On March, 10, CMS updated QSO-20-38-NH-REVISED on nursing home testing requirements and QSO-20-39-NH-REVISED on nursing home visitation. These updates bring the CMS requirements into line with CDC recommendations that were updated several weeks ago related to vaccination status.

Nursing Home Testing Requirements

Consistent with CDC recommendations, CMS now requires that all staff who are not up to date with COVID-19 vaccinations be included in routine staff screening testing according to community transmission rates. While CDC recently began using COVID Community Levels for general public health guidance, healthcare settings, including nursing homes, should continue to refer to community transmission rates for determining the frequency of routine staff screening testing. Community transmission rates are available on the COVID Data Tracker here.

CMS also requires testing of all residents and staff, regardless of vaccination status, who have been identified as a close contact of individuals testing positive for COVID-19. The guidance further recommends the use of an antigen test as opposed to a nucleic-acid amplification test when opting to test individuals who have tested positive for COVID in the past 90 days.

Nursing Home Visitation Guidance

CMS updated guidance and associated FAQs on nursing home visitation. Updates largely focus on the adoption of CDC vaccination status language “up to date / not up to date.” Consistent with CDC recommendations, CMS now requires quarantine of residents who are not up to date with vaccination following identification as a close contact of individuals testing positive for COVID-19. CMS additionally requires these residents to quarantine following admission or readmission to the nursing home. Related to visitation, the guidance explicitly states that visitors to nursing homes must meet resident criteria for discontinuation of transmission based precautions (isolation and quarantine). These updates are all consistent with existing CDC recommendations for healthcare settings and nursing homes.

What This Means for Members

As the new vaccination status language accounts for COVID-19 boosters, nursing home providers may experience an increase in the number of staff requiring routine testing in areas where staff booster rates are low. Nursing homes may also experience increases in the numbers of residents on transmission-based precautions / quarantine at a given time period in areas where resident booster rates are low. While resident guidelines have long been the recommended method for determining the duration of quarantine/isolation for visitors to healthcare settings, the new addition of these recommendations to CMS guidance may result in changes to visitation protocols in locations that were previously following general public health guidance to determine the duration of quarantine/isolation for visitors. Updates are all consistent with existing CDC recommendations for healthcare settings and nursing homes.