Pa. health officials issue new guidance on testing for nursing homes

Sep. 3--State Health Secretary Dr. Rachel Levine on Thursday said the department is issuing new guidance to nursing homes regarding testing and visitation from compassionate caregivers.

The new guidance follows what had already been released by the Centers for Medicare and Medicaid Services (CMS) in late August.

Under the new guidelines, compassionate caregivers, who can be family members, are allowed to visit a resident of a long-term care facility, regardless of the facility's visitation rules, if there is a change in the resident's health. The caregiver must test negative for COVID-19 in the last seven days before being allowed inside a facility, and they will have to be screened for symptoms and fever and must wear a mask.

Currently, Levine explained that nursing homes that have had no COVID-19 positives in the last two to four weeks can start having visitors, but compassionate caregivers will fall under a separate category for any facility.

The state health department also issued guidance on how nursing homes can test residents and staff moving forward. As of Monday, all long-term care facilities and personal care homes completed universal testing on all staff and residents at least once.

Levine said nursing homes are not expected to continue with universal testing, especially when there are no outbreaks.

Under the new guidelines, nursing homes that are located in counties with a low-level presence of COVID-19 will only have to test asymptomatic staff every four weeks, and testing of asymptomatic residents is not required. "Low" activity is defined as a county having less than 5% positivity rate within seven days.

Nursing homes in counties with a moderate-level presence of COVID-19 will have to test asymptomatic staff every week, and they will be encouraged to test asymptomatic residents who have had outside contact in the last 14 days. "Moderate" activity will include counties with 5 to 10% positivity rate of COVID-19 tests within seven days.

Facilities in counties with "substantial-level" presence of COVID-19 will have to test asymptomatic staff twice a week and commit to weekly testing of residents who have had contact with the outside in the last 14 days. Any county with 10% or greater positivity rate in test results will fall under this category.

All nursing homes are required to test symptomatic staff and residents to prevent outbreaks. Facilities with an outbreak should do universal testing on staff and residents.

The new rules follow the guidance issued by CMS on Aug. 26, and Levine said testing at nursing homes will be easier in the future because every facility in the state will receive antigen testing.

Previously, most tests were PCR diagnostic tests, which requires time to be evaluated in a laboratory. The new equipment being shipped by the federal government to nursing homes involve antigen tests, which can produce rapid results.

"It should improve the ability to test significantly," Levine said. "They're fast, less expensive and easy to use."

Levine had previously questioned the accuracy of both antigen and antibody tests, but she said the antigen tests have improved, and the equipment being sent to nursing homes has been approved for its accuracy.

Email Naomi Creason at ncreason@cumberlink.com or follow her on Twitter @SentinelCreason

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