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Consumer Voice Submits Comments to CMS Regarding COVID-19 Testing of Staff and Residents in Nursing Homes

November 03, 2020

On October 30, 2020, Consumer Voice submitted comments on the Centers for Medicare & Medicaid Services’ (CMS) proposed Interim Final Rule CMS-3401 which implemented routine testing of COVID-19 testing for all nursing home staff and testing of all staff and residents in facilities experiencing a COVID-19 outbreak. While Consumer Voice commends CMS for implementing routine and mandatory testing, we urged CMS to strengthen the rule in order to better protect nursing home residents. The new Interim Rule requiring facilities to implement a COVID-19 testing protocol under §483.80 Infection Control is crucial to help prevent 1) the introduction of COVID-19 into facilities by routinely testing nursing home staff and excluding staff members who test positive from facilities; and 2) the spread of COVID-19 within the facility after a staff member or resident tests positive.

Consumer Voice made the following recommendations -

  • Expand the criteria for frequency of testing to include both the positivity rate of COVID-19 in the county in which the facility is located and the county or counties in which facility staff reside or are employed
  • Require facilities unable to conduct rapid response (point-of-care testing) to have an agreement with an outside laboratory that is able to process test results within 48 hours; and require that facilities unable to do so document their efforts to enter such an agreement
  • Require facilities to conduct testing in accordance with the Centers for Disease Control and Prevention (CDC)'s guidance for testing nursing home residents for COVID-19, including performing an RT-PCR test when a symptomatic resident tests negative for COVID-19 using an antigen test (which, the CDC notes, is a less-accurate test)
  • Require that facility staff who test positive for COVID-19 not return to the facility until they meet the CDC's "Criteria for Return to Work for Healthcare Personnel with SARS-CoV2Infection" guidelines, including requiring multiple negative results from a RT-PCR test from symptomatic staff before they are permitted to return to work
  • Have agreements with all facility staff not directly employed by the facility who test positive for COVID-19 within 14 days of their last visit to the facility to notify the facility of the positive result
  • Address staff and resident refusal to be tested separately:
    • Require the exclusion of all staff who refuse COVID-19 testing
    • Require the facility to engage with residents who refuse testing by educating the resident about the importance of testing, learning why the resident is refusing, discussing alternatives, and explaining the consequences and risks of not being tested
  • In the event a resident tests positive for COVID-19, require the notification of a resident’s representative (unless the resident prohibits notification) within 24 hours
  • Assess civil monetary penalties for a facility’s failure to properly report data

Read the Consumer Voice's full letter here.

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