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Articles: QSO MEMO 20-38-NH

PharmQuest®
QSO Memo 20-38-NH
Testing of Staff Regulations & F-Tag (F-886)
 

• PCR (polymerase chain reaction that looks for genetic material from the virus, i.e. nasal swabs) or Antigen (proteins that live on the virus surface, i.e. nasal swab) tests can be used to comply with this regulation (antibody tests do not meet the requirements under this regulation);
• Facility “staff” which includes employees, consultants, contractors, volunteers & caregivers who provide care & services to residents on behalf of the facility;
• Three (3) triggers for testing:

 

1. Symptomatic Testing: Test any staff or resident that have signs & symptoms of COVID-19 (document the dates & times of the identification of the S&S, when testing occurred, when the results were obtained & actions facility took based on the results)
2. Outbreak Testing: An outbreak is defined as any new single infection in a staff member or any new onset infection in a resident. Once there is one case all “staff” and residents must be tested. Continue to test all “staff” and residents every 3-7 days until testing identifies no new cases of COVID-19 infection among both groups for a period of at least 14 days since the most recent positive test (document the date the case was identified, the date that all other residents & staff were tested, the dates that staff & residents who tested negative were retested as well as the results of all tests)
3. Routine Testing: Test all staff based on the extent of the virus in the community using CMS published county positivity rate in the prior week as the trigger for staff testing frequency. CMS will publish reports of COVID-19 and facilities should monitor their county positivity rate every other week, i.e. first & third Monday every month (document the facility’s county positivity rate, the corresponding testing frequency and the date each positivity rate was collected. Document the dates that testing was performed for all staff as well as the results)

 
If the county positivity rate decreases to a lower-level of activity, the facility should continue to test “staff” at the higher frequency level until the county positivity rate has remained at the lower activity level for at least 2 weeks before reducing the “staff” testing frequency
 
If the county positivity increases to a higher-level activity, the facility should immediately adjust their testing of staff to that testing frequency
 

COVID-19 Activity	County Positivity Rate in the past week	Minimum Testing Frequency
Low	< 5%	Once a month
Medium	5% - 10%	Once a week
High	>10%	Twice per week

 

• Staff & residents who have recovered from COVID-19 and are asymptomatic do not need to be retested for COVID-19 within 3 months after the date of symptom onset;
• If the 48-hour turn-around time to get tests done cannot be met (i.e. testing supply shortages, inability of the laboratory to process tests within 48 hours) the facility should have documentation of its efforts to obtain quick turnaround test results with their laboratory and contact the local and state health departments;
• If “staff” are tested elsewhere, documentation must be obtained showing the testing was completed under the same time frame.