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Federal Proposal Aims To Boost COVID-19 Testing Of Nursing Home Employees

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The Brighton Rehabilitation and Wellness Center is the site of the biggest COVID-19 nursing home outbreak in the Pennsylvania. This spring 332 residents were infected with the virus.

Nursing home employees may soon be required to have weekly coronavirus tests according to a press release from the Centers for Medicare and Medicaid Services.

The initiative has yet to go through the statutory rule-making process, so it’s anyone’s guess how it will be implemented. But CMS says it will be funded through the Coronavirus Aid, Relief and Economic Security Act and  only apply to nursing homes in states where test results have at least a five percent positive rate.

State data show that from Aug. 7-13 Pennsylvania’s positivity rate was at 4 percent. Though CMS, which did not respond to several requests for comment, has yet to disclose how it intends to calculate the 5 percent metric. 

Frequent testing, both in and outside nursing homes, is key to tracking and containing the virus. But some worry that setting this standard for an entire state is too broad.

“There are many situations, many states and time periods, where there are unequal distributions of the COVID cases within that state…It really does really need to be a little bit more directed at the local level,” said Dr. David Nace, the chief medical officer of UPMC’s senior communities.

Allegheny County's test positivity rate at 4.3 percent, though during parts of July it was roughly double that.  From July 1 to Aug. 1 coronavirus infections among nursing home residents increased by 61 percent.

Nace says frequent testing is important to identify cases early before the virus spreads to others. That's why the Pennsylvania Health Care Association, which represents the state’s long-term care facilities, supports the CMS proposal.

“Asymptomatic staff, by no fault of their own, have come in and out of facilities and transmitted the virus. Whether it’s to other staff or their residents,” said the organization’s CEO Zach Shamberg.

If the CMS proposal does come to fruition, Shamberg says there may not be enough capacity by labs to process the tests.

“Turn around times now, because of increased capacity, have ballooned from 24 to 48 hours, to in some cases longer than a week,” he said.

Which means by the time an employee gets a positive test result for the virus, dozens and dozens of residents may become infected. 

Sarah Boden covers health and science for 90.5 WESA. Before coming to Pittsburgh in November 2017, she was a reporter for Iowa Public Radio where she covered a range of issues, including the 2016 Iowa Caucuses.
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