CMS Updates Testing Guidance

COVID-19; CMS
 
​Today, the Centers for Medicare and Medicaid Services (CMS) updated their previous requirements around testing. The C​MS Memo​ updates the testing summary, including if the facility has the ability to identify close contacts of the individual with COVID-19; the facility can choose to conduct focused testing based on the known close contacts, as well as the levels of COVID-19 community transmission to now include four colors instead of the previous three. 

Testing summary changes include: 

  • Symptomatic individual identified – staff and residents, vaccinated and unvaccinated, with signs or symptoms must be tested. 
  • Newly identified COVID-19 positive staff or resident in a facility that can identify close contacts – test all staff and residents, vaccinated and unvaccinated, that had high-risk exposure (staff) or close contact (residents) with a COVID-19 positive individual. 
  • Newly identified COVID-19 positive staff or resident in a facility that is unable to identify close contact – test all staff (assigned to a specific location where the new case occurred) and residents, vaccinated and unvaccinated, facility-wide or at a group level (e.g., unit, floor, or other specific area) 
  • Routine testing for residents is not generally recommended.  

Routine testing intervals by county COVID-19 level of community transmission changes include: 

  • Low (blue) not recommended for testing of unvaccinated staff 
  • Moderate (yellow) once a week testing of unvaccinated staff* 
  • Substantial (orange) twice a week testing for unvaccinated staff* 
  • High (red) twice a week testing for unvaccinated staff* 
  • Vaccinated staff do not need to be routinely tested 

* Frequency of testing presumes availability of Point of Care testing on-site at the nursing home or where off-site testing turnaround time is <48 hours. 

Residents who refuse testing may require transmission-based precautions based on symptoms or vaccination status. CMS refers to CDC guidance Interim Infection Prevention and Control Recommendations to Prevent SARS-CoV-2 Spread in Nursing Homes

Reports of COVID-19 level of community transmission area available on the CDC COVID-19 Integrated Country View site.