QSO-20-38-NH REVISED 09/23/2022
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Clearpol's Opinion of this Guidance as of 09/23/2022
This revision updates the interim final rule related to LTC facility COVID-19 testing requirements for residents and staff, including individuals providing services under arrangement and volunteers.
· Routine testing of asymptomatic staff is no longer recommended by may be performed at the discretion of the facility.
· Updated recommendations for testing individuals who have recovered from COVID-19.
CDPH has not yet issued a revised AFL.
Testing of Nursing Home Staff and Residents
Instruct staff, regardless of their vaccination status, to report any of the following criteria to occupational health or another point of contact designated by the facility so they can be properly managed:
· a positive viral test for SARS-CoV02
· symptoms of COVID-19, or
· a higher-risk exposure to someone with SARS-CoV-2 infection
Testing of Staff and Residents with COVID-19 Symptoms or Signs
Staff with symptoms or signs of COVID-19, regardless of vaccination status, must now be tested as soon as possible and are expected to be restricted from the facility pending the results of COVID-19 testing. If COVID-19 is confirmed, follow CDC guidelines “Criteria for Return to Work for Healthcare Personnel with SARSCoV2 Infection.” Staff who do not test positive for COVID-19 but have symptoms should follow facility policies to determine when they can return to work.
Residents who have signs or symptoms of COVID-19, regardless of vaccination status, must now be tested as soon as possible. While test results are pending, residents with signs or symptoms should be placed on TBP in accordance with CDC guidance. Once test results are obtained, the facility must take the appropriate actions based on the results.
Testing of Staff with a Higher-Risk Exposure and Residents who had a Close Contact
When the facility is not in an outbreak status, follow the CDC’s Interim Infection Prevention and Control Recommendations for HCP and the Interim Guidance for Managing HCP with SARS-CoV-2 Infection or Exposure to SARS-CoV-2.
Testing of Staff and Residents During an Outbreak Investigation
An outbreak investigation is initiated when a single new case of COVID-19 occurs among residents or staff to determine if others have been exposed. An outbreak investigation would not be triggered when a resident with known COVID-19 is admitted directly into TBP, or when a resident known to have close contact with someone with COVID-19 is admitted directly into TBP and develops COVID-19 before TBP are discontinued.
Upon identification of a single new case of COVID-19 infection in any staff or Outbreak (any single new case) test all residents immediately (but not earlier than 24 hours after the exposure, if known).
Routine testing of staff
Routine screening testing of asymptomatic staff is no longer recommended but may be performed at the discretion of the facility.
Resident Testing – New Admissions
For testing information of residents who are newly admitted or readmitted to the facility and those who leave the facility for 24 hours or longer, see the Managing admissions and residents who leave the facility section of the CDC’s Interim Infection Prevention and Control Recommendations for HCP webpage.
Refusal of Testing
Residents may exercise their right to decline COVID-19 testing. Facilities must have procedures in place to address residents who refuse testing and should ensure that residents who refuse testing are managed in accordance with the CDC guidance for use of TBP.
Other Testing Considerations
In general, testing is not necessary for asymptomatic people who have recovered from SARSCoV-2 infection in the prior 30 days; testing should be considered for those who have recovered in the prior 31-90 days. For residents or staff who test positive, facilities should follow the guidance in the Testing Staff and Residents During an Outbreak section above and contact the appropriate state or local entity for contact tracing.
Clearpol Inc. does not make any guarantees regarding the accuracy of the opinions provided on our platform. Please use your own judgement.
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