Nursing Home Routine Testing and Visitation Guidance

Routine testing of unvaccinated staff and indoor visitation in nursing homes is affected by the level of COVID-19 transmission in the community or COVID-19 positivity rate. Based on Centers for Medicare and Medicaid Services (CMS) guidance, testing frequency of unvaccinated staff is determined by community transmission level. Levels of COVID-19 community transmission are available on the Centers for Disease Control and Prevention (CDC) COVID-19 Integrated County View site, and the seven-day county transmission rate document compiled by LeadingAge NY is available here.

As of Oct. 18, 2021, all New York State counties are at either a substantial or high transmission level, requiring twice-weekly testing. Moderate transmission rates require weekly staff testing, and low rates have no testing requirement.

• Facilities should monitor their level of community transmission every other week (e.g., the first and third Monday of every month) and adjust the frequency of performing staff testing according to the testing intervals suggested above.
• If the level of community transmission increases to a higher level of activity, the facility should begin testing staff at the frequency recommended as soon as the criteria for the higher activity level are met.
• If the level of community transmission decreases to a lower level of activity, the facility should continue testing staff at the higher frequency level until the level of community transmission has remained at the lower activity level for at least two weeks before reducing testing frequency.

In all settings, the CDC recommends that even fully vaccinated people wear a mask indoors in public in areas of substantial or high community transmission to reduce their risk of transmitting or contracting COVID-19.

County positivity rate together with resident vaccination rate also affects a facility’s ability to hold indoor visitation for unvaccinated residents. According to CMS guidance, facilities should always allow indoor visitation for all residents (regardless of vaccination status), except for a few circumstances, including limiting indoor visitation for unvaccinated residents if the nursing home’s COVID-19 county positivity rate is >10 percent and <70 percent of residents in the facility are fully vaccinated. Compassionate care visits should be always allowed.

Contact: Ken Allison, kallison@leadingageny.org, 518-867-8820