Summary: On August 26, 2020, The Centers for Medicare and Medicaid Services (CMS) issued State Survey Agency Directors a letter providing guidance pertaining to testing requirements in addition to a copy of the revised COVID-19 Focused Survey Tool.
Per CMS' interim final rule, requirements now include testing residents and staff at routine intervals based on the presence of COVID-19 within a specific care community. "Staff" includes employees, consultants, contractors, volunteers, caregivers, and students in nurse aide training programs or who are from affiliated academic institutions. Either rapid point-of-care (POC) diagnostic testing or offsite laboratory arrangements for testing can be utilized.
If a vendor or volunteer has already tested pursuant to the requirements of another entity, the current facility must secure documentation indicating that the test was conducted during the facility's testing frequency timeframe.
Testing is also required for staff exhibiting COVID-19 symptoms. While results are pending, affected staff members are to be restricted from entering the community. Additionally, residents who exhibit symptoms must be tested and facilities must follow CDC guidance regarding transmission-based precautions while awaiting results.
For each new positive case of COVID-19 identified in either a staff member or resident, the facility should test all other staff and residents. Those who test negative should be retested every three to seven days until no new cases are identified over a minimal period of 14 days from the date of the most recent positive result. The guidance requires for facilities to implement procedures that address those who refuse testing.
Other requirements cited include conducting tests in accordance with the appropriate regulations; obtaining an order from a physician, physician assistant, nurse practitioner or clinical nurse specialist (per state law); and maintaining safe and proper collection methods when handling specimens, including the use of personal protective equipment (PPE).
The COVID-19 Focused Survey for Nursing Homes will be utilized to assess testing compliance. As part of this process, surveyors will request that facilities produce testing documentation for review. Resident and staff records selected as a sample of the survey process will also be reviewed. As possible, surveyors should also make arrangements to observe live testing. In the event test results cannot be obtained within 48 hours or there is a shortage of testing supplies, the surveyor should ask the facility for documentation indicating that state and local health departments have been contacted to assist with those issues.
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Impact(s): For general compliance review |
