Without Funding and Resources, CMS’s New Nursing Home Testing Guidance ‘Hollow’

May 20, 2020

Without the funds and the resources needed to meet COVID-19 testing recommendations, the federal government’s guidance on reopening nursing homes could create more confusion for skilled nursing facilities — and more challenges on top of the considerable strain they already face in combating the spread of the illness.

“At a high level, I really think this is a bit of a hollow requirement,” David Grabowski, a professor of health care policy at Harvard Medical School and a member of the Medicare Payment Advisory Commission (MedPAC), told Skilled Nursing News on May 20. “You’re telling nursing homes and states to test all staff and residents regularly, yet not actually the providing the tests to them, and I think that’s a real mistake.”

The Centers for Medicare & Medicaid Services (CMS) released guidance on reopening nursing homes on May 18.

While allowing states flexibility in how the criteria in the guidelines should be implemented, the agency emphasized that SNFs should be among the last institutions to reopen as communities try to move out of their various stay-at-home phases.

The guidelines detail several parameters for testing and COVID-19 community infection status that SNFs ideally should meet before moving toward reopening, including the requirement to have baseline testing for all residents and staff — and the capacity to subsequently test staff once a week.

But states have the ability to choose how they measure their SNFs’ readiness to emerge from visitation lockdown, and some of them, such as New York, have adopted even stricter measures for testing than those in the CMS guidelines.