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Requirements for Testing of Residents and Staff in Skilled Nursing Facilities Order

June 8, 2020

Per the Order of the Secretary of the Pennsylvania Department of Health Directing Testing at Skilled Nursing Facilities, issued June 8, 2020, Skilled Nursing Facilities (SNFs) are required to complete a baseline universal test for SARS-CoV-2 of all residents and staff no later than July 24, 2020. Universal testing includes: any resident or staff person who has never been tested, and any resident or staff person who was tested prior to May 24, 2020 and whose result was negative. Facilities should not test residents or staff with a history of a positive test for SARS-CoV-2. If a facility has not had any known cases among residents or staff, the facility is still required to perform baseline universal testing of all residents and staff. While not mandated through the Order of the Secretary, facilities should follow guidelines in PA HAN 509 - 05/29/20 - Testing Guidance for COVID-19 in Long-term Care Facilities Residents and Healthcare Personnel when a new confirmed case is identified for follow-up testing.

In order to be compliant with this Order, a facility that is unfamiliar with how to test needs to pursue contracting with an external vendor to support universal testing. If a facility is struggling to find resources, the facility should send an email to ra-dhCOVIDtesting@pa.gov. The facility will receive an auto-reply with a link to a form to request support, including assistance with performing testing, from the Department of Health (Department). The form must be completed in its entirety. Note that support services are limited and should be considered a last resort.

In order be compliant with this Order, a facility lacking testing supplies can email the Department at ra- dhCOVIDtesting@pa.gov. The facility will receive an auto-reply with a link to a form to request support, including supplies, from the Department. The form must be completed in its entirety. Shipments will be based on the quantities available at the time of request review.

In order to be compliant with this Order, a facility needs to enter into a contract with a commercial laboratory to meet testing needs of the facility. A laboratory must have a current Pennsylvania laboratory permit and be approved to perform COVID-19 testing. A facility may verify licensure and approval by emailing RA-DHPACLIA@pa.gov. If timely commercial testing is not available, the State laboratory may be used as a last resort if needed to comply with this Order.

In order to be compliant with this Order, if a resident refuses to be tested, the resident should be cared for in a COVID-potentially exposed (Yellow) Zone until at least 14 days after refusal (see PA-HAN-509). If the resident develops symptoms consistent with COVID-19, testing is recommended, and the testing request should be re-visited with the resident or responsible party.

In order to be compliant with this Order, a facility's human resources department should develop a policy to address staff members who refuse to be tested. The policy should be based on the risk of exposure, community spread, and staffing needs. In order to be compliant with this Order, the facility must follow its own policy. Additionally, these staff persons should not care for residents in unexposed (Green) Zones. If these staff develop symptoms consistent with COVID-19, testing is recommended, and the staff person should be excluded from work and follow return to work criteria in PA HAN 501.

In order to be compliant with this Order, a facility is required to report baseline testing to the Department. Facilities must report in the survey tool found here within 48 hours of completing the baseline testing, or within 72 hours of issuance of the Order if baseline testing has already occurred.

In order to be compliant with this Order, a facility must implement best practices (such as those found in PA HAN-509) to implement infection control measures based upon the results of the baseline testing.

This may vary from facility to facility, but the focus of baseline testing is to enable a facility to establish initial infection control practices that will prevent further spread of COVID-19 within the facility and to establish facility readiness.

If a facility has questions on these requirements, it should consult the Frequently Addressed Questions (FAQs) that accompany this document, as well as PA HAN 509. If a question is not addressed in either of those resources, the facility may reach out to ra-dhSNFquestion@pa.gov.