Skilled Nursing Facilities

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Skilled Nursing Facilities

Skilled nursing facilities provide medical care at a higher level than general social care for an individual. A skilled nursing facility can provide:

• Long-term care for elderly residents with complex medical needs.
• Short- and long-term rehabilitation care after surgery, injury, or
disease.

• Assisted living for people with memory issues or physical
disabilities.

• Long-term care for elderly residents with complex medical needs.
• Short- and long-term rehabilitation care after surgery, injury, or disease.
• Assisted living for people with memory issues or physical
disabilities.

Regardless of size and purpose, most skilled nursing facilities share the experience of having a vulnerable population in an environment where a coronavirus outbreak can have terrible consequences. COVID-19 screening and testing procedures are a crucial element of the fight against the pandemic.

Nexsun Labs Skilled Nursing Facilities Nurse is writing prescription with senior woman

The Impact of COVID-19 on Skilled Nursing Facilities

Nexsun Labs Skilled Nursing Facilities Nursing staff is discussing treatment with senior woman

COVID-19 poses a higher risk in a skilled nursing facility because:
• Patients already have underlying health concerns.
• Close contact is necessary for medical care.
• Congregate setting with shared rooms.
• Higher risk from visitors bringing in infection.

COVID-19 poses a higher risk in a skilled nursing facility because:
• Patients already have underlying health concerns.
• Close contact is necessary for medical care.
• Congregate setting with shared rooms.
• Higher risk from visitors bringing in infection.

The experience of skilled nursing facilities in the early stages of the pandemic was that the vulnerable population inside a skilled nursing home suffered a higher death rate due to COVID-19 than other populations outside the professional care facility.

The clear message from these difficult times is that rapid, accurate, diagnostic tests of staff, patients, and visitors are crucial in preventing the transmission and fatal consequences of COVID-19 outbreaks in skilled nursing facilities.

Why Testing is Crucial for Skilled Nursing Facilities

The impact of coronavirus infection in a skilled nursing facility is catastrophic, and the residents face an increased risk of death from COVID-19 as a contributory cause. Studies into the high death rate experienced in skilled nursing facilities due to COVID highlight the crucial need for accurate testing to identify and prevent coronavirus transmission.

Testing procedures cover:
Staff – The nature of critical nursing services is that each staff member has multiple close contacts with vulnerable patients.
Visitors – Although visitors are essential for patients’ wellbeing, visitors increase the number of potential sources of exposure to COVID-19.
Current patients – The impact of catching coronavirus means it is essential to evaluate patient status regularly.
• New patients from other nursing facilities or the community.
• Patients discharged to another facility or returning home.

Testing procedures cover:
Staff – The nature of critical nursing services is that each staff member has multiple close contacts with vulnerable patients.
Visitors – Although visitors are essential for patients’ wellbeing, visitors increase the number of potential sources of exposure to COVID-19.
Current patients – The impact of catching coronavirus means it is essential to evaluate patient status regularly.
• New patients from other nursing facilities or the community.
• Patients discharged to another facility or returning home.

What You Need to Know about Testing and Surveillance for Skilled Nursing Facilities

COVID-19 surveillance for nursing homes is more rigorous because of the high risk of infection adversely affecting patient health.

COVID-19 screening for skilled nursing facilities uncovers individuals with symptoms and the need for a diagnostic test. Screening using diagnostic tests (potentially in a pool) to discover asymptomatic carriers of COVID may be necessary as a routine precaution in times of high community transmission.

Diagnostic testing for nursing homes covers both staff and patients but with a different approach.

Testing and Screening Staff

The testing and screening regime applicable to staff depends on the vaccination status of the team. Staff (both vaccinated and unvaccinated) need a PCR test when they:
• Display symptoms, even mild ones – Immediate test.
• Experience a high-risk exposure event – Two tests in sequence.

The testing and screening regime applicable to staff depends on the vaccination status of the team. Staff (both vaccinated and unvaccinated) need a PCR test when they:
• Display symptoms, even mild ones – Immediate test.
• Experience a high-risk exposure event – Two tests in sequence.

In this context, a high-risk exposure event covers any incident where the eyes, nose, or mouth may encounter COVID-19. Although staff will wear PPE, some procedures have a more significant risk of COVID-19 transmitting than others. The diagnostic testing for skilled nursing facilities after a high-risk exposure involves a test after day 2, and if this is negative, a further test between days 5 and 7.

