The New York State Senate

 
                     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.