NEwyoRK | Department sremn | of Health ANDREW M. CUOMO HOWARD A. ZUCKER, MLD..1.0. LISA4J.PINO, M.A, 4D. Govern Commoner Execute Daputy Commission July 31, 2020 ‘County Executive Steven F. McLaughiin Rensselaer County Government Center, 1800 Seventh Avenue Troy, NY 12180, Dear County Executive McLaughlin: {1am responding to your letter dated July 20, 2020, which was received an July 24, 2020, to clatify the New York State Department of Health's nursing home inspection protocols. ‘As you state in your letter, the Department of Health attempted to conduct an unannounced {focused infection control survey of Van Rensselaer Manor on July 20, 2020. The Department ‘was unable to complete the survey due to lack of cooperation from the facility and your insistence thatthe survey staff be escorted through the facility. This conduct constitutes @ Violation of 10 NYCRR 412.3 which prohibits the interference with or obstruction of @ Department inspection. As you are well aware, Department of Health stat, accompanied by the Regional Director ofthe Centers for Medicare & Medicaid Services (CMS), returned to the facility on July 23, at which time the survey was eventually completed, though not without ‘additional resistance and attempis by the County to interfere with the survey team, ‘The Department of Heath, as an agent of CMS, is required to suvey facies identified by CMS when any nursing Nome has three or more new COVID-19 suspected and confirmed cases. since its last report tothe last National Healthcare Safety Network. This is a preventative ‘measure aimed at minimizing COVID transmission in a facility. With regard tothe focused ‘survey conducted at Van Rensselaer Manor during the week of July 20, the Department of Health was specifcaly directed by the federal government to inspect this faciliy because staff there identified infections which pose a serious risk to patients. All state and federal surveys are intentionally unannounced and unaccompanied per federal requirements, This allows for an unvarnished review ofthe facilty and its operations. ‘There are ‘many reasons a faclty can be selected for survey including complaints, infection rates, and the length ofime lapsed since is last inspection. In ths particular case, Van Rensselaer Manor \was on a ist of facilties CMS directed the Department to survey. The list was based upon data facilties had set-reported to the Centers for Disease Control and Prevention (CDC), ‘The Department's surveillance teams have completed more than 1,300 inspections ~ including at least one inspection at every single nursing home and adult care faclty inthe State ~ and have never encountered the type of resistance and blatant interference with governmental administration they experienced on two separate occasions at Van Rensselaer Manor last week. As CMS informed the facity when they accompanied us, a nursing home's interference with oF obstruction of a federal survey is a violation of the terme and conditions of ite participation agreement, which can puta nursing home's ability to Medicaid andMedicare funding atrisk and may lead to actions up to and including the termination of Despite your pubic statements about the poltcization of this process, | assure you that the Department of Health's survey team adheres to established protocols and procedures for skilled nursing facies found inne State Operations Manual sn ons ao/Reguaine ans org foward the Deparment and Van Rensselaer Manor can werk coloboratvel fo ensure residents receive the best care possible and that further inspections intended to protect those Patients occur unobstructed, Sincerely, Howard Ryeler Mad, Howard A. Zucker, M.D. J.D. Commissioner of Health