I now recognize Miss leco from Arizona for five minutes of questions thank you Mr chairman uh for the American people I want to read the parts of the directive for March 25th 2020 that you Governor KO directed it says quote no resident shall be denied readmission or admission to the nursing home solely based on a confirmed or suspected diagnosis of covid-19 nursing homes are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for covid-19 prior to admission or readmission today uh Governor KO you claimed that the your nursing home directive was just following Federal guidance I I find that hard to believe sir and let me tell you why on there was on October 13th 20 21 Dr Deborah Burks in a tri transcribed interview uh was asked this question on the bottom of page four of the CMS guidance it gives guidance on how to return a resident diagnosed with covid-19 back to their nursing home and it says it should be done if a facility can follow CDC guidance for transmission-based precautions first what would those transmission-based precautions have been her answer so that would require isol ol ation and gowning masking and ensuring no contact with other residents then the question was administrator Verma the CMS administrator Verma said under no circumstances should a hospital discharge a patient to a nursing home that is not prepared to take care of those patients needs is that correct her answer correct question if we turn now to the New York guidance meaning your directive does that the same qualifier of able to take CDC precautions as the CMS guidance required her answer no question so would the March 25th directive have violated CMS guidance her answer yes then do you think at question do you think admitting potentially positive covid-19 nursing home resident back into the nursing home without the ability to quarantine or isolate them is dangerous and could lead to unnecessary deaths her answer yeah I think that's why the CDC guidance was very clear about precautions needed to protect them and I think that's why CMS administrator C SEMA Verma was proactively working on this infectious control guidance well today you also said it was up to the discretion of the nursing homes if they admitted covid sick patients you said today that the patients weren't infectious so my question to you sir how would the nursing homes know if the patient was infectious or have covid-19 if your directive explicitly let me quote nursing homes are prohibited from requiring a hospitalized resident who is determined medically stable to be tested for covid-19 prior to admission Congressman I understand the question here's the basic disconnect this was an advisory the Department of Health did 10 12 15 advisories a day 400 in a couple of weeks they did not substitute for the existing state law and the state law remains in place and the state law says on a nursing home 41526 you cannot accept the person who you can't care for 41519 says You must have an infection control plan in place if the person has to be quarantined contact let me interrupt because I have 44 seconds left sir how could your directive even then follow the New York state law if it prohibits prohibits it says nursing homes are prohibited from testing for covid yes how could you even follow your own state law CMS guidance CDC guidance if your own directive prohibits the testing yes uh the directive says they have to talk to the doctor the person want to be medically stable no the directive does not say that this is exactly what the directive says nursing homes are prohibited from requiring a hospitalized resident who determined medically stable to be tested for covid-19 prior to admission or readmission sir I'm I'm sorry but I find your testimony very very hard to believe time and I yield backed now