Nursing Home Testing Plan Moving from Residents to Staff

The three associations serving nursing home providers had a late afternoon call yesterday (Friday, 7/24) with the Ohio Department of Health (ODH) and learned that the resident testing initiative that had been planned to begin in early August is now being replaced by a program that will conduct repeat testing of all nursing home staff.  The cadence for this testing, beginning the week of August 3, will be every 14 days. Facilities participating in the state-supported process will start the cadence over the first few weeks in August, and will need to test again 14 days after their first testing date. Lab capacity has been an ongoing challenge for the staff testing accomplished to date, but the state is working to create its own testing capability (through a series of labs across the state) that it plans to have fully functional within the next few months.  In the meantime, it will work with existing lab contracts and new testing methods (e.g. pooling of tests, a process that frees lab capacity and reduces costs).

The process.  The Ohio National Guard (ONG) will not be conducting specimen collection for this testing. Instead, each facility will once again be surveyed to learn how many test kits are needed to test all staff.  The required kits will be delivered to a central location (likely, a location in the county seat) for the facility to retrieve; with a 14-day cadence, the test kits for both of the month’s sets of tests would be delivered in the facility’s name at the same time.  The testing would be completed by facility staff (with training provided) within a specified period of time (likely 24 hours). For at least the first round of tests, the specimens would picked up by the ONG for delivery to the lab.

Schedule. The schedule for testing is still in development, but the tentative plan is that ODH will provide a comprehensive schedule (i.e. the schedule will include ALL facilities) that will start with those who have experience using the data portal implemented for the ONG testing.  The every 14-day testing cadence, using the state’s central labs’ capacity, will remain in place until the rapid point-of-care testing devices CMS has promised are delivered.  The first shipment of these testing devices doesn’t include any Ohio CLIA-registered providers.  Nonetheless, as we reported in our July 17 LeadingAge Ohio COVID-19 ALERT, nursing homes should begin the application process immediately.

Test results.  This revised process with more centralized lab capabilities is anticipated to reduce delays in receiving test results. 

Costs.  As with the ONG process, labs will bill 3^rd party insurers or, for those employees without insurance, the HRSA program. Facilities will have the option to opt out of the state’s staff testing program (i.e. work with their own lab contracts); ODH has indicated that they will cover the costs for those organizations that opt out.  When questioned about providers who are self-insured, ODH was unable to confirm how these costs would be addressed;  ODH staff emphasized self-insured providers need to provide appropriate insurance information (vs. indicating ‘no insurance’). 

There are many details still to be confirmed, but the most important next step is to ensure your facility participates in the webinar ODH has scheduled for all nursing home providers for Tuesday, July 28 from 11 am - Noon.   Please register for “Testing in Nursing Homes with CCURT”.