S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1999--A
 
                        2021-2022 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             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:
 
   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.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02904-03-1

              

 A. 1999--A                          2
 
   (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.
   §  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.

 A. 1999--A                          3
 
   (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
 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

 A. 1999--A                          4
 
 infection. These policies shall accommodate for department  and  centers
 for  disease control guidance on personal protective equipment conserva-
 tion methods.
   (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.