N.Y. Declares Victory on Nursing Home Staff Testing With COVID-19 Rates Under 1%

Health officials in New York, which implemented a strict twice-a-week COVID-19 testing protocol for nursing home staffers that many operators claimed would be difficult to meet, this week announced that the mandate had been successful enough to drop the frequency down to weekly in most parts of the state.

Citing a reduction in the rate of positive tests from 3% to less than 1%, state health commissioner Dr. Howard Zucker directed Gov. Andrew Cuomo to issue an updated executive order requiring once-a-week tests for all nursing home staff in regions that have entered the second phase of the state’s multi-tiered reopening plan.

Cuomo obliged, signing the order Wednesday; twice-a-week testing must continue in areas that remain in the first phase, which as of Thursday consisted solely of the five boroughs of New York City.


“As a result of these ambitious testing operations, I believe we have successfully tracked and reduced the spread of the virus in long-term care facilities,” Zucker said. “The results of these tests has allowed facilities to take steps to ensure those residents and staff who test positive do not spread the infection.”

Cuomo on May 10 ordered the state’s nursing homes to test staff twice weekly among other new coronavirus regulations, threatening to pull the licenses of operators that failed to comply.

Also included in that order was a seeming reversal of a controversial policy that for months prevented nursing homes from denying admission of residents solely on the basis of COVID-19 infection, which critics have said only accelerated the spread of the virus among vulnerable elders.


The governor has repeatedly defended his administration’s actions regarding nursing homes during the COVID-19 crisis.

“Well, that’s harsh — no, harsh is having a nursing home resident who doesn’t get the appropriate care,” Cuomo said at the time. “That’s what’s harsh — having someone’s parent or mother or brother in a situation where they’re in a facility, they can’t even get a visitor, they’re isolated, they feel alone, and they’re not getting the appropriate care. That is what is harsh.”

The state’s nursing home industry largely welcomed the imperative to boost testing, but emphasized that due to the cost and logistical challenges of processing that many tests in a short period of time, operators would need more support to carry out the mandate.

“While we applaud Gov. Cuomo’s new testing directive to safeguard nursing home residents and staff, we will need significant assistance from state government to increase the availability of testing for skilled nursing and assisted living employees,” New York State Health Facilities CEO Stephen Hanse said in a statement last month.

Since May 10, according to Zucker, labs have processed 425,000 tests for nursing home staffers, resulting in 6,500 positives; more than half of those cases were identified in New York City, which has been one of the primary epicenters of COVID-19 infections nationwide. Early weekly results revealed a positive rate of 3%, Zucker reported, though that figure has since dropped to under 1% for the most recent full week of results.

The state also completed a baseline test of the nearly 90,000 nursing home residents in the Empire State; health officials are “working with facilities on appropriate next steps when positive cases are identified.”

Hanse on Thursday praised the governor’s decision to reduce the testing frequency, pointing to the positive early results and calling the new order “the prudent approach to safeguarding residents and staff.”

That said, he again called on the state to cover the cost of mandatory employe tests, which can cost $100 apiece.

“While New York has deemed its mandated tests as ‘medically necessary’ to ensure commercial health plans cover the costs pursuant to the federal CARES Act, we are seeing commercial health plans and union backed health plans refusing to cover these costs,” Hanse said in a statement provided to SNN. “As such, we must work in partnership with the state to ensure providers are reimbursed for these unsustainable costs.”

The question of who will foot the bill for mandatory testing has made national headlines in recent weeks, with the New York Times reporting on conflicts among nursing home operators, unions that represent workers, and private insurers over who should ultimately be responsible for the mounting testing costs.

Price tags aside, at least in New York, officials have declared their efforts a success.

“The state quickly reserved lab capacity of more than 35,000 tests per day with major commercial reference labs which were connected to facilities, and dispatched to date nearly 1 million testing kits statewide,” Zucker said. “While some called this mandate unnecessary, these test results have identified thousands of positive cases of those who may have otherwise spread the virus to vulnerable residents. There is no doubt this directive saved lives.”

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