A letter from Virginia State Health Commissioner Dr. M. Norman Oliver issued on September 9 reiterates numerous actions long term care facilities (LTCFs) should be taking to keep residents and staff healthy. Reminders included in the letter address the National Healthcare Safety Network (NHSN) reporting, CMS testing requirements, CDC antigen testing guidance, reporting results from point-of-care testing, recommendations for hospitalized patients discharged to LTCFs, CARES Act funding, vaccinations, and training resources.

Highlights from the letter include:

• NHSN Reporting – Remember to confer rights to VDH to your NHSN data.

• CMS Testing Requirements – The letter includes a summary of the testing requirements and related links.

• CDC Antigen Testing Guidance for Nursing Homes – CDC has posted a summary of considerations for the use of antigen testing in nursing homes and an algorithm for interpreting antigen testing results.

• Reporting Results from Point-of-Care (POC) Testing – Facilities using POC diagnostic equipment under a CLIA certificate of waiver must report all SARS-CoV-2 test results for each individual tested via NHSN and to the state or local health department. VDH is developing a reporting portal for POC testing results. In the interim, all positive results from POC tests should be reported to the VDH Online Morbidity Reporting Portal within 24 hours. Negative POC results should be added to a line list and faxed to the local health department and also reported within 24 hours. Once the new reporting portal is available, a statewide announcement will be made

• Recommendations for Hospitalized Patients Discharged to LTCFs – VDH recently published a simplified flow chart to inform discharge planning between hospitals and LTCFs. The resource is meant to guide discussions between facilities and ensure compliance with CDC guidance on use of transmission-based precautions for COVID-19 positive patients, and quarantine for patients potentially exposed to COVID-19.

• CARES Act Funding for LTCFs – The letter references the guidance issued by DMAS for how facilities can obtain COVID-19-related cost reimbursement using CARES Act funding

• Vaccination of Residents and Staff in LTCFs – The letter emphasizes the importance of widespread flu vaccination for residents and staff. The Virginia Immunization Information System (VIIS) is also explained. LTCFs should enroll in VIIS.

• Training Resources for LTCF Staff – Please visit the Virginia Long-Term Care Task Force website for infection control courses and other materials.

LTCFs can also reference the Virginia Long-Term Care Task Force website for current guidance.