Directs the department of health to establish and implement an infection inspection audit and checklist on residential care facilities, nursing homes and long-term care facilities.
NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A1999A
SPONSOR: Gottfried TITLE OF BILL:
An act directing the department of health to establish and implement an
infection inspection audit and checklist on residential care facilities,
nursing homes and long-term care facilities
PURPOSE:
To requires facilities to adhere to an audit evaluation checklist of
core competencies relating to infection control, personal protective
equipment, staffing, clinical care, and communication.
SUMMARY OF PROVISIONS:
Establishes an annual infection control competency audit commencing
October 1, 2021. The audit will use a checklist to evaluate competency
in relation to infection control, personal protective equipment, staff-
ing, clinical care, and communication.
If a facility meets at least 85% of the criteria, the facility will be
scored as "in adherence. If a facility meets between 85% and 60%, the
facility will be scored as "in adherence but warrants reinspection"
before the next annual inspection.
A facility that fails to meet 60%, will be scored as "not in adherence"
and continue with monthly audits until it meets at least 80% adherence.
Penalties may include a revocation or suspension of a facility's license
under certain conditions.
JUSTIFICATION:
At the legislatures' August 2020 public hearings on COVID-19 and Resi-
dential Health Care Facilities, it became evident that many residential
health care facilities were severely ill-equipped to protect against the
spread of COVID-19. The unpreparedness of nursing home led to them
becoming the unofficial epicenter of the pandemic, with countless tragic
and unnecessary COVID-19 related deaths. This bill will promote profi-
ciency and preparedness for any future crisis to come.
LEGISLATIVE HISTORY:
2020: A.11114 referred to Health Committee
FISCAL IMPLICATIONS:
None to the state
EFFECTIVE DATE:
Ninety days after it becomes law
STATE OF NEW YORK
________________________________________________________________________
1999--A
2021-2022 Regular Sessions
IN ASSEMBLY
January 14, 2021
___________
Introduced by M. of A. GOTTFRIED, WALLACE -- read once and referred to
the Committee on Health -- committee discharged, bill amended, ordered
reprinted as amended and recommitted to said committee
AN ACT directing the department of health to establish and implement an
infection inspection audit and checklist on residential care facili-
ties, nursing homes and long-term care facilities
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Definitions. For the purposes of this act, the following
2 terms shall have the following meanings:
3 (a) "Department" means the department of health.
4 (b) "Facility" means a nursing home or residential health care facili-
5 ty as defined in article 28 of the public health law.
6 (c) "Nursing home" means a facility providing therein nursing care to
7 sick, invalid, infirm, disabled or convalescent persons in addition to
8 lodging and board or health-related service, or any combination of the
9 foregoing, and in addition thereto, providing nursing care and health-
10 related service, or either of them, to persons who are not occupants of
11 the facility.
12 (d) "Audit" means the infection control competency audit created by
13 the department under this act.
14 (e) "Checklist" means the infection control competency audit checklist
15 created by the department under this act.
16 § 2. Establishing the infection control competency audit. (a) The
17 department shall promulgate rules and regulations establishing an
18 infection control competency audit for a facility consistent with the
19 provisions of this act. The audit shall include a competency checklist
20 which incorporates specific core competencies based on guidance set
21 forth in this act.
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD02904-03-1
A. 1999--A 2
1 (b) The department shall commence audits of facilities on and after
2 October 1, 2021 and such audits shall be conducted on an annual basis
3 thereafter.
4 § 3. Audit evaluation. (a) The infection control competency audit
5 shall utilize a checklist to evaluate the competency of the facility
6 being audited. Facilities subject to the infection control competency
7 audit shall be required to fulfill the required criteria of a minimum of
8 eighty-five percent of the audit checklist.
9 (b) If a facility meets at least eighty-five percent of the criteria
10 within the checklist, the facility will be scored as "in adherence" with
11 the infection control competency audit.
12 (c) If a facility meets between sixty percent and eighty-four percent
13 of the required criteria within the checklist, the facility will be
14 scored as "in adherence but warrants reinspection." Such facility will
15 be subject to reinspection by the department at least once before the
16 next annual inspection.
17 (d) If a facility meets less than sixty percent of the criteria within
18 the checklist, the facility will be scored as "not in adherence".
19 § 4. Facilities not in adherence with infection control competency
20 audit. (a) The department shall establish a penalty framework for those
21 facilities determined to be "not in adherence" with the inspection
22 control checklist. A facility being found "not in adherence" may result
23 in revocation or suspension of the facility's license; provided, howev-
24 er, that no such revocation shall be ordered unless the department has
25 provided the facility with a fourteen day grace period, solely for a
26 facility's first time being found "not in adherence", to meet at least
27 eighty percent of the criteria within the checklist.
28 (b) Audits shall continue at monthly intervals for facilities that are
29 found to be "not in adherence" by the established infection control
30 competency checklist until such facilities meet at least eighty percent
31 of the criteria within the checklist.
