S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   11114
 
                           I N  A S S E M B L Y
 
                             November 6, 2020
                                ___________
 
 Introduced  by  COMMITTEE ON RULES -- (at request of M. of A. Gottfried)
   -- read once and referred 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 licensed nursing home, residential health  care
 facility, or a facility providing long-term health-related services.
   (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  consistent with the provisions of
 this act. The audit shall include a competency checklist which  incorpo-
 rates  specific  core  competencies  based on guidance set forth in this
 act.
   (b) The department shall conduct audits on and after October 1, 2020.
   § 3. Audit evaluation. (a)  The  infection  control  competency  audit
 shall utilize a checklist with a point system to evaluate the competency
 of  the  facility  being  audited.   Each item in the checklist shall be
 valued at one point. In order to receive a point for items that have sub
 items each sub-item must be met. Facilities  subject  to  the  infection
 control  competency  audit  shall  be  required  to fulfill the required
 criteria of a minimum of eighty percent of the audit checklist.
              

 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD17348-01-0

 A. 11114                            2
 
   (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 only meets sixty percent of the required criteria
 within the checklist, the facility will be scored as "in  adherence  but
 warrants reinspection."
   (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 occur at two-week 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
 to:
   (A)  address  and improve infection control based on federal and state
 public health advisories; and
   (B) spend an adequate time in the building 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  incidence  and  corrective  actions  related  to
 infections.
   (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  infectious
 disease symptoms.
   (iv) The facility shall establish a dedicated area for those residents
 confirmed  by  testing  to be infected with an infectious disease or are
 recovering from an infectious disease.
   (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.

 A. 11114                            3
 
   (vi)  The  facility shall have ensured ongoing access to the necessary
 supplies for hand hygiene.
   (vii)  The  facility  shall  have  ensured ongoing access to federally
 registered hospital disinfectants or centers for disease control accept-
 able alternatives to allow for necessary and  appropriate  cleaning  and
 disinfecting of high touch surfaces and shared resident care equipment.
   (b)  Personal protective equipment. (i) The facility shall possess and
 maintain a supply of all necessary items of personal  protective  equip-
 ment in line with the most recent department guidance to protect facili-
 ty personnel and residents.
   (ii)  The  facility has 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.
   (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 personal protective equipment guidance.
   (c)  Staffing.  (i) The facility shall demonstrate that there has been
 advanced planning, in alignment with the facility's emergency  prepared-
 ness  plans,  for  backup staffing utilizing all resources in advance of
 staff testing to be able to cover shifts based on potential staff  quar-
 antines.
   (ii)  The facility shall have an employee responsible for conducting a
 daily assessment of staffing status and needs during outbreak of  infec-
 tious or contagious disease.
   (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.
   (ii) The facility shall ensure all  health  care  professionals  which
 enter the facility have been trained to recognize the signs and symptoms
 of COVID-19 and other 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 at a minimum of two times per
 day 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)  Communication.  The  facility shall have a written plan for daily
 communications  with  staff,  residents,  and  the  resident's  families
 regarding  the  status and impact of COVID-19 in the facility, including
 but not limited to the prevalence of  confirmed  cases  of  COVID-19  in
 staff and residents and personal protective equipment availability.
   (f) Reporting. The facility shall have a written plan for reporting of
 increased  incidence of infections to the appropriate area office of the
 office of health systems management.
   § 6. This act shall take effect immediately.