Preparedness
NYMDA COVID-19 Research Project provides comprehensive guidance and resources for COVID-19 and other respiratory illness precautions, vaccination, treatment, and testing. If you are a medical professional in a nursing home, assisted living facility, or home health care setting in NYS, please refer to this page for resources, including clinical guidelines, evidence-based practices, and practical strategies.
Precautions & Isolation
Admission & Return (>24 Hours) of Residents to the Nursing Home
- For decisions about room placement for new admissions, see Admission Room Placement.
- If admitting a patient to a unit exposed to a case of COVID-19 in the prior 14 days, notify the prospective resident and the resident’s representative of the unit’s COVID-19 exposure.
- Determine the resident’s COVID-19 vaccination status. Offer vaccination when appropriate.
- Patients should be tested for COVID-19:
- Do not test people who had a positive COVID-19 result in the last 30 days.
- People who have had a positive COVID-19 result in the last 90 days should be tested with a Point-of-Care Antigen test.
- Series of THREE COVID-19 tests. While a PCR test is preferred, an Antigen test may be used.
- FIRST COVID-19 PCR test on the day of admission or re-entry.
- SECOND and THIRD COVID-19 PCR tests every other day after admission.
- Testing is recommended regardless of vaccination status
- People who decline COVID-19 testing should be placed on contact and droplet precautions for 10 days after admission
Resources
Combined Precautions Table for all Respiratory Infections
Addresses precautions for COVID-19, Influenza, Respiratory Syncytial Virus, Parainfluenza, Human Metapneumovirus, Rhinovirus.
Signage
Sample Enhanced Contact-Droplet Precautions Sign
For COVID-19 Precautions
Vaccination & Treatment
Vaccination & Treatment Information & Resources from Other Organizations
Policy & Standing Orders
- Sample COVID-19 Vaccination Policy with Standing Order
- Sample Influenza Vaccination Policy with Standing Order
- Sample RSV Vaccination Policy with Standing Order
- Sample Paxlovid (nirmatrelvir/ritonavir) Policy
- Sample Lagevrio (molnupiravir) Policy
- Sample Pneumococcal Vaccination Policy with Standing Order
Vaccination Permission/Consent
- Sample Letter to Families about Influenza and COVID-19 Vaccination and Treatment
- Sample COVID-19 Vaccine Consent Form
- Sample Influenza Vaccine Consent Form
- Sample Pneumococcal Consent or Declination Form
- Sample Pneumococcal Shared Decision-Making Documentation Form
- Sample RSV Vaccine Shared Decision-Making & Consent Form
Treatment Consent
Vaccine Information
- Vaccine Information Statements and other resources are available at www.immunize.org.
- Additional information is available from the CDC at https://www.cdc.gov/vaccines/covid-19/index.html.
Suggested smart phrase for documenting RSV Shared Decision Making:
The resident/Health Care Proxy(HCP)/medical decision maker and I engaged in a shared decision-making conversation regarding the respiratory syncytial virus (RSV) vaccination. We discussed risk vs. benefit, RSV vaccine information/facts, clarified the resident’s treatment preferences, and I answered and reviewed all questions and concerns.
We agreed to the following vaccination treatment plan (specify either vaccination acceptance or declination), and the resident/HCP/medical decision maker signed the applicable consent form and acknowledgement of shared decision-making.
Testing
Swabbing Procedures
COVID-19 Antigen Testing
- Understanding At-Home OTC COVID-19 Antigen Test Results: https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/understanding-home-otc-covid-19-antigen-diagnostic-test-results
- CLIA / CLEP Waivers: https://www.wadsworth.org/regulatory/clep/limited-service-lab-certs
- Test Practices Self Assessment: https://www.cdc.gov/labquality/docs/waived-tests/self-assessment-checklist-good-testing-practices.pdf
Resources
- CDC: Testing and Management Considerations for Nursing Home Residents with Acute Respiratory Illness Symptoms when SARS-CoV-2 and Influenza Viruses are Co-circulating: https://www.cdc.gov/flu/professionals/diagnosis/testing-management-considerations-nursinghomes.htm.
- Respiratory Viral Testing and Isolation Recommendations for Symptomatic Resident with No Known Exposures to COVID-19 When other Viruses are Circulating.