Nexsun Labs Skilled Nursing Facilities Nursing Staff are walking hallway

Vaccinated staff may be exempt from COVID-19 surveillance testing for skilled nursing facilities, but unvaccinated staff may need:
• A PCR test three days before beginning a shift.
• Weekly screening test if community transmission is moderate.
• Twice weekly screening tests if community transmission is substantially high.

Vaccinated staff may be exempt from COVID-19 surveillance testing for skilled nursing facilities, but unvaccinated staff may need:
• A PCR test three days before beginning a shift.
• Weekly screening test if community transmission is moderate.
• Twice weekly screening tests if community transmission is substantially high.

Daily screening for staff occurs before entering the skilled nursing facility and is a health questionnaire and temperature check where necessary. The purpose of the daily screening before work is to identify staff with symptoms in need of a diagnostic PCR test.

Testing and Screening Residents

The best practice for residents in a skilled nursing facility is to perform a daily evaluation with a temperature and oxygen check to assess the patient’s general health and identify any patient with COVID-19 symptoms.

Nexsun Labs Skilled Nursing Facilities Team nurses are helping senior man walk

Typically, a temperature of 100.4°F and above indicates a fever, but inside a skilled nursing facility, a daily temperature above 100°F may prompt a more in-depth evaluation of the patient’s health.

Elderly patients may exhibit milder symptoms, and these include:
• Two temperature readings above 99°F.
• General feeling of unwellness.
• Persistent headache.
• Nausea or vomiting.
• Feeling faint.
• Loss of smell or taste.
• Diarrhea.

Elderly patients may exhibit milder symptoms, and these include:
• Two temperature readings above 99°F.
• General feeling of unwellness.
• Persistent headache.
• Nausea or vomiting.
• Feeling faint.
• Loss of smell or taste.
• Diarrhea.

The high impact of a COVID infection in patients requires diagnostic testing for skilled nursing facilities when a patient or staff member exhibits mild symptoms.

Other patients sharing or frequenting the same room as a patient with a positive PCR test are classified as close contacts and will require diagnostic screening along with more careful monitoring. Residents with a high-risk exposure or recent close contact will require a diagnostic test.

New residents or residents who have been absent for more than 24 hours will need a pre-entry test, and best practice suggests quarantining for fourteen days, regardless of a negative test result. Typically, residents transferring to a different facility (for surgery or some other procedure) will need a viral test before the transfer to determine treatment protocols.

Pool and Pod Testing

Pool testing involves obtaining samples from individuals and combining them in one test. This approach to surveillance testing in nursing homes reduces the cost of testing. A negative test will also quickly clear everyone in the pool and is an efficient way to establish areas that are free from coronavirus.

Nexsunlabs Covid-19 Pool Test Process Explanation

COVID-19 surveillance testing for skilled nursing facilities with long-term residents may use pool testing as an economical process for spotting potential outbreaks. Many outbreaks result from an asymptomatic carrier such as a visitor, patient, or staff, and strategic group testing provides an affordable indicator of a potential issue with coronavirus.

Contact Tracing

Coronavirus spreads by personal contact with an infected individual or infected surfaces. In a skilled nursing facility, contact tracing involves knowing the close contacts and locations where that person may have inadvertently created a high-risk environment in the 48 hours before the positive test.

Digital contact tracing for staff and residents within a skilled nursing home facility effectively produces a complete report, highlighting both physical locations and potential close contacts without the reliance on human memory. This feature is useful when dealing with patients with underlying memory issues.

Nexsun Labs Skilled Nursing Facilities Contact Tracing Nursing Facilities

Contact tracing also involves visitors to the facility. This process may require visitors to register when entering or be issued a pass in order to trace them throughout the facility. Contact tracing is a crucial element in stopping the further transmission of COVID to multiple individuals within the skilled nursing facility and the wider community.

Benefits of an Ongoing Testing and Surveillance Program

Living and working in a pandemic means a higher level of surveillance is necessary for skilled nursing facilities. The patients inside a skilled nursing facility are more vulnerable to the impact of contracting coronavirus or any other respiratory illness.

A surveillance system with an appropriate testing regime is beneficial in:
• Maintaining a healthy staff team and reducing staff shortages.
• Reducing the transmission of COVID-19 through a vulnerable population.
• Implementing early treatment measures through early detection.
• Shaping management techniques for effective use of resources.
• Maintaining healthy social interactions with visitors.
• Highlighting areas needing more deep cleaning.

