The Centers for Disease Control and Prevention (CDC) published updated COVID-19 testing guidelines for nursing home residents and healthcare staff on July 21. See the full update at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-testing.html. The Summary of Changes on the revision reflect one change made on July 17 and two changes made on July 1, 2020 as follows:
- Updated “Testing to Determine Resolution of Infection” to add information about people who are severely immunocompromised.
- Focus on testing recommendations for nursing home residents only.
- Create separate guidance for testing healthcare personnel (HCP), which is available in the Interim Guidance on Testing Healthcare Personnel for SARS-CoV-2.
After initially performing viral testing of all residents in response to an outbreak, the CDC recommends repeat testing to ensure there are no new infections among residents and HCP, and that transmission has been terminated. Repeat testing should be coordinated with the local, territorial, or state health department.
Testing practices should aim for rapid turnaround times (e.g., less than 24 hours) in order to facilitate effective interventions. Testing the same resident more than once in a 24-hour period is not recommended. Antibody (serologic) test results generally should not be used as the sole basis to diagnose an active COVID-19 infection and should not be used to determine infection prevention and control actions.
While this guidance focuses on testing in nursing homes, several of the recommendations such as testing residents with signs or symptoms of COVID-19 and testing asymptomatic close contacts should also be applied to other long-term care facilities, such as assisted living facilities, intermediate care facilities for individuals with intellectual disabilities, institutions for mental disease, and psychiatric residential treatment facilities.
Compliance Perspective
Issue: Nursing homes are required to stay current with changes from CMS and the CDC in their guidelines regarding the COVID-19 crisis in order to implement protocols for testing and infection control. Failure to do so may result in the spread of COVID-19 and sanctions for violations of state and federal regulations.
Discussion Points:
- Review policies and procedures to ensure that updated CMS and CDC guidelines regarding testing for COVID-19 have been implemented.
- Train staff on the guidelines for COVID-19 testing and retesting of both residents and HCP.
- Periodically audit to ensure that protocols are being followed regarding COVID-19 testing and retesting of residents and HCP, and that results of testing are being returned on a timely basis (e.g., less than 24 hours).
