August 26, 2020 – CMS has issued CMS-3401-IFC, “Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to Long-Term Care (LTC) Facility Testing Requirements and Revised COVID-19 Focused Survey Tool”, expanding standards that LTCs must follow to prevent the spread of SARS-CoV-2, the virus known to cause COVID-19.

The memorandum can be read at the CMS website and states:

On August 25, 2020, CMS published an interim final rule with comment period (IFC). This rule establishes Long-Term Care (LTC) Facility Testing Requirements for Staff and Residents. Specifically, 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 guidance reiterates rules regarding the testing of residents and staff while also establishing new standards. Facilities must test all staff, with staff defined as “employees, consultants, contractors, volunteers, and caregivers who provide care and services to residents on behalf of the facility, and students in the facility’s nurse aide training programs or from affiliated academic institutions”. Facilities are told to prioritize testing individuals who enter the facility on an at-minimum weekly basis and who have contact with either residents or staff.

The memo states, “Routine testing [of staff] should be based on the extent of the virus in the community, therefore facilities should use their county positivity rate in the prior week as the trigger for staff testing frequency. Reports of COVID-19 county-level positivity rates will be available on the following website by August 28, 2020.”

As a vendor, Aculabs will continue our RT-PCR testing initiative for all of our employees with direct patient contact, compliant with baseline testing standards established by the CDC. Employees are tested on a weekly basis.

Further in the memo, facilities are instructed that they must comply with the following standards:

  • Ensure employees access to testing, either through rapid point-of-care testing or via an off-site laboratory
  • Ensure off-site laboratories responsible for testing can ensure rapid reporting of results, e.g., within 48 hours
  • Ensure documentation is obtained for all staff who have completed the necessary testing
  • Ensure all proper PPE is used in the collection of specimen, including N95 or higher-level respirators

Facilities working with Aculabs to handle their COVID-19 testing meet all of the above standards. Aculabs employees who experience direct patient contact wear all necessary personal protective equipment (PPE) to reduce the risk of exposure to and transmitting COVID-19. This includes the usage of a respirator mask for the entirety of their time in a facility. Employees must also check their temperature twice a day – once at the start of their shift and once again several hours later, in accordance with guidance by the Centers for Disease Control and Prevention (CDC).

As well, all Aculabs employees who undergo weekly COVID-19 testing are given access to their weekly results that are accessible on a company work device that they must have with them at all times while working. Nursing staff can ask to see an employee’s results in order to allow the employee into the building.

Lastly,  facilities should continue all regular symptom screening procedures for staff, residents, and all persons who enter the facility, while following the below standard for routine testing:

Upon identification of a single new case of COVID-19 infection in any staff or residents, all staff and residents should be tested, and all staff and residents that tested negative should be retested every 3 days to 7 days until testing identifies no new cases of COVID-19 infection among staff or residents for a period of at least 14 days since the most recent positive result.

CMS also provides the following resource guides below:

Preparing for COVID-19 in Nursing Homes:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/long-term-care.html

Testing Guidelines for Nursing Homes:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-testing.html

Performing Facility-wide SARS-CoV-2 Testing in Nursing Homes:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/nursing-homes-facility-widetesting.html

Interim Guidance on Testing Healthcare Personnel for SARS-CoV-2:
https://www.cdc.gov/coronavirus/2019-ncov/hcp/testing-healthcare-personnel.html

Clients can find more COVID-19 information at the Aculabs COVID-19 Resource Hub.