A surveillance system with an appropriate testing regime is beneficial in:
• Maintaining a healthy staff team and reducing staff shortages.
• Reducing the transmission of COVID-19 through a vulnerable population.
• Implementing early treatment measures through early detection.
• Shaping management techniques for effective use of resources.
• Maintaining healthy social interactions with visitors.
• Highlighting areas needing more deep cleaning.

Critically ill patients require ongoing treatment regardless of their coronavirus infection status. Surveillance and identification of patients with or without COVID-19 enable the deployment of beds in cohorts as in many facilities isolating patients in individual rooms is neither practical nor beneficial. Diagnostic testing, where appropriate, lets you track patients’ progress and maintain control of the spread of infection in the skilled nursing home facility.

Testing Guidance for Skilled Nursing Facilities

Most states in the US recommend following both the CDC (Centers for Disease Control and Prevention) and the CMS (Centers for Medicare & Medicaid Services) regulations. Individual state regulations may insist on a greater testing frequency or other requirements to match local circumstances. Both CDC and CMS requirements defer to state rules where necessary.

In summary, the COVID-19 testing for skilled nursing facilities requirements are:
• Test individuals with symptoms regardless of vaccination status.
• Test close contacts of individuals who test positive for coronavirus despite vaccination status.
• Outbreak testing where necessary.
• Surveillance testing of unvaccinated staff at a frequency dependent on community transmission level.

In summary, the COVID-19 testing for skilled nursing facilities requirements are:
• Test individuals with symptoms regardless of vaccination status.
• Test close contacts of individuals who test positive for coronavirus despite vaccination status.
• Outbreak testing where necessary.
• Surveillance testing of unvaccinated staff at a frequency dependent on community transmission level.

When dealing with residents, routine surveillance testing for asymptomatic individuals is not recommended unless there are:
• One or more confirmed cases of COVID-19 in the facility.
• Residents frequently leaving the facility for treatment at another site.

When dealing with residents, routine surveillance testing for asymptomatic individuals is not recommended unless there are:
• One or more confirmed cases of COVID-19 in the facility.
• Residents frequently leaving the facility for treatment at another site.

You can opt to test visitors, but this step depends on resources available and individual risk assessments. Both staff and residents may refuse testing, which will trigger prevention measures that effectively treat them as if they have COVID-19. CDC guidelines allow collecting a saliva sample instead of the more invasive sampling techniques, and this testing method may meet with a higher level of compliance.

Test facilities analyzing the samples must have a CLIA certificate, and facilities must document all testing while maintaining appropriate confidentiality.

What Testing is Necessary for an Outbreak?

Two or more patients or staff members with a new COVID-19 infection is considered an outbreak and you must notify the health department, staff, residents, and family members.

What Testing is Necessary for an Outbreak?

When you have an outbreak, the following are essential considerations:
The number of resources available for contact tracing – may need
to delegate to the health board.
Vaccination rate among staff and residents – vaccination provides
better protection.
• Increase evaluation screening of residents to every shift to detect
new symptoms.

When you have an outbreak, the following are essential considerations:
The number of resources available for contact tracing – may need to delegate to the health board.
Vaccination rate among staff and residents – vaccination provides better protection.
• Increase evaluation screening of residents to every shift to detect new symptoms.

Depending on your outbreak response policy, potential actions include:
• Isolate and test those with possible symptoms.
• Contact trace and test all staff and residents at risk.
• Contact trace and test again if new cases are detected.
• Facility-wide or floor level testing if contact tracing does not stop infection spread.
• Restricted rooms and preventative measures for unvaccinated residents.

Depending on your outbreak response policy, potential actions include:
• Isolate and test those with possible symptoms.
• Contact trace and test all staff and residents at risk.
• Contact trace and test again if new cases are detected.
• Facility-wide or floor level testing if contact tracing does not stop infection spread.
• Restricted rooms and preventative measures for unvaccinated residents.

If you cannot rely on contact tracing, consider facility-wide COVID-19 testing after day 2 and then again between days 5 and 7. You can stop testing and return to normal operations after 14 days without additional cases. If more cases occur, continue facility-wide or broad testing every 3-7 days, with room restrictions until you reach 14 days without new cases. Residents can continue to have visitors during an outbreak but with appropriate warnings and control measures. Visitors are essential for maintaining residents’ mental health and emotional wellbeing. If you have a new patient admitted with a known COVID-19 infection, that event does not classify as an outbreak. Plus, any new patient who develops symptoms during the 14-day admission and quarantine period does not classify as an outbreak.

In summary – during an outbreak, you need to increase your surveillance and test:
• Individuals with symptoms.
• Close contacts of individuals who test positive.
• Until you reach fourteen days clear of new cases.