32 § 5. Audit standards core competencies. The department shall establish
33 an infection control competency audit and checklist for facilities which
34 shall include, but not be limited to:
35 (a) Infection control. (i) The facility shall have an infection lead
36 staff person to:
37 (A) address and improve infection control based on federal and state
38 public health advisories and review and implement the facility's pandem-
39 ic emergency plan as required by subdivision 12 of section 2803 of the
40 public health law; and
41 (B) spend an adequate time at the facility focused on activities dedi-
42 cated to infection control.
43 (ii) The facility shall have an infection control program with written
44 policies and procedures which includes, but is not limited to:
45 (A) A written plan to investigate, control and take action to prevent
46 infections in the facility;
47 (B) Written procedures to allow for isolation and universal precau-
48 tions for residents suspected or confirmed to have a contagious or
49 infectious disease; and
50 (C) A record of incidences and corrective actions related to
51 infections at the facility.
52 (iii) During recognized periods of contagious or infectious disease
53 outbreaks, the facility shall have screening requirements for every
54 individual entering the facility, including staff, for symptoms associ-
55 ated with the infectious disease outbreak.
A. 1999--A 3
1 (iv) The facility shall establish dedicated distinct areas for resi-
2 dents confirmed or suspected to be infected with an infectious disease
3 or are recovering from an infectious disease. Policies and procedures
4 shall be developed to isolate residents suspected to be infected with an
5 infectious disease in quarantine until their infection status can be
6 determined.
7 (v) The facility shall have a staffing plan to limit transmission that
8 shall include, but not be limited to:
9 (A) Dedicated, consistent staffing teams who directly interact with
10 residents that are confirmed or suspected to be infected with a conta-
11 gious or infectious disease; and
12 (B) Limiting clinical and other staff who have direct resident contact
13 to specific areas of the facility. There should be no rotation of staff
14 between various areas of the facility during the period they are working
15 each day during periods of recognized outbreaks.
16 (vi) The facility shall ensure ongoing access to the necessary
17 supplies for hand hygiene for staff and residents.
18 (vii) The facility shall ensure ongoing access to federally registered
19 hospital disinfectants or centers for disease control acceptable alter-
20 natives to allow for necessary and appropriate cleaning and disinfecting
21 of high traffic surfaces and shared resident care equipment.
22 (b) Personal protective equipment. (i) The facility shall possess and
23 maintain or contract to have at least a two month supply of all neces-
24 sary items of personal protective equipment in line with the most recent
25 department guidance and statutes.
26 (ii) The facility shall develop a contingency plan to address supply
27 shortages of personal protective equipment.
28 (iii) The facility shall train staff and establish protocols for
29 selecting, donning and doffing appropriate personal protective equipment
30 and demonstrate competency during resident care. The facility must keep
31 a record of this staff training.
32 (iv) The facility shall ensure availability of personal protective
33 equipment throughout the facility and outside resident rooms when there
34 are units with separate cohorted spaces for both positive and negative
35 infectious disease residents.
36 (v) The facility shall require the use of recommended personal protec-
37 tive equipment for all front-line staff in line with the most recent
38 department guidance.
39 (vi) The facility must designate a staff member who is present at
40 every shift who is responsible for ensuring the proper use of personal
41 protective equipment by all staff.
42 (c) Staffing. (i) The facility shall demonstrate that there has been
43 advanced planning, in alignment with the facility's emergency prepared-
44 ness plans and pandemic emergency plan, for contingent staffing needs in
45 the case of staff quarantines.
46 (ii) The facility shall have an employee responsible for conducting a
47 daily assessment of staffing status and needs during an outbreak of
48 infectious or contagious diseases.
49 (iii) The facility shall institute a sick-leave policy that does not
50 punish staff with disciplinary action if they are absent from work
51 because they are exhibiting symptoms, or test positive, for an infec-
52 tious disease. Such policies shall offer the maximum amount of flexibil-
53 ity to staff and be consistent with state guidance.
54 (d) Clinical care. (i) The facility shall shave infection control
55 policies that outline the recommended transmission-based precautions
56 that should be used when caring for residents with respiratory
A. 1999--A 4
1 infection. These policies shall accommodate for department and centers
2 for disease control guidance on personal protective equipment conserva-
3 tion methods.
4 (ii) The facility shall ensure all health care professionals which
5 enter the facility have been trained to recognize the signs and symptoms
6 of infectious diseases.
7 (iii) The facility has written requirements for residents to be
8 screened for symptoms and have their vital signs monitored, including
9 oxygen saturation and temperature checks in accordance with the most
10 recent state or federal guidance and and documented in the clinical
11 record during a recognized outbreak of contagious or infectious
12 diseases.
13 (iv) The facility shall ensure that residents with any suspected
14 respiratory or infectious illnesses are assessed at a more frequent
15 rate.
16 (e) Written communication plan. The facility shall have a written
17 plan for daily communications with staff, residents, and the residents'
18 families regarding the status of infections at the facility. Such plan
19 shall be consistent with the requirements set forth in paragraph (a) of
20 subdivision 12 of section 2803 of the public health law. The facility
21 must designate a staff member who is responsible for these communi-
22 cations with staff, residents and residents' families.
23 § 6. This act shall take effect ninety days after it shall have become
24 a law.
