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COVID-19 Test Result Turnaround Time for Residents and Staff in US Nursing Homes

Educational Objective
To identify the key insights or developments described in this article

1 Credit CME

JAMA Internal Medicine

Published Online: October 30, 2020

Research Letter

Article Information and Disclosures

Brian E. McGarry, PT, PhD¹;

Gillian K. SteelFisher, PhD²;

David C. Grabowski, PhD³;

Michael L. Barnett, MD, MS^2,4

Author Affiliations

¹Division of Geriatrics and Aging, Department of Medicine, University of Rochester in Rochester, New York
²Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
³Department of Health Care Policy, Harvard Medical School, Boston, Massachusetts
⁴Division of General Internal Medicine and Primary Care, Department of Medicine, Brigham and Women’s Hospital, Boston, Massachusetts

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Skilled nursing facility (SNF) residents comprise over 40% of coronavirus disease 2019 (COVID-19) deaths nationally.¹ Surveillance testing is critical for controlling asymptomatic and presymptomatic viral transmission in these high-risk settings.² For surveillance testing in SNFs to effectively guide infection control, results need to be obtained in less than 1 day.³ To facilitate such rapid testing,⁴ Medicare began distributing point-of-care severe acute respiratory syndrome coronavirus 2 antigen test instruments in July 2020, focused on SNFs in COVID-19 hot spot counties.⁵ Little is known about the adequacy of test result turnaround in SNFs.

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Article Information

Corresponding Author: Michael L. Barnett, MD, MS, Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, 677 Huntington Ave, Kresge 411, Boston, MA 02115 (mbarnett@hsph.harvard.edu).

Accepted for Publication: October 15, 2020.

Published Online: October 30, 2020. doi:10.1001/jamainternmed.2020.7330

Author Contributions: Drs McGarry and Barnett had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: McGarry, Barnett.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: McGarry, SteelFisher, Barnett.

Critical revision of the manuscript for important intellectual content: McGarry, SteelFisher, Grabowski.

Statistical analysis: McGarry, Barnett.

Obtained funding: Barnett.

Supervision: Barnett.

Funding/Support: This project was supported by the National Institute on Aging of the National Institutes of Health (K23 AG058806-01).

Role of the Funder/Sponsor: The National Institute on Aging had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The content of this manuscript is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Aging or the National Institutes of Health.

References

Kaiser Family Foundation. State Data and Policy Actions to Address Coronavirus. KFF. 2020. Accessed September 15, 2020. https://www.kff.org/coronavirus-covid-19/issue-brief/state-data-and-policy-actions-to-address-coronavirus/)

Coronavirus Commission on Safety and Quality in Nursing Homes: Commission Final Report. 2020. Accessed October 23, 2020. https://edit.cms.gov/files/document/covid-final-nh-commission-report.pdf)

Larremore DB , Wilder B , Lester E , et al Test sensitivity is secondary to frequency and turnaround time for COVID-19 surveillance. medRxiv 2020 .Accessed September 15, 2020. http://medrxiv.org/lookup/doi/10.1101/2020.06.22.20136309)

Interim Final Rule (IFC), CMS-3401-IFC, Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency related to Long-Term Care (LTC) Facility Testing Requirements and Revised COVID-19 Focused Survey Tool | CMS. Accessed September 15, 2020. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/interim-final-rule-ifc-cms-3401-ifc-additional-policy-and-regulatory-revisions-response-covid-19)

Nursing Home Data - Point of Care Device Allocation | Data.CMS.gov. Accessed September 17, 2020. https://data.cms.gov/Special-Programs-Initiatives-COVID-19-Nursing-Home/Nursing-Home-Data-Point-of-Care-Device-Allocation/jbvf-tb74)

Nursing homes fret over Trump’s testing mandate - POLITICO. Accessed September 17, 2020. https://www.politico.com/news/2020/09/08/nursing-homes-coronavirus-testing-mandate-410229)

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.