03/11/2022

CMS updates testing and visitation guidance for nursing facilities

CMS updates testing and visitation guidance
for nursing facilities

The Centers for Medicare & Medicaid Services (CMS) updated the nursing home QSO-20-38-NH testing and QSO-20-39-NH visitation memos. Both memos were updated to replace the "vaccinated” language to the newer “up to date” language consistent with CDC’s guidance. The routine testing cadence for staff now requires staff who are not up to date to be routinely tested.

Key updates to the testing guidance are noted in bold below:

• The addition of the following definition: “Up to Date” means a person has received all recommended COVID-19 vaccines, including any booster dose(s) when eligible.
• Vaccination status does not preclude staff or residents being tested if they become symptomatic or have been exposed to someone who is infected with COVID-19. Staff with symptoms or signs of COVID-19, regardless of vaccination status, must be tested immediately and are expected to be restricted from the facility pending the results of COVID-19 testing. Residents who have signs or symptoms of COVID-19, regardless of vaccination status, must be tested immediately.
• Routine testing of staff, who are not up to date, should be based on the extent of the virus in the community. Staff, who are up to date, do not have to be routinely tested. For HCP who work in the facility infrequently, see the CDC’s testing guidance. Facilities should use their community transmission level as the trigger for staff testing frequency.
• In general, testing is not necessary for asymptomatic people who have recovered from SARSCoV-2 infection in the prior 90 days; however, if testing is performed on these people, an antigen test instead of a nucleic acid amplification test (NAAT) is recommended. This is because some people may remain NAAT positive but not be infectious during this period.

Key updates to the visitation guidance are noted in bold below:

• The addition of the following definition: “Up to Date” means a person has received all recommended COVID-19 vaccines, including any booster dose(s) when eligible.
• Visitors who have a positive viral test for COVID-19, symptoms of COVID-19, or currently meet the criteria for quarantine should not enter the facility until they meet the criteria used for residents to discontinue transmission-based precautions (quarantine).
• If a resident’s roommate is not up to date with all recommended COVID-19 vaccine doses, or immunocompromised (regardless of vaccination status),visits should not be conducted in the resident’s room, if possible.
• Visitors should wear face coverings or masks and physically distance when around other residents or healthcare personnel, regardless of vaccination status.
• In areas of low to moderate transmission, the safest practice is for residents and visitors to wear face coverings or masks and physically distance, particularly if either of them is at increased risk for severe disease or are not up to date with all recommended COVID-19 vaccine doses.
• Residents, regardless of vaccination status, can choose not to wear face coverings or masks when other residents are not present and have close contact (including touch) with their visitor.
  • Residents (or their representative) and their visitors, who are not up to date with all recommended COVID-19 vaccine doses, should be advised of the risks of physical contact prior to the visit.
• Guidance for residents who leave a facility has been updated to reflect the up to date language.

LeadingAge Ohio encourages facilities to review the entirety of the two memos, update policies and communicate the updates to all stakeholders accordingly. We encourage members to email our COVID 19 email with any question at COVID19@leadingageohio.org.