CMS changes nursing home testing guidance over rural concerns

Nursing homes will face new COVID-19 testing guidelines based on their community spread, CMS said Tuesday.

The agency revised its facility staff testing standards to account for community spread in its color-coded system. If a county has 20 or fewer tests over 14 days, it will be considered green. Counties with fewer than 500 tests, fewer than 2,000 tests per 100,000 residents and a positivity rate above 10% over 14 days also will be considered green. Previously, counties meeting those standards would have been considered yellow.

The changes came after governors of rural states worried that low testing volumes could spark high positivity rates in their areas, CMS said.

“This resulted in a significant burden for nursing homes being required to conduct staff testing at a higher frequency than necessary,” the agency said.

CMS guidance issued in August required nursing homes to test staff once a month if the county’s positivity rate was less than 5%, once weekly if the county positivity rate was between 5% and 10% and twice weekly if the county positivity rate was above 10%. The agency at that time also announced that facilities that did not comply with the testing requirements would be cited for noncompliance, could face fines of $400 per day or more than $8,000 for a case of noncompliance and could be denied payment for new admissions, a move that was criticized by healthcare providers as being heavy handed.

Nursing homes have seen 231,957 confirmed COVID-19 cases, 136,259 suspected cases and 55,845 deaths, according to the latest CMS data. Nationwide, there have been 7,129,313 COVID-19 cases and 204,598 deaths, according to the latest CDC data.


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