Covid Testing Required for All Nursing Home Staff or Fines Ensue

All nursing homes must test their staff for Covid-19 regularly to detect exposure to the virus under new requirements CMS announced Tuesday.

There was “good compliance” with previous recommendations that nursing homes test staff routinely in surging states, Centers for Medicare & Medicaid Services Administrator Seema Verma said in a press briefing. But “we want to make sure that every single nursing home is doing this, and if they are not then they’re going to face sanctions,” she said.

Nursing homes have been at the epicenter of the Covid-19 pandemic because elderly and frail people are most likely to die from the virus, and the close conditions and rotating caregivers makes it easier for the disease to spread.

Additional guidance will specify how frequently nursing home staff should be tested. It will likely require testing once a month if Covid positivity levels in a county are below 5%, once a week if positivity levels are between 5% and 10%, and twice a week if positivity is above 10%, Verma said.

An additional $2.5 billion for testing at nursing homes will be made announced this week, which is in addition to $5 billion announced July 22, Verma said.

Covid Data Required

Nursing homes must also offer testing to residents for Covid-19 when there is an outbreak or when residents show symptoms. Laboratories and nursing homes using point-of-care testing devices will be required to report test results under the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the CMS said.

Nursing homes that don’t comply with the new requirements may face penalties exceeding $400 per day or over $8,000 for an instance of noncompliance, the CMS said.

The new rule also requires hospitals to provide Covid-19 data to the Department of Health and Human Services or risk losing their Medicare and Medicaid payments, Verma said.

American Hospital Association president and CEO Rick Pollack reacted swiftly against the new CMS regulation, calling it a “heavy-handed regulatory approach” that “threatens to expel hospitals from the Medicare program.”

Laboratories must also report Covid-19 test results daily to the HHS or be penalized $1,000 the first day and $500 for each subsequent day, it said.

CMS also revised its previous policy to cover repeated Covid-19 testing for Medicare beneficiaries without practitioner orders during the public health emergency. The revised policy specifies that beneficiaries may receive one test without the order of a health practitioner, but orders will be required all further Covid-19 tests for Medicare reimbursements.

The change “helps ensure that beneficiaries receive appropriate medical attention if they need multiple tests. It is also designed to stop fraudsters from performing or billing for unnecessary tests,” CMS said.

Nursing Homes Get Training, Masks

The HHS also implemented a national training program for the nation’s 15,400 certified nursing homes to stop the spread of Covid-19 among residents.

The training for front-line staff will include best practices, such as infection control and prevention, visitor screening, grouping admissions and transfers appropriately, and using personal protective equipment.

Nursing home management training will focuses on infection control and cleanliness as well as larger institution-wide issues like using telehealth, emergency preparedness, and vaccine delivery.

The training will be available on the CMS Quality, Safety & Education Portal.

Nursing homes will also receive 1.5 million N95 respirators in the next two weeks directly from the Strategic National Stockpile, Navy Rear Admiral John Polowczyk said during the call.

An additional 14 million respirators will go into the commercial market for nursing homes, hospitals, dentists, and first responders to purchase in August and September, rather than going into the stockpile under contracts with the federal government, he said.

— With assistance from Shira Stein