Head of Centers for Medicare and Medicaid Services responds to NYS March nursing home advisory | WNYT.com

Head of Centers for Medicare and Medicaid Services responds to NYS March nursing home advisory

Head of Centers for Medicare and Medicaid Services responds to NYS March nursing home advisory Photo: AP .

Jill Konopka
Updated: May 30, 2020 09:20 PM
Created: May 30, 2020 05:25 PM

The Administrator of the Centers for Medicare and Medicaid Services, Seema Verma, spoke to Fox News Radio earlier this week about Gov. Andrew Cuomo’s March 25 Advisory on Hospital Discharges and Admissions to Nursing Homes in NYS.  NewsChannel 13 attempted to contact Verma independently have so far been unsuccessful.

Verma told Fox Radio on Wednesday, "Under no circumstances should a hospital discharge a patient to a nursing home that is not prepared to take care of those patients' needs.” Verma added, “The federal guidelines are absolutely clear about this.”

Gov. Cuomo has repeatedly stated that March 25th guidance followed President Trump and the CDC.

On May 23, inside the Executive Mansion on Eagle Street, the site of the Governor’s Memorial Day weekend coronavirus briefing, he told reporters, “What NY did was follow what the Republican administration said to do. That’s not my attempt to politicize it. It’s my attempt to de-politicize it. So, don’t criticize the state for following the President’s policy,” Governor Cuomo stated.

Secretary to the Governor Melissa DeRosa adding to the Governor’s comment, “That read, and I quote nursing homes ‘should’ admit any inviduals from hospitals where COVID is present. Not could, should. That is President Trump, CMS and CDC.”

NewsChannel 13 copied and pasted that NYS advisory from March 25 below, which shows was distributed immediately to Nursing Home Administrators, Directors of Nursing Directors of Social Work, Hospital Discharge Planners.

"March 25, 2020 TO:  Nursing Home Administrators, Directors of Nursing, and Hospital Discharge Planners FROM: New York State Department of Health

COVID-19 has been detected in multiple communities throughout New York State. There is an urgent need to expand hospital capacity in New York State to be able to meet the demand for patients with COVID-19 requiring acute care. As a result, this directive is being issued to clarify expectations for nursing homes (NHs) receiving residents returning from hospitalization and for NHs accepting new admissions. 

Hospital discharge planning staff and NHs should carefully review this guidance with all staff directly involved in resident admission, transfer, and discharges. 

During this global health emergency, all NHs must comply with the expedited receipt of residents returning from hospitals to NHs. Residents are deemed appropriate for return to a NH upon a determination by the hospital physician or designee that the resident is medically stable for return.     Hospital discharge planners must confirm to the NH, by telephone, that the resident is medically stable for discharge. Comprehensive discharge instructions must be provided by the hospital prior to the transport of a resident to the NH. 

No resident shall be denied re-admission or admission to the NH solely based on a confirmed or suspected diagnosis of COVID-19. NHs are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for COVID-19 prior to admission or readmission. 

Information for healthcare providers on COVID-19 is readily available on the New York State Department of Health public website at https://coronavirus.health.ny.gov/information-healthcareproviders. As always, standard precautions must be maintained, and environmental cleaning made a priority, during this public health emergency.

Critical personal protective equipment (PPE) needs should be immediately communicated to your local Office of Emergency Management, with the appropriate information provided at the time of request. Requests MUST include: 

Type and quantity of PPE by size; Point of contact at the requesting facility or system; Delivery location; Date request is needed to be filled by; AND Record of pending orders. 

Thank you for your ongoing support and cooperation in responding to COVID-19. General questions or comments about this advisory can be sent to covidnursinghomeinfo@health.ny.gov. "

Rich Azzopardi is a senior advisor to Gov. Cuomo.  He sent this statement to NewsChannel 13:

"Federal guidelines and state law both state that facilities need the space, the staff and the protective equipment to care for a patient or they have to transferred and that remained the standard during this pandemic. As a matter of fact 10 nycrr 415.26 specifically says that a nursing home shall accept and retain ONLY those nursing home residents for whom it can provide adequate care. If facilities couldn’t care for patients, New York has offered to help with transfers, provided access to 96,000 staffers – which 400 out of 600 homes used --  and have given them more than 13 million pieces of PPE.  While some politicians seem to be more than happy to exploit this pandemic, these are the indisputable facts."

Federal guidelines:

https://www.cms.gov/files/document/3-13-2020-nursing-home-guidance-covid-19.pdf

Note: Nursing homes should admit any individuals that they would normally admit to their facility, including individuals from hospitals where a case of COVID-19 was/is present. 

The March 13th federal guidance further proves our point. You can’t discriminate against them purely due to their COVID-19 status, but you also have a responsibility to ensure you can care for them (relevant excerpts from the 3/13 guidance which predates 3/25):

“When should a nursing home accept a resident who was diagnosed with COVID-19 from a hospital?  A nursing home can accept a resident diagnosed with COVID-19 and still under Transmission Based Precautions for COVID-19 as long as the facility can follow CDC guidance for Transmission-Based Precautions.  If a nursing home cannot, it must wait until these precautions are discontinued.”    

“Note: Nursing homes should admit any individuals that they would normally admit to their facility, including individuals from hospitals where a case of COVID-19 was/is present.”

Pre-existing federal regulation:

“Facilities are required to determine their capacity and capability to care for the residents they admit. Therefore, facilities should not admit residents whose needs they cannot meet,” and….  “The facility must conduct and document a facility-wide assessment to determine what resources are necessary to care for its residents competently during both day-to-day operations and emergencies. The facility must review and update that assessment, as necessary, and at least annually.

Pre-existing state regulation:

10 nycrr 415.26

(1)   The nursing home shall:…..(ii) accept and retain only those nursing home residents for whom it can provide adequate care;"

Earlier in May, the Associated Press released statistics they had gathered on New York State nursing homes.

The AP findings suggested 4,300 recovering COVID-19 patients were sent to New York nursing homes under the March 25 advisory.

When asked Memorial Day weekend why the state’s survey hadn’t been released, state officials told members of the media there was not any related information they hadn’t released at that point in time.  On Mother’s Day, May 10 Gov. Cuomo and state officials announced hospitals cannot return coronavirus patients to nursing homes in NYS unless and until they tested negative for COVID-19. 

Here’s the link to the original March 25th 2020 guidance.   https://coronavirus.health.ny.gov/system/files/documents/2020/03/doh_covid19-_nhadmissionsreadmissions_-032520.pdf

Once you click on the link it states, “We're sorry, the page that you are looking for is not found.

This document may have moved. Please try this URL.

http://coronavirus.health.ny.gov/system/files/documents/2020/05/doh_covid19_discontinueisolation_053020-final.pdf   (which is dated May 30).

NewsChannel 13 did save an original copy of the advisory from March 25th, 2020.


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