S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   9029
 
                             I N  S E N A T E
 
                              October 5, 2020
                                ___________
 
 Introduced  by  Sens.  SKOUFIS,  RIVERA,  MAY  -- read twice and ordered
   printed, and when printed to be committed to the Committee on Rules
 
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
              

                       [ ] is old law to be omitted.
                                                            LBD17348-01-0

 S. 9029                             2
 
 control  competency  audit  shall  be  required  to fulfill the required
 criteria of a minimum of eighty 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 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

 S. 9029                             3
 
 between various areas of the facility during the period they are working
 each day during periods of recognized outbreaks.
   (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.

 S. 9029                             4
 
   (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.