News & Press: COVID-19 News & Updates

More Information on Testing Requirements for Nursing Facilities

Friday, August 28, 2020   (0 Comments)
Posted by: Alyse Meyer
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QSO-20-38-NH was released on August 26, 2020 providing additional guidance on the interim final rule published August 25, 2020.  

Texas HHSC sent an initial provider notification and will be sending a follow-up alert providing additional information regarding implementation. Texas HHSC is also developing an FAQ document.

I wanted to provide some additional information and key takeaways from the memo following a presentation we received from CMS, discussions with Texas HHSC, and in response to trending member questions. Please continue to email me any questions you may have.

  • These regulations are effective on the date of publication at the Office of the Federal Register. CMS anticipates no later than September 2, 2020. HHSC Texas anticipates potential lag time in enforcement. However, facilities should begin planning and implementing the new requirements as soon as feasible.
  • Texas HHSC will provide more information on the September 2 NF Provider COVID Webinar with HHSC and DSHS. Registration not yet posted.
  • Texas HHSC is preparing a provider letter and FAQ to be sent next week.
    • More information on CLIA reporting requirements will be included in the PL. For example, what data elements need to be captured and to what entity providers need to report.  
  • Frequency of routine staff testing is determined by county positivity rates which may be found here. This file will be updated weekly. See Table 2 on pg. 5 of QSO-20-38.
  • CMS does not expect routine testing of staff to take place on the same day.  Facilities should prioritize those individuals who are regularly in the facility (e.g., weekly) and have contact with residents or staff.
  • Refusal of Testing is addressed in the memo.
    • When staff refuse to test and are asymptomatic with no known exposure HHSC recommends contacting your local health department to determine appropriate next steps based on “local jurisdiction policies”.
  • Surveyors may not cite the facility for noncompliance if the facility documents their attempt to perform and obtain testing as described in pg. 10 of QSO-20-38. Note: The inability to test due to financial reasons is not acceptable to CMS. 
    • View pg. 10, 11. Staff and Resident Testing of the COVID-19 Focused Infection Control Survey attached to QSO-20-38 for more information about documentation and surveyor expectations.
    • When facilities believe they have exhausted all options to access and administer testing HHSC recommends reaching out to your Regional Director to discuss your efforts and ensure outreach/documentation is adequate.
  • Also see pg. 10, 10. Infection Preventionist (IP) of the COVID-19 Focused Infection Control Survey for more information on IP responsibilities and expectations.
  • A facility’s selection of a test should be person-centered. pg.8


Alyse Meyer
VP Advocacy
LeadingAge Texas