COVID 19

Recommendations for Enhanced SARS-CoV-2 Testing
in Long-term Care Facilities

(This information can be obtained directly from MDH website: https://www.health.state.mn.us/diseases/coronavirus/hcp/ltcenhanced.pdf)


Recommendations for Enhanced SARS-CoV-2 Testing in Long-term Care Facilities
8/2/2021
The delta variant of SARS-CoV-2, the virus that causes COVID-19, has become the dominant strain circulating in the U.S. This virus variant spreads more easily and quickly than the early SARS-CoV-2 virus, leading to more cases of COVID-19, especially among unvaccinated and otherwise vulnerable people. Residents of long-term care (LTC) facilities are at particular risk because they live in close proximity to others and may have conditions that make them medically vulnerable and potentially less likely to be protected by the vaccine (e.g., age, immunocompromising conditions).
SARS-CoV-2 often enters long-term care facilities through infected staff members. This document outlines recommendations for enhanced testing in Minnesota long-term care facilities (skilled nursing and assisted living facilities) in response to increasing spread of the SARS-CoV-2 delta variant. The objective of enhanced testing is to identify infectious people before the virus can spread to others. These testing approaches are strongly encouraged by Minnesota Department of Health (MDH) but are not required. Long-term care facilities are still required to meet testing requirements as outlined by MDH and Centers for Medicaid and Medicare Services (CMS).
Support for long-term care testing
Abbott BinaxNOW antigen tests are available from MDH and the U.S. Department of Health and Human Services (HHS) at no cost to long-term care facilities. Nursing homes and assisted living facilities can request BinaxNOW kits from MDH and/or can receive routine shipments of BinaxNOW kits from HHS.
 Information for Providers Requesting Abbott BinaxNOW Antigen Tests (www.health.state.mn.us/diseases/coronavirus/hcp/binaxnow.html)
 Email address to ask HHS for Abbott BinaxNOW kits: binax.team@hhs.gov
Facilities can ask MDH questions about how, when, and who to test by emailing MN_MDH_TestSupport.COVID19@state.mn.us. Recommendations for the use of antigen-based testing are available from MDH.
 Using Antigen-based Point-of-Care (POC) Testing for COVID-19 in Long-term Care Facilities (www.health.state.mn.us/diseases/coronavirus/hcp/ltcantigentest.pdf)
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Required testing in LTC facilities
Skilled nursing and assisted living facilities must continue to adhere to outbreak testing and routine staff testing as required by MDH and/or CMS.
 COVID-19 Testing Recommendations for Long-term Care Facilities (www.health.state.mn.us/diseases/coronavirus/hcp/ltctestrec.pdf)
 CMS QSO-20-38-NH (www.cms.gov/files/document/qso-20-38-nh.pdf)
Recommendations for enhanced testing
MDH encourages the following measures of enhanced SARS-CoV-2 testing, given the high transmissibility of the SARS-CoV-2 delta variant. As needed, MDH will communicate changes to these recommendations. The table below includes information about both required testing and recommended enhanced testing (not required).
Situation
Current Required Testing that Must be Continued
Recommended Additional Enhanced Testing
County vaccination rate less than 70% of total population1
or
Facility staff vaccination rate less than 70%
 Facilities must continue to comply with MDH and CMS staff testing requirements.2,3
 Conduct testing of all unvaccinated staff at least weekly, regardless of county test positivity rate.
 Consider testing unvaccinated staff more frequently than weekly.
 Test with either PCR or antigen tests.
Case detected in staff or resident in the facility (i.e., outbreak)
 Facilities must continue to meet testing requirements, as outlined by CMS and MDH.2,3
 Conduct testing of all residents and staff every three to seven days, as currently required, until 14 days have passed since the last positive case. PCR-based testing is strongly recommended.
▪ Testing every three days is preferred, because the delta variant is highly transmissible.
 Conduct antigen-based testing of all staff daily or every other day, regardless of vaccination status.
New admissions and re-admissions, regardless of vaccination status
 Conduct PCR or antigen-based test at admission and on days three and seven post-admission.
Residents at higher risk (e.g., frequently leave facility for dialysis)
 Consider including these residents in routine testing (e.g., group with staff testing), especially if unvaccinated.
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References

  1. Vaccine Data (https://mn.gov/covid19/vaccine/data/index.jsp)
  2. COVID-19 Testing Recommendations for Long-term Care Facilities (www.health.state.mn.us/diseases/coronavirus/hcp/ltctestrec.pdf)
  3. CMS QSO-20-38-NH (www.cms.gov/files/document/qso-20-38-nh.pdf)
    Wear a mask. Wash your hands. Stay 6 feet from others. Stay home if you feel sick.
    Minnesota Department of Health | health.mn.gov | 651-201-5000 625 Robert Street North PO Box 64975, St. Paul, MN 55164-0975
    Contact health.communications@state.mn.us to request an alternate format.

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