Senators’ questions from August 2020 public hearings on

nursing homes and hospitals:

1) A witness reported that the nursing home where her father was showing symptoms
said they didn’t know how to test him. This was in late March or early April. She believed
they meant they had no way to do testing onsite. At what point did nursing homes gain
the ability to test their residents? Did the state help with that? Do they all have that
capability now?

2) We heard from nursing home staff that they not only had insufficient PPE during the
worst of the crisis, they did not have time to change it or put it on properly, because they
were so understaffed. What planning have you done to make sure there is not only
adequate PPE but adequate staff in long-term care facilities?

3) Many legislators asked about the number of nursing home and assisted living
resident deaths being reported. Please provide a full break out of all deaths of
individuals in long term care residential settings who died in the facilities and those who
were transferred and died in a hospital. Include both covid confirmed and presumed
numbers for the residents who died in hospitals as you have been reporting those two
categories for facility deaths.

4) What steps are being taken to ensure that nursing homes and other long term care
residential facilities have and maintain sufficient staffing levels? What is being done to
ensure sufficient staffing levels are maintained during any public health emergencies?

5) There are many concerns about the change to un-enroll patients from a Managed
Longterm Care plan after a 90 day short term rehab stay. Can this policy change be
delayed in light of the pandemic?

6) When can we expect an answer to the letter of August 14th concerning visitation
policies and changes to these policies? This is an extremely urgent concern for families,
residents, and staff.

7) When can we expect an answer to the letter of August 5rd concerning visitation
policies in pediatric nursing homes and changes to those policies?

8) Can we get clarification on the current status of the ability for families to install
cameras in rooms?

9) Has DOH considered implementing unscheduled inspections? We heard a lot about

how facilities prepare for them in ways that don’t necessarily reflect day-to-day realities.

10) What planning is being undertaken now to identify step-down facilities regionally in
NY for the transfer of COVID-positive residents from hospitals, in the event of another
surge? Please provide an update on this planning and whether a regional approach is
being undertaken.

1
11) Will the Department of Health provide guidance on the role of compassionate
caregivers?

12) How does broad immunity for healthcare entities protect those minority communities
who already received a lower standard of care?

13) How does such immunity serve the Department of Health’s mission to “protect,
improve and promote the health, productivity and wellbeing of all New Yorkers”?
14) During the hearings testimony indicated it was regularly taking 7 to 14 days to get a
test back for staff caring for nursing home residents and that the costs of these tests are
very high. What is being done to prioritize COVID19 testing so limited supplies and
short turn arounds are available for those most at risk, like nursing home residents and
staff? Is there a role for “pooled” testing? When can we expect accurate rapid tests
and will the state use federal dollars or other funding sources to help pay for the
testing?
15) Please provide the raw data upon which the Department of Health Nursing Home
Report of July 2020 was based.
16) What state and federal dollars have been allocated to address the COVID response
in nursing homes and hospitals? We heard for example during the hearings that $1
million in federal dollars was made available for technology to assist nursing homes with
virtual communication/visits, but that as of the August 3rd hearing the funds had not
actually been released by the State. Please provide an accounting of where all state
and federal dollars have been spent and what funds, both state and federal, remain
unspent/distributed to date and if they are earmarked for a particular purpose.
17) At the first hearing, Senator Thomas asked Commissioner Zucker about Article 81
guardianship. We'd like to follow up.

Many nursing home patients become the subject of guardianship proceedings pursuant
to art 81 of the MHL. A mandatory part of this process according to the statute is that the
court must appoint what is known as a court evaluator (typically a lawyer) to meet with
the subject and interview them and report to the court within 4 weeks of the person's
overall condition. If the person DOES NOT want a guardian, the evaluator must
immediately notify the court and then the court appoints a lawyer for that person.

During the lockdown, evaluators and attorneys were not allowed to enter facilities. The
effect was that the guardianships often could not go forward. At the peak, judges and
attorneys understood this was necessary. Family members were likewise not allowed to
visit.

As of June visitors are allowed but what we are hearing from court evaluators in Nassau
County is that facilities are still not allowing evaluators or attorneys to enter. Judge
Diamond, supervising judge of guardianship in Nassau, has asked DOH counsel's office
for a carve-out from the governor's order to allow these interviews and or hearings to
proceed as necessary IF the home and attorneys agree to safety protocol. Judge

2
Diamond has obtained consent from the Northwell system so long as DOH issues a
carve out.

Does DOH have plans to issue a carve-out to allow court evaluators and attorneys into
nursing homes so that incapacitated people can receive the services they need?