Coronavirus Update #159
Additional CMS Guidance on Staff Testing and Reporting, New CMS QSO Memos,
AHCA/NCAL Webinar, MDH Webinar, Reminders
CMS Issues Additional Guidance on Staff Testing and Reporting Requirements

Earlier this week, we reported that the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule with a comment period that revises regulations in several areas for long term care facilities and other providers. 

As highlighted this rule establishes a new requirement for long term care facilities for COVID-19 testing of residents and staff. CMS did not establish a specific frequency or criteria for testing in the rule but listed potential criteria that will be considered and addressed further in guidance. 
The regulations are effective immediately upon their publication at the Office of the Federal Register. Most of the new regulations are applicable only for the duration of the COVID-19 public health emergency. CMS is providing a 60-day comment period for public input on these requirements. 
Read here a more detailed analysis and summary of additional provisions in the rule. 

CMS Issues Two QSO Memos on Staff Testing and CLIA Reporting Requirements 

#1 QSO Memo 20-38-NH: Complying with 483.80(h) Testing of Staff Regulations and New F-tag (F-886) 

CMS issued a QSO memo 20-38 that outlines details on how to comply with new interim final rule 483.80(h) requiring COVID-19 testing of staff. AHCA has summarized the guidance, but we recommend members read the entire QSO memo as this regulation goes into effect as soon as the interim final rule is published in the Federal register. 

At a high level, the QSO memo outlines: 

CMS is requiring facilities to conduct three types of testing: 

  • Symptomatic Testing: Test any staff or residents who have signs or symptoms of COVID-19 (facility must continue screening all staff, residents and other visitors).

  • Outbreak Testing: Test all staff and residents in response to an outbreak (defined any single new infection in staff or any nursing home onset infection in a resident) and continue to test all staff and residents that tested negative every 3-7 days until 14 days has passed since the most recent positive result. 

  • Routine Testing: Test all staff based on the extent of the virus in the community, using CMS’ published county positivity rate in the prior week as the trigger for staff testing frequency. NOTE: CMS will publish reports of COVID-19 county-level positivity rates at: 

CMS has also provided requirements related to the following, which are further explained in AHCA’s summary here. 

  • Types of tests (antigen and PCR) 
  • Definition of facility staff (staff and contractors or vendors who regularly provide care and services) 
  • Documenting issues with test supplies and shortages 
  • Dealing with refusals by residents or staff 
  • Reporting requirements  
  • Documenting test results 
  • Conducting tests 
  • Documenting/demonstrating compliance at F886 

#2 QSO Memo 20-37-NH: Requirements of Reporting by Clinical Laboratory Improvement Amendments (CLIA) Certified Labs 

CMS issued a QSO memo 20-37 that describes the survey frequency and citations and fines for not compliance with CLIA regulations related to POC antigen testing. AHCA’s summary is available here
Member Webinar Today with Mark Parkinson & Dr. David Gifford 

New CMS Testing Requirements for Staff & Residents: What You Need to Know

Please join AHCA/NCAL for an all member webinar with President and CEO Mark Parkinson and Chief Medical Officer Dr. David Gifford TODAY, Friday, August 28 at 11 a.m. Eastern on the interim final rule released this week.

As a reminder, the rule establishes a new requirement for nursing home facilities for COVID-19 testing of staff and residents. On tomorrow’s webinar, learn what providers can do now to successfully comply and implement the new requirements.This webinar is for AHCA/NCAL facility members only.
Friday, August 28
11 a.m. Eastern
 New CMS Testing Requirements for Staff & Residents: What you Need to Know
Please Note:  

  • Use Google Chrome to avoid technical problems.
  • Members must log in using their existing AHCA/NCAL username and password first. 
  • Register once logged in to the website.
  • Forgot your password? Click here.
  • If you are new to the site, create an account here. After doing so, you will be able to register for the webinar. Please note, all new account holders must add their member facility to their account at the time of account creation.
  • The webinar recording will be posted on ahcancalED as soon as it is available.
  • Need further assistance? Email
MDH Webinar Recap

Yesterday, the Maryland Department of Health held a webinar call to update the long-term care sector on COVID-19 developments and best practices. The call was recorded, in case you were unable to join or would like to review the topics discussed, which included:

  • Review current situation of COVID-19
  • CovidCONNECT
  • Rapid Antigen Testing
  • Updated Guidance for Managing COVID-19
  • Q&A

If you have any questions, please email

REMINDER: Updated Guidance on Preparing for and Responding to COVID-19

Earlier this week, the Maryland Department of Health released updates to the guidance on Preparing for and Responding to COVID-19 in Nursing Homes and Assisted Living Facilities. Please carefully review the documents.

The updates in the guidance will allow residents who are not on precautions to leave their rooms, and to attend therapy in the rehab gym under limited circumstances. These updates apply to all facilities including those who have not yet entered Phase 1 of relaxing restrictions.
Flu Vaccination Outreach and National Immunization Awareness Month 

As we ready for FLU season, here are some resources that may be helpful for you and your teams. Please encourage you colleagues, family, friends and communities to get the FLU shot. There will be more resources to come, but for now, please see links below:

  • Here is the link to the OASH childhood vaccination resources. Please note that these materials are for the general public and consist of graphics, widgets, videos, and toolkits.

Did you miss HFAM's previous alerts?

Visit our website to view all previous HFAM alerts, as well as guidance
from our federal and state partners.
Thank you.

We cannot thank you enough for the dedication and diligence in doing all that you can for the residents in your communities. HFAM continues to monitor the COVID-19 pandemic with our state and national partners and will do all we can to support you during this time.