New York State Stroke Designation Program

The New York State Department of Health (NYSDOH) has released updated NYS Stroke Center Guidance Document Version 23.1 . These updated New York State Stroke Center specific standards will become effective on September 1, 2023 for all initial certifications and recertifications.

Please note the following dates and information for the upcoming 2023 Stroke HERDS Annual Review Tool Survey:

  • 2023 Stroke HERDS Annual Review Tool Survey Opens: Monday, April 3, 2023 at 9 AM
  • 2023 Stroke HERDS Annual Review Tool Survey Training Webinar: Monday, April 3, 2023, 2:30- 3:30 PM
  • Technical Assistance Webinar 1 (Optional): Tuesday, April 18, 2023, 11:00 AM-12:00 PM
  • Technical Assistance Webinar 2 (Optional): Thursday, May 11, 2023, 1:00 PM-2:00 PM
  • Annual Submission Due Date: Wednesday, May 31, 2023 at 11:59 PM

For questions about the HERDS Survey or the training and technical assistance webinars please contact strokedocs@health.ny.gov

In response to the COVID-19 pandemic the NYSDOH has extended the transition timeline for hospital to complete their stroke center certification and designation.

The transition timeline in the Stroke Services Regulations (NYCRR 405.34) has been extended for one year following the adoption of an amendment to NYCRR 405.34 on December 9, 2021. The new timeline is as follows:

  1. Hospitals must be contracted with an approved certifying organization by March 2022.
  2. Hospitals must have completed and received certification by an approved certifying organization and applied to the Department for Stroke Designation by March 2023.

The NYSDOH will work with hospitals that have expressed an interest in continuing to be a Designated Stroke Center and have demonstrated a good faith effort to satisfy the requirements of the transition period.

Stroke Designation Program - Adopted March 2019

On March 20, 2019, a new regulation at 10 NYCRR 405.34 was adopted to allow the New York State Designation Program to transition to a three-tiered stroke system of care that recognizes the advanced capabilities of hospitals to treat complex stroke patients in a multi-tiered system. The goal of the Stroke Designation Program is to recognize and treat stroke patients as quickly as possible at the right place.

The New York State Department of Health (NYSDOH) will recognize and designate hospitals as:

  1. Primary Stroke Centers: Capable of treating acute ischemic stroke with IV thrombolytics and comprehensive supportive care.
  2. Thrombectomy Capable Stroke Centers: Capable of treating large vessel occlusions with intracranial endovascular intervention.
  3. Comprehensive Stroke Centers: Capable of treating subarachnoid intracerebral hemorrhage with neurosurgical services.

List of Currently Designated Stroke Centers in New York State

How to Become a NYSDOH Designated Stroke Center

A hospital seeking designation as a stroke center at any level must achieve certification from an approved Certifying Organization. Certification must be achieved on or after March 20, 2019. This certification verifies that a hospital's stroke program meets specified criteria related to advanced stroke care. The certifying organization will survey based on their own standards, as well as New York State specific criteria, that was developed using evidence and guidelines in collaboration with the New York State Stroke Advisory Group, when certifying your hospital. The New York State specific criteria is outlined in the New York State Stroke Center Guidance document found below. Once a hospital receives certification, they must request designation from the NYSDOH utilizing the Request for Designation form (PDF). Certifications must be achieved on or after March 20, 2019 to ensure that all hospitals are using the New York State criteria as outlined in the guidance document.

The NYSDOH has developed a program guide for New York State general hospitals to assist in developing a stroke program and meeting requirements relating to the New York State Stroke Designation Program and Title 10 NYCRR 405.34: Stroke Services. It serves to detail the process by which a hospital may request designation as a stroke center from the New York State Department of Health and it outlines New York State specific standards for all levels of stroke designation.

Approved Certifying Organizations

Why Should a Hospital Seek Designation as a Stroke Center?

Designation allows consumers, other hospitals, and Emergency Medical Service (EMS) providers to identify the capabilities of the hospital to treat stroke patients. Additionally, it allows EMS providers to preferentially triage and transport patients with a suspected stroke to a center capable of providing appropriate care.

Transition Period

Any hospital in NYS that has received stroke center designation prior to March 20, 2019 must act to comply with 10 NYCRR 405.34: Stroke Services regulations within the timeframe described in the transition period. The transition period is described in the table below:

NYS Designated Primary Stroke Centers Transition Timeline
Effective Date of Stroke Services Regulation: March 20, 2019
Years 1 and 2 After the Effective Date of Stroke Services Regulations (March 20, 2019) Hospitals interested in remaining stroke centers enter into a contractual agreement with a NYSDOH approved Certifying Organization.
Within 1 year of Initiation of Contract Hospitals complete certification at the Primary, Thrombectomy Capable or Comprehensive level and request designation to operate as such from NYSDOH.
3 years after Effective Date (March 20, 2022) Hospitals who fail to receive certification and NYSDOH designation within 3 years of the effective date of the regulations will no longer maintain stroke center designation.
1 year Extension to the Transition Timeline (March 20, 2023) NYSDOH amended the transition timeline in response to the COVID-19 pandemic.