In summary – during an outbreak, you need to increase your surveillance and test:
• Individuals with symptoms.
• Close contacts of individuals who test positive.
• Until you reach fourteen days clear of new cases.

Which Program is Best for Skilled Nursing Facilities?

The testing program that will best suit the needs of your facility will depend on resources and your risk assessment. Possible testing programs include:
• Screening and surveillance testing – individuals and pools.
• Testing symptomatic individuals.
• Testing all close contacts of positive cases.
• Testing patients on admission and discharge.
• Routine testing of patients who regularly leave the facility for
treatment.
• Weekly or twice weekly testing of unvaccinated staff.
• Testing unvaccinated staff before shift cycle.
• Requiring visitors to have a negative test result.

The testing program that will best suit the needs of your facility will depend on resources and your risk assessment. Possible testing programs include:
• Screening and surveillance testing – individuals and pools.
• Testing symptomatic individuals.
• Testing all close contacts of positive cases.
• Testing patients on admission and discharge.
• Routine testing of patients who regularly leave the facility for treatment.
• Weekly or twice weekly testing of unvaccinated staff.
• Testing unvaccinated staff before shift cycle.
• Requiring visitors to have a negative test result.

Which Program is Best for Skilled Nursing Facilities?

The factors that help develop your testing program include:
• Resources – Some testing programs are more affordable and use fewer resources.
• Vaccination status – A low number of vaccinated residents and staff may mean more testing.
• Patient turnover – Constant patient movement increases the risk of infection.
• Community transmission rate which sets the mandatory frequency of testing.
• The facility’s capacity to manage potential outbreaks.
• Patient vulnerability to the impact of infection.

The factors that help develop your testing program include:
Resources – Some testing programs are more affordable and use fewer resources.
Vaccination status – A low number of vaccinated residents and staff may mean more testing.
Patient turnover – Constant patient movement increases the risk of infection.
• Community transmission rate which sets the mandatory frequency of testing.
• The facility’s capacity to manage potential outbreaks.
• Patient vulnerability to the impact of infection.

When you consider your risk factors and outbreak response measures, you can plan a program of appropriate diagnostic testing for skilled nursing facilities.

How Our Program Works

Our CLIA certified laboratory meets your testing requirements for any diagnostic test taken using salvia or a nasal swab. You can opt to have individual or pool testing. If the pool tests are positive, you follow up with individual tests, but this approach can significantly reduce the number of individual tests necessary.

Our efficient laboratory can test your samples for COVID-19, flu, or a combination of both. Although many diseases cause symptoms like COVID-19 (and are an issue), our program focuses on a highly sensitive test that gives you an accurate confirmation that the individual has (or doesn’t have) COVID-19.

We supply you with the sample collection equipment and paperwork. Our laboratory commits to a rapid turnaround of results, and we expect to deliver your results within 24 hours of the sample arriving at the laboratory.

Why Partner with Nexsun Labs for Your Testing Needs?

Nexsun offers you the following advantages in testing for COVID-19:
• CLIA certification meets regulatory testing requirements.
• PCR test is a viral test acknowledged as highly sensitive and accurate.
• Rapid turnaround for efficient treatment protocols.
• Our laboratory is specific for COVID-19 and flu testing.
• Volume testing for individuals and pools.
• We supply all testing materials.
• We offer the less invasive saliva test.

Nexsun offers you the following advantages in testing for COVID-19:
• CLIA certification meets regulatory testing requirements.
• PCR test is a viral test acknowledged as highly sensitive and accurate.
• Rapid turnaround for efficient treatment protocols.
• Our laboratory is specific for COVID-19 and flu testing.
• Volume testing for individuals and pools.
• We supply all testing materials.
• We offer the less invasive saliva test.

As a skilled nursing facility, you focus on providing the best clinical care for your residents. As a dedicated COVID-19 CLIA certified laboratory, our focus is on testing for COVID-19 accurately and quickly. Our testing process means you can focus on your patients, confident that you will get an accurate COVID-19 result when you need it.

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Prefer to Call?
Speak with a lab specialist today.



Nexsun Labs Logo

Fast

Affordable

Accurate

Nexsun Labs Result in 24hrs

Fast Results

Nexsun Labs 99.9% Accurate

Accurate Test Results

Nexsun Labs Secure Delivery

Secure, Verifiable Results

Nexsun Labs Travel Certification

Travel Certificates

Nexsun Labs Travel Certification

CLIA & COLA Registered Lab

Prefer to Call?
Speak with a lab specialist today.