The New York State Department of Health (DOH) has released emergency regulations that, effective immediately, require confirmatory testing for both COVID-19 and influenza whenever a hospital patient or nursing home resident has a known exposure or symptoms consistent with either disease. Testing must also be performed when a patient or resident is suspected of having died of such disease, within 48 hours after death. The regulations are intended to allow DOH to fully assess and differentiate the number of COVID-19- and influenza-related cases and to conduct contact tracing.

The regulations will likely increase testing for influenza and, in certain cases, post-mortem testing for COVID-19 and influenza. GNYHA is aware that hospitals will soon increase and in many cases, combine COVID-19, influenza, and other common respiratory virus testing in response to the perennial increase in prevalence of respiratory viruses. We are therefore monitoring the availability of such tests and related other supplies and will work to ensure that hospitals are not experiencing shortages.

Below is a summary of key requirements in the new regulations. The full regulations can be found here.

Confirmatory Testing of Patients and Residents

The regulations require hospitals and nursing homes to test any patient or resident “who is known to have been exposed to COVID-19 or influenza or has symptoms consistent with COVID-19 or influenza” for both diseases.

Confirmatory Testing of Deceased Persons

Hospitals

In addition, the regulations provide that “Whenever a person expires while in the hospital, or while en route to the hospital, and in the professional judgment of the attending clinician there is a clinical suspicion that COVID-19 or influenza was a cause of death, but no such tests were performed in the 14 days before death,” the hospital must administer both a COVID-19 and influenza test within 48 hours after death. The regulations state that such tests shall be performed using rapid testing methodologies to the extent available. Hospitals must then report the deaths to DOH through the Health Emergency Response Data System (HERDS)

Nursing Homes

Similarly, the regulations provide that “Whenever a person expires while in a nursing home, where in the professional judgment of the nursing home clinician there is a clinical suspicion that COVID-19 or influenza was a cause of death, but no such tests were performed in the 14 days before death,” the nursing home must administer both a COVID-19 and influenza test within 48 hours after death. The regulations also call for performing the tests using rapid testing methodologies to the extent available. The nursing home must then report the death through HERDS.

Funeral Directors

Whenever a funeral director has been advised by an attending health care practitioner (whether the death was in hospice, an adult care facility, or any other setting where a positive diagnosis was not made) and there is a clinical suspicion that COVID-19 or influenza was a cause of death, but no such tests were performed within 14 days prior to death in a nursing home or hospital, or by the hospice agency, coroner, or medical examiner, the funeral director is required to administer both a COVID-19 and influenza test within 48 hours after death, whenever the body is received within 48 hours after death. The funeral director must then report the death through a means determined by DOH.

Coroners and Medical Examiners

Finally, whenever a coroner or medical examiner has a reasonable suspicion that COVID-19 or influenza was a cause of death, but no such tests were performed within 14 days prior to death in a nursing home or hospital, or by the hospice agency, the coroner or medical examiner is required to administer both a COVID-19 and influenza test within 48 hours after death, whenever the body is received within 48 hours after death. The coroner or medical examiner must report the death through a means determined by DOH.