New York State Stroke Designation Program

In response to the COVID-19 pandemic the NYSDOH has made the following updates to the Stroke Designation Program Requirements:

  1. CY 2019 Stroke Designation HERDS submission deadline is now 06/01/21.
  2. CY 2020 Stroke Designation HERDS submission deadline is 7/31/21.
  3. The transition timeline in the Stroke Services Regulations (NYCRR 405.34) will be extended for an additional year upon adoption of an amendment to NYCRR 405.34. 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.
  4. Due to reduction in stroke volumes at NYS hospitals, NYSDOH is implementing a temporary reduction in eligibility volume requirements for organizations that are applying for recertification or initial certification but have not undergone their review. The NYSDOH stroke designation program will allow for the following temporary reduction in procedure volume requirements:
    • Organizations seeking recertification for TSC and CSC must meet 50% of the current procedure volume eligibility for mechanical thrombectomy and CSCs must meet 75% of the current volume eligibility for subarachnoid hemorrhage (SAH) care and aneurysm clipping/coiling.
    • New applicants for TSC and CSC certifications do not have established track records of meeting our volume requirements in the past. Therefore, the requirement is higher for initial certification. Organizations seeking initial certification for TSC and CSC will be required to meet 80% of the current eligibility volumes.
    • UPDATE: Due to the reduction in COVID-19 cases in the community, original stroke volume requirements will be reinstated on September 1, 2021. Original volume requirements for Thrombectomy Capable and Comprehensive Stroke center certification are outlined in the NYSDOH Stroke Guidance Document.

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.

New York State will recognize and designate hospitals as:

  1. Primary Stroke Centers: Capable of treating acute ischemic stroke with IV t-PA 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 hospitals stroke program meets specified criteria related to advanced stroke care. The certifying organization will use their 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 Department 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.

*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.

Existing stroke centers that have not completed the certification process with a Certifying Organization within three years of the effective date of the regulations will no longer maintain stroke designation and will not be recognized within the New York State stroke system of care by EMS as a destination for suspected stroke patients.

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

History of Stroke Designation Program

The New York State Department of Health (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. The NYSDOH has historically recognized hospitals who have advanced capabilities to treat and support stroke patients at Primary Stroke Centers. Primary Stroke Centers in New York State demonstrate 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.

As of February 2019, New York State has designated 122 hospitals as Primary Stroke Centers.

Stroke Center Resources