On September 23, 2022, the Centers for Medicare & Medicaid Services (CMS) released revised guidance for the August 25, 2020, interim final rule that established long-term care (LTC) facility testing requirements for staff and residents. The interim final rule states that facilities are required to test residents and staff, including individuals providing services under arrangement and volunteers, for COVID-19 based on parameters set forth by the HHS Secretary.
The newly issued guidance states that routine testing of asymptomatic staff is no longer recommended but may be performed at the discretion of the facility. It also gives updated recommendations for testing individuals who have recovered from COVID-19.
The new guidance also says to instruct facility staff, regardless of their vaccination status, to report any of the following criteria to occupational health or another point of contact designated by the facility so they can be properly managed:
· A positive viral test for SARS-CoV-2
· Symptoms of COVID-19
· A higher-risk exposure to someone with SARS-CoV-2 infection
Staff and residents with symptoms or signs of COVID-19, regardless of vaccination status, must be tested as soon as possible.
An outbreak investigation is initiated when a single new case of COVID-19 occurs among residents or staff to determine if others have been exposed. An outbreak investigation would not be triggered when a resident with known COVID-19 is admitted directly into transmission-based precautions (TBP), or when a resident known to have close contact with someone with COVID-19 is admitted directly into TBP and develops COVID-19 before TBP are discontinued. The detailed guidance on the interim final rule can be accessed here.
Issue:
To enhance efforts to keep COVID-19 from entering and spreading through nursing homes, facilities are required to test residents and staff based on parameters and a frequency set forth by the HHS Secretary. Swift identification of confirmed COVID-19 cases allows facilities to take immediate action to remove exposure risks to nursing home residents and staff.
Discussion Points:
- Review infection control policies and procedures to ensure that all guidelines for preventing the spread of COVID-19 are in place and being followed. Update policies and procedures to reflect the new testing requirements.
- Educate staff on the importance of infection control, and on the new testing requirements. Document that the education has occurred, and place proof of attendance in the employee’s education file.
- Periodically audit to ensure that the new testing requirements are being followed, and that all staff are following proper infection control procedures.
