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December 17, 2020

COVID-19 Testing recommendations in PCH and ALR Facilities

As the COVID-19 cases continue to rise in the Commonwealth, please keep in mind that the level of COVID-19 transmission in the community surrounding a long-term care facility has a direct impact on the risk of COVID-19 introduction into the facility.   While our previous guidance included the following recommendations, we are urging providers that have not established a routine testing of asymptomatic staff and residents to do so as soon as possible.   Identifying the first case of COVID-19 in your facility quickly can significantly impact how widespread the infection becomes in your facility.    

Developing an appropriate screening testing strategy for each facility may depend on many local factors, including presence and availability of testing supplies and clinical support. Facilities that may need clinical support can complete the Universal Testing Needs Assessment form or contact their Regional Response Health Collaboration Program (RRHCP) which will be available until 12/31/20.

The following table outlines the Department’s recommended approach to continued testing in PCHs and ALRs which are not experiencing an outbreak, to increase detection and prevent transmission of COVID-19. 

Recommended Testing Intervals for PCHs and ALRs Vary by Community COVID-19 Transmission Level
Level of Community COVID-19 TransmissionCounty %PositivityRoutine Testing of Asymptomatic ResidentsRoutine Testing of Asymptomatic Staff
LOW<5%Not recommendedTesting is encouraged of all staff members every 4-6 weeks
MODERATE5% to 10%Weekly testing is encouraged of all residents with outside contact in the last 14 days, if they have not otherwise been tested during that period.Testing is encouraged of all staff that have not been tested in thepast 30 days and repeat testing every 30 days
SUBSTANTIAL>10%Weekly testing is encouraged of all residents with outside contact in the last 14 days, if they have not otherwise been tested during that period.Testing is encouraged of all staff members once per week

This recommendation applies only to testing of asymptomatic individuals. Individuals with a prior confirmed diagnosis of COVID-19 do not need to be retested. However, based on CMS guidance, testing should be considered for those with a prior confirmed diagnosis 3 months after the date of onset of the prior infection if deemed necessary based on the recommended testing intervals in the chart above.  

Prompt testing of any resident or staff experiencing COVID-19 compatible symptoms is required.  Facilities experiencing an outbreak should immediately begin universal testing, ideally of all staff and residents, but unit, wing, or floor specific testing is acceptable, if the facility has dedicated staff to units, wings, or floors. 

In addition to this regular screening testing, all previous guidance on testing of symptomatic and exposed individuals as indicated in PA-HAN 530 should be followed regardless of transmission level. 

Residents who leave the facility routinely should be considered for regular testing. In the table above, the Department refers to residents who leave the facility routinely as having “outside contact,” which could include but is not limited to outpatient health care visits including dialysis treatment, social visits in the community, day programs, employment, and return after admission to another health care facility. 

Please direct any questions to [email protected].

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