Skilled nursing facilities provide medical care at a higher level than general social care for an individual. A skilled nursing facility can provide:
Skilled Nursing Facilities
Skilled Nursing Facilities
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.
The Impact of COVID-19 on Skilled Nursing Facilities
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.
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.
Diagnostic testing for nursing homes covers both staff and patients but with a different approach.
Testing and Screening Staff
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
Which Program is Best for Skilled Nursing Facilities?
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 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?
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.
