructions to the visitor on the proper donning and doffing of PPE, as well as proper hand hygiene protocols.
• Testing After Emergency Department Visit or Hospital Admission Prior to Return to Nursing Home or ACF: When a resident is treated and released after an emergency department visit, the hospital is not required to test the resident for COVID-19 prior to their return to the nursing home or ACF. However, when a resident is admitted to a hospital or treated in a hospital under observation status, the resident must receive a negative molecular (i.e., PCR) test prior to their discharge to a nursing home or ACF.

Contact: Karen Lipson, klipson@leadingageny.org, 518-867-8838