First Round of Point-of-Care Tests for Nursing Homes Drops to 600 as HHS Announces Additional Priority Criteria

The federal government on Wednesday revealed more details about the prioritization of nursing homes that will receive point-of-care testing kits for COVID-19 under an ambitious new plan, with 600 set to be sent this week.

In addition to targeting facilities with at least three or more confirmed or suspected cases in the last week, as well as those in hotspot areas, the Department of Health and Human Services (HHS) will dole out the antigen testing units based on the following criteria, according to Rachel Kellogg, deputy chief of staff for assistant health secretary Admiral Brett Giroir:

  • Facilities with at least one new COVID-19 case within the last seven days, after previously having none
  • Facilities that experienced “inadequate access to testing” over the last days
  • Facilities with at least one resident death from COVID-19 in the last seven days
  • Facilities with at least one new confirmed or suspected staff case within the last seven days

Kellogg made the comments on a twice-monthly stakeholder call with nursing home leaders hosted by the Centers for Medicare & Medicaid Services (CMS).

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“This is incredibly important to protect our nursing homes and to potentially save thousands of lives,” Kellogg said.

HHS will send varying amounts of testing supplies and point-of-care devices to facilities based five separate size groups: small, small to medium, medium, large, and “major outlier” facilities that Kellogg described as “mega nursing homes” with high bed counts.

Kellogg provided the following breakdown:

  • Small: 150 testing kits and one device
  • Small to medium: 240 to 250 testing kits, and one device
  • Medium: 325 to 330, and one device
  • Large: 600 and one device
  • “Major outlier”: More than 900 kits and two devices

As HHS had confirmed previously, operators must have a CLIA certificate of waiver in order to receive the units, the Quidel Sofia 2 and Sofia 2, and the BD Veritor Plus.

“Shipping will begin this week and will continue over the course of 14 weeks, and potentially beyond those 14 weeks — but right now, that’s what we’re tracking,” Kellogg said. “We are hoping to hit, like I said, every nursing home with a CLIA certificate of waiver.”

About 90% of facilities in the country have such a waiver, which allows them to perform tests that would normally be restricted to a formal laboratory. CMS has additionally indicated a plan to expedite applications for facilities without the waiver authority.

The government announced last week that it would send COVID-19 point-of-care testing devices and supplies to all SNFs in the U.S.

At the time, leaders indicated that the first 2,000 would be sent this week to facilities chosen by CMS as the most at risk, including those in community hotspots and nursing homes with at least three confirmed cases.

After the initial shipments, SNFs can order tests from the manufacturer of the testing device for under $25 each through a “special concierge service,” Giror said last week.

The units themselves will remain the property of the nursing homes after the COVID-19 pandemic passes, Kellogg confirmed Wednesday; in the future, they can potentially be used to test residents for the more familiar influenza virus.

Evan Shulman, director of CMS’s nursing home division, acknowledged that many questions remain about the logistics of the rollout, asserting that CMS and HHS have prioritized speed in developing the program.

“While we’re still working on some of the questions, we think it’s more important to get the machines out to as many as we can, at the same time that we can reconcile some of these things,” Shulman said.

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