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CMS Point-of-Care Initiative Announced, All SNFs to Receive Testing Devices

The Centers for Medicare and Medicaid (CMS) has announced that all SNFs will be receiving a point-of-care testing device for COVID-19. In a conference call to with nursing homes. On the call. CMS Administrator Seema Verma said that this program was a direct result of feedback from AHCA/NCAL and providers nationwide on challenges to accessing testing and slow turnaround on results.

The devices, according to the manufacturers’ websites, can run 15-20 tests a day and deliver results within 15 minutes. They are commonly used in doctor’s offices to diagnose strep throat or flu. The tests are antigen tests that detect the presence of viral proteins in a biological sample, as opposed to the traditional PCR or molecular test. HSS Assistant Secretary Admiral Girior, MD, explained that these tests are slightly less sensitive than the PCR. The antigen test is generally 80-90% accurate while the PCR is generally 95-98% accurate, meaning the chance of a false negative is higher with the antigen test.

Both Administrator Verma and Admiral Girior said that if you have to wait over 48 hours for a lab test, the PCR’s sensitivity degrades, so it may not be helpful in controlling spread.  Admiral Giror also said that if you get a positive result with the antigen test, you can “bet the farm on it,” and a suspicious negative may warrant a follow-up lab test, such as a negative on a person in a high-risk environment.

The SNFs that will receive the devices are hotspots like Florida, Texas, and Arizona, and CMS will use NHSN data to look prioritize facilities in those areas that have three or more cases and low hospital capacity. CMS will work to deliver devices to all nursing homes within 2-3 months. Upon delivery, the SNF will received approximately start-up 400 test kits. After that, the will cost approximately $25 each.

DHCFA is working to find out where Delaware lies on the priority list.