AMDA: COVID-19 Universal Testing Mandates Must Include Funding for Costs, Staffing Testing decisions should be part of an individual facility strategy

May 18, 2020

Columbia, MD – Many states are issuing orders for nursing homes and assisted living communities to conduct universal testing of all staff and/or residents. AMDA – The Society for Post-Acute and Long-Term Care Medicine says these mandates, while well-intentioned, will be counterproductive unless they are part of a broader strategy that addresses considerations such as costs, staffing, frequency, and type of test, among others.

Instead, testing decisions must be made by individual facilities with a clear understanding of the community prevalence of the disease, local testing accessibility and capacity, and well-defined testing goals. Also, states issuing such mandates must be prepared to support nursing homes with additional funding, staffing, and other assistance if residents need to be transferred or cohorted.

In a policy statement released today, AMDA cited a number of issues that must be addressed before implementing a universal testing strategy, including:


·       What is meant by universal testing and how frequently is retesting to be done?

·       Should healthcare personnel (HCP), residents, or both be tested?

·       What type(s) of test(s) should be used?

·       How are facilities to cover the costs of testing?

·       Are HCP tests to be covered by private insurance or with public support?

·       Is there a plan in place to deal with the test results?

·       What is the emotional impact of repeated testing of residents with dementia, anxiety, post-traumatic stress disorders or other psychological health conditions?

·       What happens if large numbers of staff must suddenly be furloughed?

“We are grateful that states are addressing the perilous situation of our nation’s older adults and personnel living and working in nursing homes. However, any mandate for universal testing must account for the many important considerations detailed in today’s statement. Testing alone is not enough, and there are no one-size-fits-all solutions,” says AMDA Executive Director Christopher E. Laxton, CAE. Plans must be developed with strict attention to clinical case-finding, screening of staff for symptoms, and visitor restrictions, in addition to the prevention of transmission with universal masking, appropriate use of PPE, and environmental cleaning.

“I raised many of these points in my May 15 letter to New York Governor Andrew Cuomo,” Mr. Laxton continues. “We urge all federal and state officials to work closely with clinical specialists in post-acute and long-term care medicine, including certified medical directors, before implementing any mandates for universal COVID-19 testing.”

Read today’s complete policy statement here.


AMDA – The Society for Post-Acute and Long-Term Care Medicine is the only medical specialty society representing the community of over 50,000 medical directors, physicians, nurse practitioners, physician assistants, and other practitioners working in the various post-acute and long-term care (PALTC) settings. Dedicated to defining and improving quality, we advance our mission through timely professional development, evidence-based clinical guidance, and tireless advocacy on behalf of members, patients, families, and staff. Visit for more information