Frequently Asked Questions: COVID-19 Testing at Skilled Nursing Facilities/ Nursing Homes includes 27 FAQs:

1. Who will receive the testing platforms and U.S. Food and Drug Administration (FDA)- authorized antigen diagnostic tests?

2. How is distribution of the testing platforms and FDA-authorized antigen diagnostic tests being determined? Will these devices be sent directly to the nursing homes or to states for distribution? 

3. When will the testing platforms and authorized point-of-care tests be distributed?

4. How many COVID-19 test kits will nursing homes receive?

5. Who will provide training to nursing home staff? In what format will the training be provided in?

6. How were nursing homes prioritized to receive a testing platform and FDA-authorized antigen diagnostic tests?

7. Will HHS be providing more tests after the initial shipment?

8. What safety precautions are required when performing these tests?

9. Will every nursing home receive a point-of-care instrument and associated tests? 

10. Which nursing homes will receive instruments and tests in the first wave of shipments?

11. When will my nursing home receive the shipment of testing platforms and FDAauthorized antigen diagnostic tests?

12. How will states be made aware that nursing homes within their states will receive instruments and supplies?

13. What are antigen tests? Is it required to retest negative results with a PCR test?

14. How many tests can be conducted with the Quidel Sofia 2 Instrument and the BD Veritor™ Plus System testing platforms?

15. Why is the federal government sending antigen testing supplies to nursing homes if they cannot be used to rule out SARS-CoV-2 infection and should not be used as the sole basis for treatment?

16. Are nursing homes required to report results of any COVID-19 tests?

17. Can nursing homes keep the testing platforms? 

18. How should facilities handle indeterminate results?

19. Do facilities need a provider order to conduct the test?

20. How should the materials be stored when they arrive?

21. Does a Skilled Nursing Facility/ Nursing Facilities need a CLIA (Clinical Laboratory Improvement Amendments of 1988) Certificate of Waiver in order to perform testing of specimens for COVID-19?

22. I understand that HHS will be distributing tests and test systems to Skilled Nursing Facilities/ Nursing Facilities. What type of CLIA certificate would my facility need in order to perform this testing?

23. How do I apply for a CLIA Certificate of Waiver so that my Skilled Nursing Facility/ Nursing Facility can perform COVID-19 testing?

24. If my Skilled Nursing Facility/ Nursing Facility already holds a CLIA Certificate of Waiver, can we begin performing COVID-19 testing?

25. If my Skilled Nursing Facility/ Nursing Facility already holds a CLIA Certificate of Waiver, am I required to update my test menu with CMS?

26. How does my Skilled Nursing Facility/ Nursing Facility obtain the instrument, test kits and disposables?

27. My Skilled Nursing Facility/ Nursing Facility is located in a CLIA Exempt State (Washington or New York). Will we be able to get one of the new test systems? 

Coronavirus Disease 2019 (COVID-19) and Diabetes: The Importance of Prevention, Management, and Support

You may participate in this COCA Call via Zoom

During this COCA Call, presenters will focus on current information about the impact and increased risk for COVID-19 complications in people with diabetes and the importance of diabetes prevention, management, and support.

Testing Guidelines for Nursing Homes FRIDAY, JULY 17, 2020

Revisions were made on July 17, 2020, to reflect the following:

• Updated “Testing to determine resolution of infection” to add information about people who are severely immunocompromised.

The Centers for Disease Control and Prevention (CDC) offers strategies for optimizing the supply of:

N95 respirators

Face masks

Isolation gowns

Eye Protection

Gloves

Powered Air-Purifying Respirators (PAPRs)

Elastomeric respirators

Ventilators

These charts provide an update to the Comorbidity HCC groups used for the SNF QRP as covariates for the Change in Self-Care score, Change in Mobility score, Discharge Self-Care sore, and Discharge Mobility score.

They appear to be an update/crosswalk to the ICD-10 codes listed in table A-5 of the SNF QRP Measure Calculations and Reporting User’s Manual.

It's worth noting that, in the user guide, there are only 24 HCC Groups, but this updated crosswalk lists 190 groups.

Initial and Repeated Point Prevalence Surveys to Inform SARS-CoV-2 Infection Prevention in 26 Skilled Nursing Facilities — Detroit, Michigan, March–May 2020

Early Release / July 1, 2020 / 69

Guillermo V. Sanchez, MSHS, MPH1; Caitlin Biedron, MD1; Lauren R. Fink, MPH2; Kelly M. Hatfield, MSPH1; Jordan Micah F. Polistico, MD3,4; Monica P. Meyer, MS, MPH3,4; Rebecca S. Noe, MN, MPH1; Casey E. Copen, PhD1; Amanda K. Lyons, MS1; Gonzalo Gonzalez, DNP2; Keith Kiama2; Mark Lebednick2; Bonnie K. Czander2; Amen Agbonze2; Aimee R. Surma, MS2; Avnish Sandhu, DO3,4; Valerie H. Mika, MS4; Tyler Prentiss, MA5; John Zervos, JD5; Donia A. Dalal2; Amber M. Vasquez, MD1; Sujan C. Reddy, MD1; John Jernigan, MD1; Paul E. Kilgore, MD4; Marcus J. Zervos, MD4,5; Teena Chopra, MD3,4; Carla P. Bezold, ScD2; Najibah K. Rehman, MD2 (View author affiliations)

View suggested citation

Summary

What is already known about this topic?

Symptom-based screening in skilled nursing facilities (SNFs) is inadequate to detect SARS-CoV-2 transmission. Repeated point prevalence surveys (serial testing of all residents and health care personnel at a health care facility irrespective of symptoms) can identify asymptomatic cases during outbreaks.

What is added by this report?

Repeated point prevalence surveys at 26 Detroit SNFs identified an attack rate of 44%; within 21 days of diagnosis, 37% of infected patients were hospitalized and 24% died. Among 12 facilities participating in a second survey and receiving on-site infection prevention and control (IPC) support, the percentage of newly identified cases decreased from 35% to 18%.

What are the implications for public health practice?

Repeated point prevalence surveys in SNFs can identify asymptomatic COVID-19 cases, inform cohorting and IPC practices, and guide prioritization of health department resources.

3-day inpatient qualifying hospital stay waiver

Benefit period ending/renewal waiver

New MLN Matters article reviews in detail which residents each waiver applies to, including some useful examples for the benefit period waiver. Also provides extensive billing instructions.

Changes to Staffing Information and Quality Measures Posted on the Nursing Home Compare Website and Five Star Quality Rating System due to the COVID-19 Public Health Emergency

Memo #QSO 20-34-NH

Posting Date 2020-06-25

Fiscal Year 2020

Summary

The Centers for Medicare & Medicaid Services (CMS) is committed to transparency about changes in publicly reported information on nursing homes during the COVID-19 public health emergency. Changes to the Nursing Home Compare Website and Five Star Quality Rating System:

• Staffing Measures and Ratings Domain: On July 29, 2020, Staffing measures and star ratings will be held constant, and based on data submitted for Calendar Quarter 4 2019.

o Also, CMS is ending the waiver of the requirement for nursing homes to submit staffing data through the Payroll-Based Journal System. Nursing homes must submit data for Calendar Quarter 2 by August 14, 2020.

• Quality Measures: On July 29, 2020, quality measures based on a data collection period ending December 31, 2019 will be held constant.