*Note, the transition period does not apply to hospitals who had not achieved NYS stroke center designation prior to March 20, 2019. There will be no transition period and request for designation from these hospitals will be accepted on a rolling basis.

Hospitals that have received certification from a Certifying Organization prior to the effective date of the regulations must be recertified before requesting designation from NYSDOH.

During the transition period, all currently designated stroke centers will continue to receive suspected stroke patients from EMS. The transition period should not disrupt established EMS protocols.

Reporting Performance Measures and Time Targets

After a stroke center receives New York State Stroke Center Designation, it will be required to report specific performance measures and time targets, as outlined in the NYS Stroke Center Guidance Document, to the Department. Following designation, stroke centers will no longer submit performance measures and time targets to HERDS but will instead enter this data in a stroke registry (e.g. Get With The Guidelines). The Department will access stroke center data on a quarterly basis for quality improvement purposes. Stroke centers are required to give the Department permission to access their data directly in the stroke registry. Data review will occur according to the following schedule:

Quarter Timeframe Review
Q1 January 1 - March 31 Mid-April
Q2 April 1 - June 30 Mid-July
Q3 July 1- September 30 Mid- October
Q4 October 1- December 31 Mid- January

New York State Stroke Coordinator Consortiums

There are three independent stroke coordinator consortiums (not endorsed or facilitated by NYSDOH) in New York State. These consortiums meet on a pre-determined schedule to collaborate on a regional basis in order toto share resources to optimize stroke patient outcomes. NYSDOH encourages facilities to participate in regional QI collaborations. Please contact the appropriate contact person for the county in which your facility is located.

Greater New York Metropolitan Area Stroke Coordinator Consortium (GNYMASCC)

Purpose of Group: The mission of the GNYMASCC is to identify barriers to meeting stroke patient care goals, to share resources to optimize stroke patient outcomes and to collaborate to address challenges when implementing best practices.

Counties Served: Suffolk, Nassau, Queens, New York, Richmond, and Westchester Counties

Website: https://www.gnymascc.com

Contact Person:

Von Jessee, MA

Manager, Quality Improvement

Quality, Outcomes Research & Analytics (QORA) - Northeast American Heart Association

Phone: 203.303.3333

Email: Von.Jessee@aha.org

Capital Region Stroke Coordinator Consortium

Purpose of Group: Regional collaboration of hospital-based stroke programs to improve the delivery of stroke care.

Counties Served: Albany, Rensselaer, Columbia, Greene, Saratoga, Schenectady, Warren, Washington, Fulton, Hamilton Counties

Contact Person(s):

Robyn Kaminski: kaminsr1@amc.edu

Cassandra Moore: cmoore1@glensfallshosp.org

Central/Western Region Stroke Coordinator Consortium (CWSC)

Purpose of Group: The CWSC exists to support coordinators, through mentorship and sharing of successful strategies and barriers which may assist or hinder successful implementation of a quality stroke care program for the people of the Central and Western NY region.

Counties Served: The group serves Central and Western New York including the North Country and encompasses the population of over 25 counties.

Website: https://cwscsteering.wixsite.com/website

Contact Person(s): cwscsteering@gmail.com

History of Stroke Designation Program

The NYSDOH stroke designation program began as a demonstration pilot program in 2002 in select areas of the state and later expanded to the entire state in 2004. Under this pre-regulation program, the NYSDOH only recognized hospitals with advanced capabilities to treat and support stroke patients as Primary Stroke Centers. Primary Stroke Centers in New York State demonstrated these advanced capabilities by satisfying standards developed by NYSDOH based on evidence from "The Brain Attack Coalition Guidelines for Primary Stroke Centers." The Brain Attack Coalition is a group of professional, voluntary, and governmental organizations dedicated to setting direction, advancing knowledge, and communication of the best practices to prevent and treat stroke. On March 20, 2019, a new regulation at 10 NYCRR 405.34 was adopted to allow the New York State Designation Program to transition to a three-tiered stroke system of care that recognizes the advanced capabilities of hospitals to treat complex stroke patients in a multi-tiered system. This regulation effectively ended the single tier, pre-regulation Stroke Designation Program and created the multi-tiered Stroke Designation Program.

Stroke Center Resources