Mary Madison, RN, RAC-CT, CDP
Clinical Consultant – Briggs Healthcare
Friday, August 28, 2020 CMS began posting information on COVID-19 testing. The COVID-19 Nursing Home Data website is where this information will be made available along with the NHSN data. This website is part of QSO-20-38-NH … Interim Final Rule issued August 26, 2020. This QSO memorandum notes that, routine testing of staff correlates with the positivity rate in the county over the past week. If it is below 5%, staff should be tested once a month; If the positivity rate is between 5% and 10%, staff should be tested once a week. If the positivity rate is over 10%, staff should be tested twice a week. If you have not read this QSO yet, take some time now to do so. This is important – there is a lot of information to digest. You should also review and share the Interim Final Rule (IFC) for guidance for testing and other COVID-19 related requirements. This IFC is effective on Wednesday, September 2, 2020 when CMS-3401-IFC is published in the Federal Register.
Back to the COVID-19 Nursing Home Data website, scroll about a third down the page to find this (it sits atop the graphs and dataset):
As part of CMS’ commitment to protecting nursing home residents, and to boost the surveillance of COVID-19, nursing homes are now required to conduct testing of residents and staff. More information about these requirements and guidelines can be found here. These guidelines include testing staff on a certain frequency based on the COVID-19 positivity rate for the county the nursing home resides in. Rates of county positivity are posted here. Facilities should monitor these rates every other week and adjust staff testing accordingly.
Supporting COVID-19 Testing
The Department of Health and Human Services, Office of the Assistant Secretary for Health (OASH), recently announced that we will begin providing nursing homes with a Point of Care (POC) rapid response testing instrument to bolster each facility’s ability to prevent the spread of COVID-19. The data collected through the NHSN system directly supports this initiative by helping to prioritize the nursing homes with testing needs and an increasing number of cases. For the methodology describing how facilities are prioritized, and a listing of the facilities, please click here. A list of frequently asked questions (FAQs) is also available here.
This is a snapshot of what you will see when you select the 2nd hyperlink beneath COVID-19 Testing (PLEASE check this site NOW so you know the frequency of testing going forward at this time:
Here’s another view of a few counties in state of IA (i.e., my county currently has a positivity rate of 5.6% so staff in our LTCFs will need to be tested once a week then see what the positivity rate is next week; Buchanan county is 10.3% so LTC staff will be required to test twice this week):
Check the COVID-19 Nursing Home Data website every other week and follow the CMS guidance on frequency for testing your staff based on the positivity rate in your county. Designate someone (select an “heir and a spare” – someone else knows how to do this in case of illness or day off) to diligently monitor this website. Likely candidates would be your Infection Preventionist, Administrator, Director of Nursing – someone who understands the importance of consistent monitoring and notification to your management team. You must absolutely know what your county’s positivity rate is in order to do the required testing.