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Feds to Require COVID Tests for All Nursing Home Staff

Residents in facilities with evidence of coronavirus must also be offered tests

spinner image Health care worker in PPE giving a COVID-19 test to a woman
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Nursing homes across the country will be required to routinely test their staff for the coronavirus and residents will be offered tests if new COVID-19 cases are discovered or if residents develop symptoms of the disease, the Centers for Medicare & Medicaid Services (CMS) announced Tuesday.

"This testing is part of an overall effort to identify asymptomatic staff and residents who may be infected and serve as a source of transmission of the virus into the nursing home,” CMS Administrator Seema Verma said in a call with reporters on Tuesday. “While testing alone will not resolve the spread of COVID-19 in nursing homes, it is an important tool for detecting cases early."

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Up to now, CMS has recommended routine testing for nursing home staff; this is the first time such screenings will be required. “While we've had good compliance across the country, we want to make sure that every single nursing home is doing this,” Verma said.

The COVID-19 pandemic has disproportionately affected nursing home residents and staff, claiming 70,000 lives in the facilities — 40 percent of coronavirus deaths in the United States. AARP has been advocating for increased testing and the availability of adequate personal protective equipment (PPE) and staffing in those facilities.

How often nursing homes will be required to test staff members will depend on the level of COVID-19 infection in the community where the nursing home is located. Verma said detailed guidance for facilities will be released later this week but said, for example, if the positivity rate in a particular county is below 5 percent, staff testing would be required once a month. If the level is between 5 percent and 10 percent, staff would have to be tested once a week. And, if the level of infection in a particular community is above 10 percent, twice weekly testing would be required.

These requirements and several others Verma announced took effect on Tuesday, although members of the public will have 60 days to comment on the new rules, which could be amended after that period.

Verma said that nursing homes will be able to use rapid point-of-care devices that already have been sent to some nursing homes and that more such tests are on the way. So far, point-of-care equipment has been sent to over 5,590 nursing homes, and by the end of September such tests are expected to be shipped to more than 14,000 facilities, Brett Giroir, assistant secretary for health at the Department of Health and Human Services (HHS), said on the call. There are over 15,000 nursing homes in the U.S. Giroir said that while nursing homes can use any test they want, the point-of-care screenings that get a result within 15 minutes is the preferred method of testing.

The federal government will provide $2.5 billion to help offset the cost of this new testing, Verma said, on top of the $5 billion already allocated to facilities through the Provider Relief Fund. Verma said residents will be covered for any tests they are given, either through their health insurance, Medicare or Medicaid.

New reporting requirements

The new regulation also requires laboratories and nursing homes that use point-of-care tests to report their results to the federal government. Hospitals will be required to provide information about their COVID-19 cases.

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Facilities that do not comply with the new requirements will face penalties. Nursing homes that do not do the necessary testing may face penalties of more than $400 a day or more than $8,000 in total if they do not comply.

Hospitals could also face the stiff penalties for not reporting such information as the number of confirmed or suspected COVID-19 positive patients, the number of ICU beds occupied and the availability of essential supplies and equipment such as ventilators and PPE.

"While many hospitals are voluntarily reporting this information now, not all are,” Verma said. If hospitals do not comply with the new regulation, they could temporarily or even permanently lose their reimbursement funding from the Medicare and Medicaid programs.

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