What to know about visiting nursing homes

Beginning Friday — for nearly the first time since almost a year ago, when visitation was suspended entirely as the state government learned more about the extent of the pandemic.

It depends. No testing is mandated if a county’s known infection rate is below 5% on a seven-day rolling average, though the state recommends testing regardless. If a county's positivity level is between 5 and 10%, visitors must test negative within 72 hours before the visit or via a rapid test from the facility.

If a county’s positivity rate exceeds 10%, no visits are allowed, except for "compassionate care visits," according to a directive issued Monday by the state health department. The U.S. Centers for Medicare & Medicaid Services defines compassionate care to include "end of life situations," a resident who had been living with family recently and was recently admitted to a nursing home, or a resident mourning a recent death of a friend or family member. Other exceptions include "residents who are exhibiting signs and symptoms of emotional distress … seldom speaking or crying more frequently [when the resident had rarely cried in the past], refusing to participate in an activity or activities, staying in bed longer than usual, or exhibiting behavior considered abnormal for the individual," the state directive said.

Yes, those who are currently COVID-19 positive, those with symptoms or signs of the disease or those under 14-day quarantine or observation due to exposure.

According to the health department directive, visits can resume only if "[t]here has been no new onset of COVID-19 cases in the last 14 days and the facility is not currently conducting outbreak testing." It’s unclear whether there is a definitive "compassionate care" exception to these rules.

Yes, the number of visitors must not exceed 20% of the resident head count.

Early in the pandemic, Cuomo’s administration enacted policies barring nursing homes from conditioning admission or readmission on a negative COVID-19 test and issued guidance that was perceived as an order to accept COVID-19 patients from hospitals — leading, critics have said, to the coronavirus spreading in the nursing homes and infecting others inside. (Cuomo blames the spread on facility staff.) The policies have since been rescinded. The governor also signed a law, later rolled back in August, broadly protecting nursing-home operators and others from certain coronavirus-related civil and criminal liability. There was also a report in January by state Attorney General Letitia James alleging an undercount, by about 50%, of patient deaths connected to nursing homes. (Until after the James report, New York State had not counted the death of a nursing home patient if the patient died after being transferred to a hospital, where the death would be attributed instead. New York was the only state to tally this way.) Lawmakers, including some Democrats, are incensed that the breakdown had been withheld from the legislature for fear of what a Cuomo aide would argue was a politically motivated investigation by the U.S. Department of Justice under then-President Donald Trump into whether the policies endangered patients. The Justice Department reportedly continues to investigate.