Twice weekly testing of staff at nursing homes and adult care facilities has been underway this week in New York.
But on the local level throughout upstate New York, that's presented a new set of challenges during the COVID-19 pandemic.
For weeks, there was a testing shortage. Now tens of thousands of tests are being conducted a day. Gov. Cuomo is urging New Yorkers to get tested.
The new problem? Find laboratories to process the wave of new tests, many coming from nursing homes and their staff.
"I think there's an absolute capacity problem," said County Executive Steve McLaughlin. "We've gone from a supply problem, a kit problem, to a capacity problem."
State officials said this week nursing homes would be paired with labs to manage the influx of the tests.
Gareth Rhodes, an advisor to the governor who sits on the task force, said in an interview the facilties are being paried with large reference labs to handle the volume. Half of the facilities have existing relationships with the labs, he said.
The deaths of more than 5,400 nursing home residents since March has been attributed to or are believed to be caused by the coronavirus pandemic.
Cuomo has come under criticism for the policy of requiring nursing homes to take COVID-positive residents, but his administration this month ended the practice of hospitals discharging patients back to nursing homes until after they test negative.
In the last day alone more than 45,000 tests were conducted in New York for COVID-19 -- beyond the 40,000-a-day goal set by Cuomo weeks earlier.
The twice weekly tests for staff at the facilities is meant to mitgate deaths and spread of the virus.
"Senior facilities are without a question our biggest challenge and our biggest point of risk right now," said Ulster County Executive Pat Ryan. "That's why that's our biggest point of focus on the public health response."
Twice weekly of testing can present its own challenges for nursing homes and could lead to staff shortages. In April, one Ulster County facility found a COVID positive rate of 30 percent among staffers.
"If that were to happen again, yes the facilities would have some challenges," Ryan said. "The staffs are under tremendous challenges."
And then there are adult care facilities. Steuben County Manager Jack Wheeler says many are operating on shoestring budgets and do not have full-time medical staff.
"So they don't even have a way to get these staff members twice a week," he said. "They certainly don't have a relationship or the resources to find a relationship with a laboratory to process the testing."
The Department of Health has issued guidance that tests are medically necessary and have directed them to cover the costs.