On August 26, 2020, the Centers for Medicare & Medicaid Services (CMS) announced new requirements for nursing homes to test staff and offer testing to residents for coronavirus disease 2019 (COVID-19).
“These new rules represent a dramatic acceleration of our efforts to track and control the spread of COVID-19,” said CMS Administrator Seema Verma. “Reporting of test results and other data are vitally important tools for controlling the spread of the virus and give providers on the front lines what they need to fight it.”
The frequency of the testing depends on the facility’s community prevalence of COVID-19. Staff must be tested monthly in counties with low community spread of less than 5%. For counties with 5% to 10%, staff must be tested once per week and in counties with a rate higher than 10% staff must be tested twice per week.
For weekly or greater testing, the presumption is the nursing home has point-of-care testing or can receive results in less than 48 hours.
Prior to this new requirement, CMS only required nursing homes to test during an outbreak or if a resident showed COVID-19 symptoms. This testing requirement remains in effect; however, general testing of asymptomatic residents will not be required. Please note, states may have defined stricter rules for testing. Nursing homes must be aware of, and follow, their state's most restrictive requirements.
CMS also revealed that facilities may receive between $400 per day in fines or $8,000 per instance.
In a memo sent to State Survey Agency Directors, CMS noted nursing homes that do not comply with the testing requirements would receive a F-Tag 886 citation. In addition, CMS has revised the COVID-19 Survey Focused Tool to include assessing compliance with testing requirements, designating one or more persons as the infection preventionist and other COVID-19 changes.
Below are the new F-Tag regulations:
483.80 Infection Control483.80(h) COVID-19 Testing. The LTC facility must test residents and facility staff, including individuals providing services under arrangement and volunteers, for COVID-19. At a minimum, for all residents and facility staff, including individuals providing services under arrangement and volunteers, the LTC facility must:
(1) Conduct testing based on parameters set forth by the Secretary, including but not limited to:
(i) Testing frequency;
(ii)The identification of any individual specified in this paragraph diagnosed with COVID-19 in the facility;
(iii)The identification of any individual specified in this paragraph with symptoms consistent with COVID-19 or with known or suspected exposure to COVID-19;
(iv) The criteria for conducting testing of asymptomatic individuals specified in this paragraph, such as the positivity rate of COVID-19 in a county;
(v) The response time for test results; and
(vi) Other factors specified by the Secretary that help identify and prevent the transmission of COVID-19.
(2) Conduct testing in a manner that is consistent with current standards of practice for conducting COVID-19 tests;
(3) For each instance of testing:
(i) Document that testing was completed and the results of each staff test; and
(ii) Document in the resident records that testing was offered, completed (as appropriate to the resident’s testing status), and the results of each test.
(4) Upon the identification of an individual specified in this paragraph with symptoms consistent with COVID-19, or who tests positive for COVID-19, take actions to prevent the transmission of COVID-19.
(5) Have procedures for addressing residents and staff, including individuals providing services under arrangement and volunteers, who refuse testing or are unable to be tested.
(6) When necessary, such as in emergencies due to testing supply shortages, contact state and local health departments to assist in testing efforts, such as obtaining testing supplies or processing test results.
How Can LW Consulting, Inc. (LWCI) Help?
Infection control is critical due to the public health emergency and COVID-19. LWCI has experts in infection control and team members with Centers for Disease Control Infection Preventionist certifications. We also have expertise in assisting providers with environmental services as it relates to infection control.
Our team of experts are conducting mock infection control surveys, assisting with the development and revisions of infection control policies, procedures, and processes. We also provide education for nursing home staff.
Is your goal to provide the highest quality care and keep your employees and residents COVID-19 free? Contact Patty Klinefelter at 540-686-1311 or email PKlinefelter@LW-Consult.com.