S T A T E O F N E W Y O R K
________________________________________________________________________
1783
2021-2022 Regular Sessions
I N S E N A T E
January 15, 2021
___________
Introduced by Sens. SKOUFIS, MAY, RIVERA -- read twice and ordered
printed, and when printed to be committed to the Committee on Health
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:
Section 1. Definitions. For the purposes of this act, the following
terms shall have the following meanings:
(a) "Department" means the department of health.
(b) "Facility" means a nursing home or residential health care facili-
ty as defined in article 28 of the public health law.
(c) "Nursing home" means a facility providing therein nursing care to
sick, invalid, infirm, disabled or convalescent persons in addition to
lodging and board or health-related service, or any combination of the
foregoing, and in addition thereto, providing nursing care and health-
related service, or either of them, to persons who are not occupants of
the facility.
(d) "Audit" means the infection control competency audit created by
the department under this act.
(e) "Checklist" means the infection control competency audit checklist
created by the department under this act.
§ 2. Establishing the infection control competency audit. (a) The
department shall promulgate rules and regulations establishing an
infection control competency audit for a facility consistent with the
provisions of this act. The audit shall include a competency checklist
which incorporates specific core competencies based on guidance set
forth in this act.
(b) The department shall commence audits of facilities on and after
October 1, 2021 and such audits shall be conducted on an annual basis
thereafter.
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD02904-02-1
S. 1783 2
§ 3. Audit evaluation. (a) The infection control competency audit
shall utilize a checklist to evaluate the competency of the facility
being audited. Facilities subject to the infection control competency
audit shall be required to fulfill the required criteria of a minimum of
eighty-five percent of the audit checklist.
(b) If a facility meets at least eighty-five percent of the criteria
within the checklist, the facility will be scored as "in adherence" with
the infection control competency audit.
(c) If a facility meets between sixty percent and eighty-four percent
of the required criteria within the checklist, the facility will be
scored as "in adherence but warrants reinspection." Such facility will
be subject to reinspection by the department at least once before the
next annual inspection.
(d) If a facility meets less than sixty percent of the criteria within
the checklist, the facility will be scored as "not in adherence".
§ 4. Facilities not in adherence with infection control competency
audit. (a) The department shall establish a penalty framework for those
facilities determined to be "not in adherence" with the inspection
control checklist. A facility being found "not in adherence" may result
in revocation or suspension of the facility's license; provided, howev-
er, that no such revocation shall be ordered unless the department has
provided the facility with a fourteen day grace period, solely for a
facility's first time being found "not in adherence", to meet at least
eighty percent of the criteria within the checklist.
(b) Audits shall continue at monthly intervals for facilities that are
found to be "not in adherence" by the established infection control
competency checklist until such facilities meet at least eighty percent
of the criteria within the checklist.
§ 5. Audit standards core competencies. The department shall establish
an infection control competency audit and checklist for facilities which
shall include, but not be limited to:
(a) Infection control. (i) The facility shall have an infection lead
staff person to:
(A) address and improve infection control based on federal and state
public health advisories and review and implement the facility's pandem-
ic emergency plan as required by subdivision 12 of section 2803 of the
public health law; and
(B) spend an adequate time at the facility focused on activities dedi-
cated to infection control.
(ii) The facility shall have an infection control program with written
policies and procedures which includes, but is not limited to:
(A) A written plan to investigate, control and take action to prevent
infections in the facility;
(B) Written procedures to allow for isolation and universal precau-
tions for residents suspected or confirmed to have a contagious or
infectious disease; and
(C) A record of incidences and corrective actions related to
infections at the facility.
(iii) During recognized periods of contagious or infectious disease
outbreaks, the facility shall have screening requirements for every
individual entering the facility, including staff, for symptoms associ-
ated with the infectious disease outbreak.
(iv) The facility shall establish dedicated distinct areas for resi-
dents confirmed or suspected to be infected with an infectious disease
or are recovering from an infectious disease. Policies and procedures
shall be developed to isolate residents suspected to be infected with an
S. 1783 3
infectious disease in quarantine until their infection status can be
determined.
(v) The facility shall have a staffing plan to limit transmission that
shall include, but not be limited to:
(A) Dedicated, consistent staffing teams who directly interact with
residents that are confirmed or suspected to be infected with a conta-
gious or infectious disease; and
(B) Limiting clinical and other staff who have direct resident contact
to specific areas of the facility. There should be no rotation of staff
between various areas of the facility during the period they are working
each day during periods of recognized outbreaks.
(vi) The facility shall ensure ongoing access to the necessary
supplies for hand hygiene for staff and residents.
(vii) The facility shall ensure ongoing access to federally registered
hospital disinfectants or centers for disease control acceptable alter-
natives to allow for necessary and appropriate cleaning and disinfecting
of high traffic surfaces and shared resident care equipment.
(b) Personal protective equipment. (i) The facility shall possess and
maintain or contract to have at least a two month supply of all neces-
sary items of personal protective equipment in line with the most recent
department guidance and statutes.
(ii) The facility shall develop a contingency plan to address supply
shortages of personal protective equipment.
(iii) The facility shall train staff and establish protocols for
selecting, donning and doffing appropriate personal protective equipment
and demonstrate competency during resident care. The facility must keep
a record of this staff training.
(iv) The facility shall ensure availability of personal protective
equipment throughout the facility and outside resident rooms when there
are units with separate cohorted spaces for both positive and negative
infectious disease residents.
(v) The facility shall require the use of recommended personal protec-
tive equipment for all front-line staff in line with the most recent
department guidance.
(vi) The facility must designate a staff member who is present at
every shift who is responsible for ensuring the proper use of personal
protective equipment by all staff.
(c) Staffing. (i) The facility shall demonstrate that there has been
advanced planning, in alignment with the facility's emergency prepared-
ness plans and pandemic emergency plan, for contingent staffing needs in
the case of staff quarantines.
(ii) The facility shall have an employee responsible for conducting a
daily assessment of staffing status and needs during an outbreak of
infectious or contagious diseases.
(iii) The facility shall institute a sick-leave policy that does not
punish staff with disciplinary action if they are absent from work
because they are exhibiting symptoms, or test positive, for an infec-
tious disease. Such policies shall offer the maximum amount of flexibil-
ity to staff and be consistent with state guidance.
(d) Clinical care. (i) The facility shall shave infection control
policies that outline the recommended transmission-based precautions
that should be used when caring for residents with respiratory
infection. These policies shall accommodate for department and centers
for disease control guidance on personal protective equipment conserva-
tion methods.
S. 1783 4
(ii) The facility shall ensure all health care professionals which
enter the facility have been trained to recognize the signs and symptoms
of infectious diseases.
(iii) The facility has written requirements for residents to be
screened for symptoms and have their vital signs monitored, including
oxygen saturation and temperature checks in accordance with the most
recent state or federal guidance and and documented in the clinical
record during a recognized outbreak of contagious or infectious
diseases.
(iv) The facility shall ensure that residents with any suspected
respiratory or infectious illnesses are assessed at a more frequent
rate.
(e) Written communication plan. The facility shall have a written
plan for daily communications with staff, residents, and the residents'
families regarding the status of infections at the facility. Such plan
shall be consistent with the requirements set forth in paragraph (a) of
subdivision 12 of section 2803 of the public health law. The facility
must designate a staff member who is responsible for these communi-
cations with staff, residents and residents' families.
§ 6. This act shall take effect ninety days after it shall have become
a law.
